Abstract / Summary
Aim and background: Docetaxel is a taxane-based chemotherapeutic agent widely used in the management of breast cancer, non-small cell lung cancer, gastric cancer, prostate cancer, and head and neck malignancies.Although generally well tolerated, rare but serious adverse events such as docetaxel-induced interstitial lung disease (ILD) have been reported.This complication carries a high risk of morbidity and mortality.Most cases described in the literature demonstrate clinical improvement following prompt discontinuation of the drug and initiation of systemic corticosteroids.We report a case of severe docetaxel-induced ILD with a refractory clinical course.Methods/case description: A patient receiving docetaxel-based chemotherapy developed progressive dyspnea and hypoxemia following drug administration.Comprehensive clinical evaluation, high-resolution computed tomography (HRCT) of the chest, and extensive microbiological investigations were performed to exclude infectious, cardiac, and alternative pulmonary etiologies.Based on the temporal relationship with chemotherapy, characteristic radiological findings, and exclusion of other causes, a diagnosis of docetaxel-induced ILD was established.Docetaxel was immediately discontinued, and the patient was treated with high-dose systemic corticosteroids along with additional immunomodulatory agents.Results: Despite early recognition and aggressive immunosuppressive therapy, the patient failed to demonstrate significant clinical or radiological improvement.Respiratory status progressively worsened, culminating in severe respiratory failure.This lack of response suggested a refractory form of docetaxel-induced ILD, in contrast to previously reported cases that showed favorable outcomes with corticosteroid therapy alone.Conclusion: Docetaxel-induced ILD, though uncommon, may follow a rapidly progressive (RP) and treatment-refractory course.Reliance on corticosteroid therapy alone may be inadequate in selected patients.Clinical significance: This case highlights the importance of heightened vigilance for pulmonary toxicity during taxane therapy.Early identification of non-responders and timely escalation of treatment are crucial.Consideration of upfront combination immunosuppressive strategies, including triple immunosuppression, may be warranted in future cases of refractory pulmonary ILD to improve outcomes.