Pulmonary toxicity during prostate cancer treatment with docetaxel and thalidomide

The standard therapies of surgery, radiotherapy, and hormonal manipulations often fail to control metastatic prostate cancer (PC). Docetaxel and thalidomide may have activity in refractory PC. We highlight the potential pulmonary toxicity when docetaxel is combined with thalidomide. We reviewed three examples of docetaxel and thalidomide pulmonary toxicity at the National Cancer Institute (NCI) and summarized the published literature regarding docetaxel and thalidomide pulmonary toxicity. Docetaxel and thalidomide pulmonary toxicity has the following four main presentations: (1). symptomatic effusions; (2). dyspnea on exertion without any objective pathologic evidence; (3). interstitial lung disease; and (4). pulmonary embolus. As chemotherapy becomes more common in the treatment of PC, clinicians must consider possible pulmonary toxicities. If pulmonary symptoms or signs develop, clinicians should consider holding chemotherapy pending a complete evaluation.