Pulmonary Toxicity of Therapy

The pulmonary toxicity induced by novel antineoplastic agents has not been well characterized because of the simultaneous or sequential use of drugs and of a multimodality therapeutic approach. Diagnosis is based on exclusion of other factors that can cause respiratory failure in cancer patients including pneumonia, cardiogenic pulmonary edema, diffuse alveolar hemorrhage, and lymphangitic carcinomatosis. These conditions are not easily differentiated based on clinical presentation and radiographic findings, not even on lung biopsy specimens. Nonspecific interstitial pneumonitis, bronchiolitis obliterans with organizing pneumonia, eosinophilic pneumonia, pulmonary fibrosis, and diffused alveolar damage are the most common pathological patterns, but they are nonspecific for anticancer therapy-induced pulmonary toxicity. Clinicians should be aware of potential pulmonary toxicity as a complication in the treatment of cancer and focus on its early detection or prediction.