Management of mammalian target of rapamycin inhibitor–associated noninfectious pneumonitis in advanced breast cancer: A nursing perspective

Abstract

The identification of the disease progression and drug resistance pathways involved in breast cancer led to the development of mammalian target of rapamycin (mTOR) inhibitors. Since their introduction, mTOR inhibitors have improved clinical outcomes in patients with advanced breast cancer. These agents are generally well tolerated, but they have a unique adverse event (AE) profile of which clinicians and nurses should be aware. Although rare, noninfectious pneumonitis (NIP) is one such mTOR-associated AE that is generally mild and manageable, but it can result in severe or potentially life-threatening toxicity. Previous clinical experience with everolimus and temsirolimus in renal cell carcinoma has led to the development of guidelines for the diagnosis and management of mTOR-associated AEs, including NIP. However, specific guidelines in the advanced breast cancer setting are currently lacking. Herein we review the available literature regarding the development of mTOR-associated NIP in patients with advanced breast cancer. In addition, we have developed a set of guidelines that will provide nurses with appropriate management strategies for the treatment of mTOR inhibitor–associated NIP in patients with advanced breast cancer.