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Respiratory medicine
Rapidly progressive pneumonitis days after receiving tisotumab vedotin: a new antibody–drug conjugate
  1. Marcos E Valentin1,
  2. Qassem Abdelal2,
  3. Samantha Isern2 and
  4. Tracy Ashby3
  1. 1Pulmonary, University of Florida College of Medicine—Jacksonville, Jacksonville, Florida, USA
  2. 2University of Florida Health, Gainesville, Florida, USA
  3. 3Pulmonary and Critical Care, University of Florida Health at Jacksonville, Jacksonville, Florida, USA
  1. Correspondence to Dr Marcos E Valentin; marcos.valentinrentas{at}jax.ufl.edu

Abstract

The emergence of antibody–drug conjugates (ADCs) shows promise for treating a variety of tumours by using target-specific monoclonal antibodies to deliver cytotoxic substances directly to cancer cells. Their clinical development, however, is often hindered by significant toxicities. We report a case of a woman in her late 50s who developed grade 4 pneumonitis after receiving tisotumab vedotin (TV) for recurrent, metastatic squamous cell carcinoma of the cervix. 5 days post infusion, the patient exhibited severe respiratory distress, marked by hypoxaemia and diffuse ground-glass opacities on imaging. After careful ruling out of infection and alveolar haemorrhage via bronchoscopy, a presumptive diagnosis of drug-induced pneumonitis was established given the temporal relationship to receiving TV. The patient was treated with high-dose intravenous steroids and immunoglobulin, leading to eventual recovery. This case exhibits the potential for severe pulmonary toxicity associated with TV and highlights the need for greater awareness and investigation of adverse effects related to ADCs.

  • Drugs and medicines
  • Drugs: respiratory system

https://doi.org/10.1136/bcr-2024-264150

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: MEV is the guarantor and main author responsible for conceptualising and analysing the current data as it pertains to the case presented. QA was responsible for the clinical management of the patient and collection of data and imaging studies. SI was responsible for reviewing pertinent literature and drafting of the manuscript. TA conducted a final review and analysis of the manuscript to ensure its quality. The following authors gave final approval of the manuscript: MEV, QA, SI and TA.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.