Anti-Angiogenic Drugs Inhibit Interstitial Lung Disease Progression in Patients With Advanced Non-Small Cell Lung Cancer

Abstract

BackgroundInterstitial lung disease (ILD) is the most serious complication of chemotherapy in lung cancer patients with pre-existing ILD. The effect of anti-angiogenic drugs in lung cancer patients with ILD remains unclear. We examined the effect of anti-angiogenic drugs on reducing the risk of ILD progression in non-small cell lung cancer (NSCLC) patients receiving chemotherapy.MethodsWe analyzed the risk of ILD progression in 52 patients with advanced NSCLC with ILD who received first-line chemotherapy with (anti-angiogenic group, n = 22) and without (non-anti-angiogenic group, n = 30) anti-angiogenic drugs between August 2014 and January 2021.ResultsThe incidences of chemotherapy-related ILD progression were significantly lower in the anti-angiogenic than in the non-anti-angiogenic groups (0% vs. 20.0%, p = 0.033). However, there were no differences in other events as the competing risk factors of ILD progression between the two groups. The overall-cumulative incidence of ILD progression during the first-line and subsequent chemotherapy was 30.8% (16 of the 52). The median progression-free survival had no significant difference between the anti-angiogenic and the non-anti-angiogenic groups (10.3 vs. 8.1 months, p = 0.386).ConclusionsThe addition of anti-angiogenic drugs to chemotherapy regimens may reduce the risk of chemotherapy-related ILD progression in patients with NSCLC-ILD.

Lung Cancer and Interstitial Lung Diseases

“…The anti-VEGF a antibody bevacizumab has been tested in patients with ILD and lung cancer and has been reported to prevent chemotherapy-induced AE-ILD [139,140].…”

Management of patients with idiopathic pulmonary fibrosis and lung cancer: challenges in clinical practice

“…Pemetrexed or gemcitabine combined with platinum agents might be a feasible option for some patients with IPF and lung cancer [108]. Overall, irrespective of regimen, postchemotherapy-acute exacerbations have been observed in 8–13% of patients with the percentage rising up to even 30% in the Asian population [2,84 ▪▪ ,88 ▪ ,95,96,106,109].…”

“…Interesting results were found following retrospective analysis of patients with fibrotic ILDs that received the monocloncal antibody against vascular endothelial growth factor-α (VEGF-α), bevacizumab. Combination of bevacizumab and chemotherapy regimens seemed to reduce the risk of chemotherapy-induced acute exacerbation-ILD in patients with ILD and lung cancer [88 ▪ ]. Another retrospective study suggested that the rate of ILD progression might be slower in patients with ILD and lung cancer treated with antiangiogenic compounds [89].…”

“…Taken together, current literature suggests that chemotherapy regimens should be implemented in most patients with IPF and lung cancer given the high proportion of overall response (27–70%) and the acceptable safety profile [2,85,88 ▪ ,96,106,109]. High-quality randomized-controlled trials for targeted approaches (tyrosine kinase inhibitors, immune-checkpoint inhibitors) are greatly anticipated.…”

Development of a zinc(ii) 2-pyridinecarboxaldehyde thiosemicarbazone complex with remarkable antitumor and antiangiogenic activities

“…In the past decades, antiangiogenic therapy for cancer has been widely investigated in the development of novel drugs. 24,25 On the one hand, tumor growth requires tumor blood vessels to provide nutrients and oxygen, 26,27 and on the other hand, angiogenesis plays a remarkable role in tumor metastasis. [28][29][30] Interestingly, previous studies have suggested that metal thiosemicarbazone complexes exhibit excellent antiangiogenic activity.…”