The Efficacy and Safety of Chemotherapy in Patients With Nonsmall Cell Lung Cancer and Interstitial Lung Disease

Abstract

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Modified GAP index for prediction of acute exacerbation of idiopathic pulmonary fibrosis in non‐small cell lung cancer

“…Assessment of the clinical course of IPF has revealed that the incidence rate of AE was 5–15% per year . In addition, the incidence rate of IPF‐AE and mortality is increased in patients with NSCLC and ILD because of chemotherapy treatment . Importantly, in the present study, we found that the incidence rate of IPF‐AE among patients with NSCLC and mGAP stage I IPF, who were treated with a platinum‐doublet as first‐line chemotherapy was similar to that in patients with a general IPF without NSCLC .…”

“…19,20 In addition, the incidence rate of IPF-AE and mortality is increased in patients with NSCLC and ILD because of chemotherapy treatment. [1][2][3][4][5][6][7] Importantly, in the present study, we found that the incidence rate of IPF-AE among patients with NSCLC and mGAP stage I IPF, who were treated with a platinum-doublet as first-line chemotherapy was similar to that in patients with a general IPF without NSCLC. 19,20 However, the incidence rate of IPF-AE in patients with NSCLC and mGAP stage II IPF was higher.…”

“…Several studies found that the incidence rate of acute exacerbation (AE) of ILD ranged between 5% and 35% in patients with NSCLC and ILD undergoing chemotherapy. [1][2][3][4][5][6][7][8] We recently reported that mortality after AE in these patients was 20%. 5 It has been previously reported that the incidence rate and severity of AE in ILD were significantly higher in patients with lung cancer with a usual interstitial pneumonia (UIP) pattern on computed tomography (CT) than in those with a non-UIP pattern, 8,9 and 'inconsistent with UIP' patterns on HRCT scanning, which may not be a risk factor for AE in patients with NSCLC and ILD.…”

“…Briefly, the following criteria were used to obtain a total score ranging between 0 and 5: gender (female, 0; male, 1), age (years) (≤60, 0; 61-65, 1; >65, 2) and %FVC (>75%, 0; 50-75%, 1; <50%, 2). Similar to the GAP index, patients were categorized into two groups based on the mGAP index scores for IPF: stage I (0-3) and stage II (4)(5). In addition, we compared the 1-year survival rate, overall survival (OS) and incidence of IPF-AE between the two mGAP stages.…”

“…Although chemotherapy is often used for patients with NSCLC and ILD, evidence for improved prognosis with chemotherapy is lacking. Several studies found that the incidence rate of acute exacerbation (AE) of ILD ranged between 5% and 35% in patients with NSCLC and ILD undergoing chemotherapy . We recently reported that mortality after AE in these patients was 20% .…”