A patient with rectal cancer and liver metastasis who developed interstitial pneumonia after regorafenib administration

Abstract

We report a patient with liver metastasis from rectal cancer who developed interstitial pneumonia during regorafenib administration. The patient described herein was a 69-year-old female. In January 2011, she underwent low-position anterior resection of rectal cancer at another hospital. In May 2013, right iliac metastasis was detected and she was referred to our hospital. Radiotherapy (30 Gy) was performed to treat bone metastasis and pain was relieved. Ursodeoxycholic acid (300 mg/day) and a glycyrrhizic acid/glycine/l-cysteine injection (20 mL/day) were subsequently administered. In July 2013, the administration of regorafenib (160 mg/day) was initiated and computed tomography (CT) was performed every week. CT revealed the appearance of diffuse ground-glass opacities in the bilateral lungs 13 days after starting the administration of regorafenib. Steroid pulse therapy was started following a tentative diagnosis of regorafenib-related interstitial pneumonia, which resulted in the amelioration of the ground-glass opacities. Although there has been no case report on interstitial pneumonia in a clinical study prior to approval, interstitial pneumonia developed during the administration of regorafenib in the present case. As steroid therapy improved the patient’s condition and CT findings, the patient was diagnosed with regorafenib-related interstitial pneumonia. Prompt management, such as steroid therapy, may be important when interstitial pulmonary disorders are detected during the administration of regorafenib.