HER2 Support Group Forums - View Single Post - Tykerb Lung Breathing reaction

Poppy · 11-13-2013, 05:33 AM

My wife is HER2+ Stage 4 and has recently been changed from Herceptin (well controlled small lung and liver secondaries) to Tykerb (Lapatinib, Tyverb) and Xeloda (Capecetabine) standard 5 a day/21 day cycle following a brain met and Gamma Knife. Despite all this, her general health is very strong.

She was also on steroids (Dextramethasone 8 mg) to control the brain met pending treatment. 36 hrs after she finally came off the steroids she had a temperature of 102 F and increased breathing rate. No response to Amoxicillin and 72 hrs later blood oxygen saturation and blood pressure dropped through the floor. Xrays and CT scan showed extensive areas of inflammation but no obvious clot or tumour. Lapatinib stopped. Nightmare 48 hrs on 100% Oxygen under pressure and she turned the corner. It is an interstitial lung disease (an atypical Pneumonia), practically no fluid in the airspace.

Nearly a week on the fever has been gone for 3/4 days and she the lungs are recovering - still on Oxygen, but it improves daily so far. No one knows if this is an infection, drug reaction or if there is a cancer involvement, but interstitial Pneumonia is typical of a drug interaction, so my 'independent' advisor tells me.

Does anyone have experience or knowledge of Lapatinib/lung issues that might help? Some sources do say that Lapatinib patients should be monitored for interstitial lung disease (which is what she has) though officially it is a <1 in 1000 occurence. Reading your histories on this site, I have seen a number of cases where there has been a breathing reaction and dosage change, which doesn't square with 1 in 1000. Our Oncologist is fully aware of the issue but has not had this before.

Will put the history together soon, but meanwhile any information very welcome. She is bright and cheerful, eating and drinking well and getting bored now, thanks!

11-13-2013, 05:33 AM	#1
Poppy Junior Member Join Date: Nov 2013 Posts: 3	Tykerb Lung Breathing reaction - HELP My wife is HER2+ Stage 4 and has recently been changed from Herceptin (well controlled small lung and liver secondaries) to Tykerb (Lapatinib, Tyverb) and Xeloda (Capecetabine) standard 5 a day/21 day cycle following a brain met and Gamma Knife. Despite all this, her general health is very strong. She was also on steroids (Dextramethasone 8 mg) to control the brain met pending treatment. 36 hrs after she finally came off the steroids she had a temperature of 102 F and increased breathing rate. No response to Amoxicillin and 72 hrs later blood oxygen saturation and blood pressure dropped through the floor. Xrays and CT scan showed extensive areas of inflammation but no obvious clot or tumour. Lapatinib stopped. Nightmare 48 hrs on 100% Oxygen under pressure and she turned the corner. It is an interstitial lung disease (an atypical Pneumonia), practically no fluid in the airspace. Nearly a week on the fever has been gone for 3/4 days and she the lungs are recovering - still on Oxygen, but it improves daily so far. No one knows if this is an infection, drug reaction or if there is a cancer involvement, but interstitial Pneumonia is typical of a drug interaction, so my 'independent' advisor tells me. Does anyone have experience or knowledge of Lapatinib/lung issues that might help? Some sources do say that Lapatinib patients should be monitored for interstitial lung disease (which is what she has) though officially it is a <1 in 1000 occurence. Reading your histories on this site, I have seen a number of cases where there has been a breathing reaction and dosage change, which doesn't square with 1 in 1000. Our Oncologist is fully aware of the issue but has not had this before. Will put the history together soon, but meanwhile any information very welcome. She is bright and cheerful, eating and drinking well and getting bored now, thanks!