J Dig Cancer Res.  2024 Dec;12(3):224-228. 10.52927/jdcr.2024.12.3.224.

Diagnosis and Treatment of Imatinib-induced Pneumonitis in a Patient with High-risk Rectal Gastrointestinal Stromal Tumor

• Kim SJ
• Lee J

• KMID: 2563747
• DOI: http://doi.org/10.52927/jdcr.2024.12.3.224

Abstract

Imatinib is a well-established targeted therapeutic agent for gastrointestinal stromal tumors (GISTs), acting as a key tyrosine kinase inhibitor. Despite its clinical efficacy, imatinib is associated with a variety of side effects, ranging from minor issues like diarrhea and fatigue to serious complications such as hepatotoxicity, cardiotoxicity, and hematologic abnormalities that necessitate discontinuation. Notably, imatinib-induced pneumonitis, though rare, can be fatal, necessitating early detection and intervention. This side effect usually manifests as severe dyspnea, fever, and cough shortly after the start of therapy. The diagnosis requires the exclusion of other causes of pneumonia, such as infections, and is supported by imaging that reveals interstitial infiltrates in both lungs. Imatinib should be discontinued immediately, and corticosteroid therapy should be initiated. If treatment with imatinib is deemed necessary following recovery, a lower dose may be considered, but there is a high risk of recurrence. In such cases, sunitinib may be considered as an alternative treatment option. We present a case of imatinib-induced pneumonitis in a 68-year-old male patient who underwent adjuvant imatinib therapy following endoscopic resection of a high-risk rectal GIST. The purpose of this report is to review the clinical features, diagnosis, and treatment of imatinib-induced pneumonitis using a literature review.

Keyword

Imatinib mesylate; Gastrointestinal stromal tumors; Pneumonitis