Death from interstitial lung disease caused by apatinib mesylate tablets

A 53-year-old female patient with advanced lung cancer, who was negative for all types of driving genes, received apatinib mesylate tablets(apatinib) 500 mg/d orally after 2 cycles of ineffective chemotherapy of pemetrexed disodium plus cisplatin (21 days as 1 cycle). After 22 days of medication, apatinib was reduced to 250 mg/d because of the hand-foot skin reactions. After 7 months of treatment with apatinib, the pulmonary neoplasms shrank, but the patient developed shortness of breath. CT examination showed bilateral pulmonary interstitial fibrosis. Apatinib was discontinued and hormone therapy was given. The patient′s symptoms were progressively aggravated. On day 32 of drug discontinuation, CT scan showed that the pulmonary interstitial fibrosis was aggravated and the patient developed typeⅠrespiratory failure. An IV infusion of methylprednisolone 500 mg/d and oxygen inhalation were given. However, the patient′s condition was still deteriorating. On day 37 of drug discontinuation, the patient died. Key words: Protein kinase inhibitors; Apatinib; Adenocarcinoma of lung; Lung diseases, interstitial