{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:58:39Z","timestamp":1777931919676,"version":"3.51.4"},"reference-count":17,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,8,19]]},"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:p>Ado-trastuzumab emtansine (T-DM1) is a monoclonal antibody drug conjugate approved for the treatment of HER2-positive breast cancers. Presented here is a case report of a patient who developed fatal pulmonary toxicity in the form of acute eosinophilic pneumonia while undergoing treatment with T-DM1. Prior to beginning T-DM1 therapy, this patient had been treated with two HER2-targeted agents (trastuzumab, pertuzumab) per National Comprehensive Cancer Network (NCCN) guidelines. This case represents a novel presentation of toxicity associated with T-DM1 while perhaps demonstrating additive toxicity associated with multiple lines of HER2 targeted therapies.<\/jats:p>","DOI":"10.1136\/bcr-2021-243881","type":"journal-article","created":{"date-parts":[[2021,9,3]],"date-time":"2021-09-03T12:14:19Z","timestamp":1630671259000},"page":"e243881","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Acute eosinophilic pneumonia: a fatal reaction to ado-trastuzumab"],"prefix":"10.1136","volume":"14","author":[{"given":"Daniel","family":"LaMorte","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland, USA"},{"name":"Department of Internal Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Desmond","sequence":"additional","affiliation":[{"name":"Department of Oncology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Ellis","sequence":"additional","affiliation":[{"name":"Department of Pulmonology and Critical Care, Walter Reed National Military Medical Center, Bethesda, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stanley","family":"Lipkowitz","sequence":"additional","affiliation":[{"name":"Women's Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,9,3]]},"reference":[{"key":"2025082708521253000_14.9.e243881.1","unstructured":"Genentech, Inc . 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Kadcyla (Ado-Trastuzumab emtansine) [package insert]. San Francisco (CA), 2013."},{"key":"2025082708521253000_14.9.e243881.10","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1159\/000491574","article-title":"Ado-trastuzumab emtansine-induced pulmonary toxicity: a single-institution retrospective review","volume":"11","author":"Egloff","year":"2018","journal-title":"Case Rep Oncol"},{"key":"2025082708521253000_14.9.e243881.11","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-020-05754-8"},{"key":"2025082708521253000_14.9.e243881.12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1914510"},{"key":"2025082708521253000_14.9.e243881.13","unstructured":"Genentech . Perjeta (Pertuzumab) [package insert]. San Francisco (CA), 2012."},{"key":"2025082708521253000_14.9.e243881.14","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(13)70130-X"},{"key":"2025082708521253000_14.9.e243881.15","doi-asserted-by":"crossref","DOI":"10.1186\/s12885-019-6132-0","article-title":"Efficacy and safety of HER2 inhibitors in combination with or without pertuzumab for HER2-positive breast cancer: a systematic review and meta-analysis","volume":"19","author":"Chen","year":"2019","journal-title":"BMC Cancer"},{"key":"2025082708521253000_14.9.e243881.16","doi-asserted-by":"crossref","first-page":"2415","DOI":"10.1016\/S0140-6736(16)32417-5","article-title":"Her2-Positive breast cancer","volume":"389","author":"Loibl","year":"2017","journal-title":"The Lancet"},{"key":"2025082708521253000_14.9.e243881.17","doi-asserted-by":"publisher","DOI":"10.1126\/science.3798106"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-243881","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:52:17Z","timestamp":1756309937000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-243881"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9]]},"references-count":17,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,9,3]]},"published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1136\/bcr-2021-243881"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-243881","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9]]}}}