The Prognosis of Small Cell Lung Cancer in Patients with Pulmonary Fibrosis

Matsumoto, Yōko; Ōhara, S.; Furukawa, Ryutaro; Usui, Kazuhiro

doi:10.21873/anticanres.12021

Cited by 3 publications

(3 citation statements)

References 15 publications

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“…The annual incidence of AE-ILD in patients with GPS 2 was 50.0% (three patients), which was higher than that reported ILD associated with SCLC who received cytotoxic chemotherapy (11.9%-36.4%). [22][23][24][25] However, the frequency of AE-ILD within the first year of chemotherapy of 9.5% (two patients) in the GPS 0 subgroup was lower than that previously reported. Based on these results, we propose that using GPS to monitor patients could lead to mitigation of chemotherapy-triggered AE-ILD risk.…”

Section: Discussioncontrasting

confidence: 73%

“…Given the difficulty of conducting prospective studies in this area, our study remains important despite its retrospective nature and small sample size. Furthermore, previous studies had sample sizes ranging from 17 to 59 patients, 22,[24][25][26][27]43 and many were as large as our study. Even with such a small sample size, our study identified GPS as a significant marker for predicting the occurrence of AE-ILD and the prognosis of patients with SCLC and ILD.…”

Section: Discussionmentioning

confidence: 99%

“…5,18 Studies exclusively conducted in patients with small cell lung cancer (SCLC) have reported incidence rates of chemotherapy-triggered acute exacerbation (AE)-ILD ranging from 11.9% to 36.4%. [22][23][24][25] These results indicate that lung cancer and ILD occur concomitantly with each other, and it is important to evaluate not only lung cancer but also ILD itself during chemotherapy. However, in most clinical trials, the presence of concomitant ILD is an exclusion criterion for patient enrollment because fatal exacerbation of ILD is problematic.…”

Section: Introductionmentioning

confidence: 91%

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Glasgow prognostic score for prediction of chemotherapy‐triggered acute exacerbation interstitial lung disease in patients with small cell lung cancer

et al. 2021

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Background: Predicting the incidence of chemotherapy-triggered acute exacerbation of interstitial lung disease (AE-ILD) in patients with lung cancer is important because AE-ILD confers a poor prognosis. The Glasgow prognostic score (GPS), which is an inflammation-based index composed of serum levels of C-reactive protein and albumin, predicts prognosis in patients with small cell lung cancer (SCLC) without ILD. In this study, we investigated AE-ILD and survival outcome based on the GPS in patients with ILD associated with SCLC who were receiving chemotherapy. Methods: Medical records of patients who received platinum-based first-line chemotherapy between June 2010 and May 2019 were retrospectively reviewed to compare the incidence of AE-ILD and overall survival (OS) between GPS 0, 1, and 2. Results: Among our cohort of 31 patients, six (19.3%) experienced chemotherapytriggered AE-ILD. The AE-ILD incidence increased from 9.5% to 25.0% and 50.0% with increase in GPS of 0, 1, and 2, respectively. Univariate and multivariate analyses revealed remarkable associations between GPS 2 and both AE-ILD (odds ratio for GPS 2, 18.69; p = 0.046) and prognosis (hazard ratio of GPS 2, 13.52; p = 0.002). Furthermore, median OS in the GPS 0, 1, and 2 groups was 16.2, 9.8, and 7.1 months, respectively (p < 0.001). Conclusions: Our results suggest that GPS 2 is both a predictor of risk of chemotherapy-triggered AE-ILD and a prognostic indicator in patients with ILD associated with SCLC. We propose that GPS may be used as a guide to distinguish chemotherapy-tolerant patients from those at high risk of AE-ILD.

