Supportive Care in Cancer

, Volume 13, Issue 1, pp 70–72

Prompt control of bronchorrhea in patients with bronchioloalveolar carcinoma treated with gefitinib (Iressa)

  • Daniel T. Milton
  • Mark G. Kris
  • Jorge E. Gomez
  • Marc B. Feinstein
Short Communication

Abstract

Bronchorrhea is a condition in which voluminous sputum is produced daily, typically seen with bronchioloalveolar cell carcinoma (BAC). Unless the underlying cancer can be controlled, bronchorrhea causes substantial symptomatic distress. We report two cases of bronchorrhea associated with advanced BAC successfully treated with the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, gefitinib. Prompt resolution of these patients’ bronchorrhea, dyspnea, and supplemental oxygen requirements are detailed. Given the limited success of alternative interventions, a trial of gefitinib should be considered for patients with bronchorrhea secondary to BAC.

Keywords

BAC Bronchorrhea EGFR Gefitinib 

References

  1. 1.
    Chang GC, Yang TY, Wang NS, Huang CM, Chiang CD (2003) Successful treatment of multifocal bronchioloalveolar cell carcinoma with ZD1839 (Iressa) in two patients. J Formos Med Assoc 102:407–411PubMedGoogle Scholar
  2. 2.
    Ebright MI, Zakowski MF, Martin J, Venkatraman ES, Miller VA, Bains MS, Downey RJ, Korst RJ, Kris MG, Rusch VW (2002) Clinical pattern and pathological stage but not histological features predict outcomes for bronchioloalveolar carcinoma (BAC). Ann Thorac Surg 74:1640–1646CrossRefPubMedGoogle Scholar
  3. 3.
    Homma S, Kawabata M, Kishi K, Tsuboi E, Narui K, Nakatani T, Nakata K (1999) Successful treatment of refractory bronchorrhea by inhaled indomethacin in two patients with bronchioloalveolar carcinoma. Chest 115:1465–1468CrossRefPubMedGoogle Scholar
  4. 4.
    Kris MG, Natale RB, Herbst RS, Lynch TJ Jr, Prager D, Belani CP, Schiller JH, Kelly K, Spiridonidis H, Sandler A, Albain KS, Cella D, Wolf MK, Averbuch SD, Ochs JJ, Kay AC (2003) Efficacy of gefitinib, an inhibitor of the epidermal growth factor receptor tyrosine kinase, in symptomatic patients with non-small cell lung cancer. JAMA 290:2149–2158CrossRefPubMedGoogle Scholar
  5. 5.
    Lopez-Vidriero M, Charman J, Keal E, Reid L (1975) Bronchorrhea. Thorax 30:624–630PubMedGoogle Scholar
  6. 6.
    Lynch TJ, Bell DW, Sordella R, Gurubhagavatula S, Okimoto RA, Brannigan BW, Harris PL, Haserlat SM, Supko JG, Haluska FG, Louis DN, Christiani DC, Settleman J, Haber DA (2004) Activating mutations in the epidermal growth factor receptor underlying responsiveness of non-small-cell lung cancer to gefitinib. N Engl J Med 350: 2129–2139CrossRefPubMedGoogle Scholar
  7. 7.
    Miller VA, Kris MG, Shah N, Patel J, Azzoli CG, Gomez J, Krug LM, Pao W, Rizvi NA, Pizzo B, Tyson L, Venkatraman ES, Ben-Porat L, Memoli N, Zakowski MF, Rusch VM, Heelan R (2004) Bronchioloalveolar pathologic subtype and smoking history predict sensitivity to gefitinib in advanced non-small cell lung cancer. J Clin Oncol 22:1103–1109CrossRefPubMedGoogle Scholar
  8. 8.
    Nadel JA (2001) Role of epidermal growth factor receptor activation in regulating mucin synthesis. Respir Res 2:85–89CrossRefPubMedGoogle Scholar
  9. 9.
    Paez JG, Janne PA, Lee JC, Tracy S, Greulich H, Gabriel S, Herman P, Kaye FJ, Lindeman N, Boggon TJ, Naoki K, Sasaki H, Fujii Y, Eck MJ, Sellers WR, Johnson BE, Meyerson M (2004) EGFR mutations in lung cancer: correlation with clinical response to gefitinib therapy. Science 304:1497–1500CrossRefPubMedGoogle Scholar
  10. 10.
    Suga T, Sugiyama Y, Fujii T, Kitamura S (1994) Bronchioloalveolar carcinoma with bronchorrhea treated with erythromycin. Eur Respir J 7:2249–2251CrossRefPubMedGoogle Scholar
  11. 11.
    Takao M, Inoue K, Watanabe F, Onoda K, Shimono T, Shimpo H, Yada I (2003) Successful treatment of persistent bronchorrhea by gefitinib in a case with recurrent bronchioloalveolar carcinoma: a case report. World J Surg Oncol 1:8–11CrossRefPubMedGoogle Scholar
  12. 12.
    Yano S, Kanematsu T, Miki T, Aono Y, Azuma M, Yamamoto A, Uehara H, Sone S (2003) A report of two bronchioloalveolar carcinoma cases which were rapidly improved by treatment with the epidermal growth factor receptor tyrosine kinase inhibitor ZD1839 (“Iressa”). Cancer Sci 94:453–458PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Daniel T. Milton
    • 1
    • 3
  • Mark G. Kris
    • 1
  • Jorge E. Gomez
    • 1
  • Marc B. Feinstein
    • 2
  1. 1.Division of Thoracic Oncology, Department of MedicineMemorial Sloan-Kettering Cancer Center and the Weil Medical College of Cornell UniversityNew YorkUSA
  2. 2.Division of Pulmonary Medicine, Department of MedicineMemorial Sloan-Kettering Cancer Center and the Weil Medical College of Cornell UniversityNew YorkUSA
  3. 3.Memorial Sloan-Kettering Cancer CenterNew YorkUSA

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