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An event is serious (based on the ICH definition) when the patient outcome is:
* death
* life-threatening
* hospitalisation
* disability
* congenital anomaly
* other medically important event
In a single-center study conducted in Japan involving five women, a 51-year-old woman was described, who developed pneumonia during treatment with paclitaxel for ovarian cancer.
The woman had stage IIIC serous carcinoma of her ovaries, which was complicated by deep vein thrombosis and diabetes mellitus. On pretreatment examination, deep venous thrombus and ascitic fluid retention were observed, which led to the initiation of neoadjuvant chemotherapy. She started receiving a tri-weekly regimen, comprising paclitaxel 180 mg/m2 [route not stated], carboplatin and bevacizumab. At the end of three cycles, CT demonstrated improvement in her underlying condition; however, the new appearance of ground-glass opacity, infiltrative shadows and a rounded morphology in her bilateral middle as well as lower lung fields were observed. The CT findings were suspicious of COVID-19, but real-time polymerase chain reaction (RT-PCR) results were negative.
The woman's chemotherapy was discontinued temporarily. After 2 weeks, a repeat CT showed infiltrative shadows with fibrosis in both inferior lung fields, which was compatible with the resolution of pneumonia. After another 2 weeks, a repeat CT was performed and the ground-glass opacity and fibrosis tended to dissipate. However, swelling of her retroperitoneal lymph nodes related to underlying cancer returned. After 2 weeks, repeat CT showed no change in the pneumonia. Her underlying ascites worsened. RT-PCR results were negative again. The possible causes of pneumonia were considered as COVID-19 and drug-induced pneumonia. She had COVID-19 which was not active. A priority of chemotherapy was considered due to the exacerbation of her primary disease. A possibility of drug [paclitaxel]-induced pneumonia was considered, and therefore, her drug therapy was switched from paclitaxel to doxorubicin liposomal, and the chemotherapy with carboplatin and bevacizumab was resumed.
Reference
- Nogami Y, et al. Impact of the COVID-19 epidemic at a high-volume facility in gynecological oncology in Tokyo, Japan: A single-center experience. Journal of Ovarian Research 13: No. 1, 11 Sep 2020. Available from: URL: 10.1186/s13048-020-00711-x [DOI] [PMC free article] [PubMed]