Clinical characteristics of acute respiratory deterioration in pulmonary fibrosis associated with lung cancer following anti‐cancer therapy

Isobe, Kazutoshi; Hata, Yoshinobu; Sakamoto, Susumu; Takai, Yujiro; Shibuya, Kazutoshi; Homma, Sakae

doi:10.1111/j.1440-1843.2009.01666.x

Cited by 73 publications

(38 citation statements)

References 25 publications

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“…Further, pre-existing ILD was found to be a risk factor of pneumonitis. Similarly, previous studies reported that approximately 20% of patients with pre-existing ILD developed pneumonitis, and that pre-existing ILD is the most significant risk factor [3, 20–24]. Based on these findings, pneumonitis seems to be a relatively common event in patients with advanced NSCLC.…”

Section: Discussionmentioning

confidence: 57%

Characteristics and Prognostic Impact of Pneumonitis during Systemic Anti-Cancer Therapy in Patients with Advanced Non-Small-Cell Lung Cancer

et al. 2016

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BackgroundData on characteristics, outcomes, and prognosis of advanced non-small-cell lung cancer (NSCLC) patients who develop pneumonitis during systemic anti-cancer therapy (pneumonitis) are currently lacking.MethodsWe conducted a retrospective cohort study of 910 consecutive patients diagnosed with advanced NSCLC between January 2004 and January 2014. Of these, 140 patients were excluded because they did not receive systemic anti-cancer therapy at this hospital.ResultsA total of 770 patients were included in the study, of whom 44 (6%) were diagnosed with pneumonitis. The mortality rate of pneumonitis was 36%. The incidence of pneumonitis was independently associated with pre-existing ILD (adjusted odds ratio, 2.99, P = 0.008), and survivors were significantly associated with younger age (P = 0.003) and radiographic non-acute interstitial pneumonia pattern (P = 0.004). In all patients, pneumonitis was identified as an independent predictor of overall survival (OS) (adjusted hazard ratio 1.53, 95% CI, 1.09–2.09, P = 0.015). Performance status was poor in 82% of survivors of pneumonitis; in 62% of survivors, the PS worsened after the pneumonitis improved. Additionally, 54% of survivors received no further systemic anti-cancer therapy after pneumonitis. The median survival time of survivors after pneumonitis was 3.5 months (95% CI, 2.3–7.2 months).ConclusionsOur study indicated that 6% of patients with advanced NSCLC developed pneumonitis during systemic anti-cancer therapy. The early mortality rate of pneumonitis is high, and the survival and PS after pneumonitis is extremely poor. Additionally, pneumonitis has an adverse impact on the survival of patients with advanced NSCLC. These data should be considered for the management of pneumonitis, and we recommend that future work focuses on pneumonitis particularly to improve the survival of patients with advanced NSCLC.

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Section: Discussionmentioning

confidence: 57%

Characteristics and Prognostic Impact of Pneumonitis during Systemic Anti-Cancer Therapy in Patients with Advanced Non-Small-Cell Lung Cancer

et al. 2016

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“…Since available therapeutic options for AE are scarce and no established standard of care exists at present, this clinical condition is associated with an extremely poor prognosis [9][10][11]. In patients with lung cancer and preexisting IP, AE frequently occurs during anticancer treatments, including chemotherapy [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Second-line docetaxel for patients with platinum-refractory advanced non-small cell lung cancer and interstitial pneumonia

Watanabe

Niho

Kirita

et al. 2015

Cancer Chemother Pharmacol

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“…The median survival was 3.5 years for patients with an oncogenic driver and genotype-directed therapy, compared with 2.4 years for those with any oncogenic driver(s) who did not receive genotype-directed therapy. By contrast, patients with severe complications, such as ILD, are excluded from a number of clinical trials, as pre-existing ILD is a risk factor for the NSCLC therapy related to ILD (10,11).…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of carboplatin plus nab-paclitaxel for treating advanced non-small-cell lung cancer with interstitial lung disease

Niwa

Nakahara

Yokoba

et al. 2017

Molecular and Clinical Oncology

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Abstract. There are few established treatments for patients with non-small-cell lung cancer (NSCLC) with interstitial lung disease (ILD). The safety and efficacy of albumin-bound paclitaxel (nab-paclitaxel) in combination with carboplatin is uncertain, although the combination of carboplatin and paclitaxel is the most common regimen for treating NSCLC patients with ILD. A total of 9 NSCLC patients with ILD, treated between April 2013 and March 2016, were retrospectively investigated. Carboplatin (AUC 5-6) was administered on day 1 and nab-paclitaxel on days 1, 8 and 15, every 4-6 weeks. The median age of the patients upon initiating chemotherapy was 67 years. The pathological examination revealed 6 patients with squamous cell carcinoma, and 6 patients exhibited the typical pattern of ILD. The response rate was 55.6%, and the median progression-free and overall survival time was 174 and 344 days, respectively. Acute exacerbation of ILD was not observed in any of the patients, and febrile neutropenia developed in 3 patients (3/9, 33.3%). Thus, treatment with carboplatin plus nab-paclitaxel was found to be safe and effective for NSCLC patients with ILD, although management of hematological adverse events, such as febrile neutropenia, was required. However, these encouraging results require confirmation by a large-scale clinical trial.

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Clinical characteristics of acute respiratory deterioration in pulmonary fibrosis associated with lung cancer following anti‐cancer therapy

Abstract: Patients with lung cancer who have pre-existing PF should be carefully managed because of their high risk for developing acute respiratory deterioration after anti-cancer therapy.

Cited by 73 publications

References 25 publications

Characteristics and Prognostic Impact of Pneumonitis during Systemic Anti-Cancer Therapy in Patients with Advanced Non-Small-Cell Lung Cancer

Characteristics and Prognostic Impact of Pneumonitis during Systemic Anti-Cancer Therapy in Patients with Advanced Non-Small-Cell Lung Cancer

Second-line docetaxel for patients with platinum-refractory advanced non-small cell lung cancer and interstitial pneumonia

Safety and efficacy of carboplatin plus nab-paclitaxel for treating advanced non-small-cell lung cancer with interstitial lung disease

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