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Background <p>The weekly Paclitaxel-Trastuzumab (wPH) regimen is frequently employed in patients with HER2-positive breast cancer who also have small tumors. Interstitial lung disease induced by paclitaxel-trastuzumab is an exceedingly uncommon side effect, referred to as drug-induced interstitial lung disease (DIILD). Identifying the specific drug responsible for ILD can be challenging when the condition arises.</p> Case presentation <p>A 58-year-old female with HER2-positive breast cancer developed interstitial pneumonitis during weekly paclitaxel plus trastuzumab therapy. Nevertheless, after paclitaxel completion and a three-month hiatus, trastuzumab was successfully reintroduced as a single agent. The patient tolerated the full subsequent year of trastuzumab monotherapy, experiencing only a transient infusion reaction without recurrence of pneumonitis.</p> Conclusion <p>A systematic causality assessment using the Naranjo scale, complemented by a successful single-agent rechallenge, can identify the causative agent in multi-drug DIILD and allow for the safe continuation of essential targeted therapy.</p>

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Interstitial lung disease during paclitaxel trastuzumab therapy enables safe trastuzumab rechallenge: a case report and review of the literature

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月17日

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  • Zhaojun Wang,
  • Daoling Wang,
  • Jiangang Xu,
  • Zhiwei Li,
  • Xiaoqing Hu,
  • Qianye Yan

摘要

Background

The weekly Paclitaxel-Trastuzumab (wPH) regimen is frequently employed in patients with HER2-positive breast cancer who also have small tumors. Interstitial lung disease induced by paclitaxel-trastuzumab is an exceedingly uncommon side effect, referred to as drug-induced interstitial lung disease (DIILD). Identifying the specific drug responsible for ILD can be challenging when the condition arises.

Case presentation

A 58-year-old female with HER2-positive breast cancer developed interstitial pneumonitis during weekly paclitaxel plus trastuzumab therapy. Nevertheless, after paclitaxel completion and a three-month hiatus, trastuzumab was successfully reintroduced as a single agent. The patient tolerated the full subsequent year of trastuzumab monotherapy, experiencing only a transient infusion reaction without recurrence of pneumonitis.

Conclusion

A systematic causality assessment using the Naranjo scale, complemented by a successful single-agent rechallenge, can identify the causative agent in multi-drug DIILD and allow for the safe continuation of essential targeted therapy.