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Section: Discussioncontrasting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 91%

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Glasgow prognostic score for prediction of chemotherapy‐triggered acute exacerbation interstitial lung disease in patients with small cell lung cancer

et al. 2021

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Carboplatin plus nab‐paclitaxel for recurrent small cell lung cancer: A phase II study

et al. 2022

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Background We conducted a phase II study of carboplatin plus nab‐paclitaxel for the treatment of small cell lung cancer (SCLC) after the failure of a prior standard chemotherapy containing platinum, etoposide, irinotecan, and amrubicin if indicated. Patients with interstitial pneumonia complications were included in the study. Methods Patients received 100 mg/m2 of nab‐paclitaxel weekly (on days 1, 8, and 15) and an AUC 5 of carboplatin on day 1. The study treatment was repeated every 3 weeks until disease progression or the appearance of unacceptable toxicities. The primary endpoint was the objective response rate. Results A total of 21 patients were enrolled, all of whom were eligible for inclusion in the analysis. Twelve patients had pre‐existing interstitial pneumonia. The overall response rate was 19.0% (90% confidence interval [CI]: 6.8%–38.4%). The lower limit of the 90% CI for the response rate did not exceed the prespecified threshold value of 10%. Among the 12 patients with pre‐existing interstitial pneumonia, the response rate was 25%. The median progression‐free survival time was 2.5 months (95% CI: 1.5–3.4 months), and the median survival time was 5.1 months (95% CI: 2.1–8.1 months). Two patients developed interstitial lung disease; both of these patients had pre‐existing interstitial pneumonia. One of the patients died from interstitial lung disease. Conclusion Combination chemotherapy with carboplatin plus nab‐paclitaxel for recurrent SCLC had a modest activity, although the primary study endpoint was not met. Further investigation of this regimen for patients with recurrent SCLC and interstitial pneumonia is warranted.

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Prognosis of Small Cell Lung Cancer with Idiopathic Pulmonary Fibrosis: Assessment according to GAP Stage

Song

Lim

Yoon

et al. 2019

Journal of Oncology

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Introduction. Idiopathic pulmonary fibrosis (IPF) is an independent risk factor for lung cancer development, and small cell lung cancer (SCLC) comprises 15-20% of lung cancers with IPF. The objective of this study was to investigate survival outcomes and treatment-related complications according to GAP (gender, age, and physiology) stage in patients having SCLC with IPF (SCLC-IPF). Materials and Methods. Retrospectively collected data of SCLC-IPF patients from two tertiary care university hospitals in South Korea were reviewed. A total of 59 SCLC-IPF patients were identified and categorized according to GAP stage, which was proposed by Ley et al. in 2012 to predict the prognosis of IPF. Survival outcomes and treatment-related complications were compared between the two groups. Results. In a total of 59 patients, the median age was 71 years and 58 (98.3%) were male. In a comparison of the median overall survival (OS) according to GAP stage, median OS of the advanced GAP stage group was significantly shorter than median OS of GAP stage I group (7.1 months vs. 16.1 months; p = 0.002). Treatment-related complications occurred more frequently in the advanced GAP stage group; advanced GAP stage was the only predictor that exhibited a significant association with the incidence of acute exacerbation of IPF. Conclusions. Inferior survival outcome and higher incidence of treatment-related pulmonary toxicities were noted in the advanced GAP stage group. Furthermore, advanced GAP stage was the only predictor of treatment-related acute exacerbation of IPF. Physicians should thus consider GAP stage, which reflects the severity of IPF, during treatment of SCLC-IPF.

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The Prognosis of Small Cell Lung Cancer in Patients with Pulmonary Fibrosis

Cited by 3 publications

References 15 publications

Glasgow prognostic score for prediction of chemotherapy‐triggered acute exacerbation interstitial lung disease in patients with small cell lung cancer

Glasgow prognostic score for prediction of chemotherapy‐triggered acute exacerbation interstitial lung disease in patients with small cell lung cancer

Carboplatin plus nab‐paclitaxel for recurrent small cell lung cancer: A phase II study

Prognosis of Small Cell Lung Cancer with Idiopathic Pulmonary Fibrosis: Assessment according to GAP Stage

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