Effect of platinum-based chemotherapy for non-small cell lung cancer patients with interstitial lung disease

Kenmotsu, Hirotsugu; Naito, Tateaki; Mori, Keita; Ko, Ryo; Ono, Akira; Wakuda, Kazushige; Imai, Hisao; Taira, Tetsuhiko; Murakami, Haruyasu; Endo, Masahiro; Takahashi, Toshiaki

doi:10.1007/s00280-014-2670-y

Cited by 60 publications

(77 citation statements)

References 25 publications

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“…Preexisting IP has been speculated to be a significant risk factor for the development of AE during chemotherapy. Previous studies in NSCLC patients with IP reported that the incidence of AE associated with first-line platinum-based chemotherapy ranged from 5.6 [16][17][18][19][20]32]. In the present study, the rate of AE associated with second-line docetaxel monotherapy (14.3 %) was comparable to those associated with first-line chemotherapy in earlier studies [16][17][18][19][20]32].…”

Section: Discussionsupporting

confidence: 90%

“…Previous studies in NSCLC patients with IP reported that the incidence of AE associated with first-line platinum-based chemotherapy ranged from 5.6 [16][17][18][19][20]32]. In the present study, the rate of AE associated with second-line docetaxel monotherapy (14.3 %) was comparable to those associated with first-line chemotherapy in earlier studies [16][17][18][19][20]32]. Previously, Tamiya et al [33] reported that among all the treatment lines that were examined, docetaxel-related interstitial lung disease was more common in patients with IP than in those with a normal lung background (25.9 vs. 1.9 %).…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

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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“…A previous study showed that according to CT findings, the UIP pattern was a risk factor of pneumonitis [12], while other studies did not find a significant association between these factors [39, 40]. Additionally, previous reports also indicated that the CT pattern was not associated with the survival [41, 42]. Larger studies are needed to investigate these associations in patients with pre-existing ILD.…”

Section: Discussionmentioning

confidence: 99%

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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“…The optimal chemotherapy for such patients remains controversial (1,20), and the best-characterized regimen is CBDCA plus PTX (1-3). The efficacy of CBDCA plus nab-PTX for treating NSCLC patients without ILD has been established (17).…”

Section: Discussionmentioning

confidence: 99%

“…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 (1)(2)(3). Lung cancer is the leading cause of cancer-related mortality worldwide (4), although the treatment of patients with NSCLC is gradually improving (5).…”

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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Effect of platinum-based chemotherapy for non-small cell lung cancer patients with interstitial lung disease

Abstract: Our study suggests that the prognosis of NSCLC patients with ILD is poor. The risk of exacerbation of ILD in patients treated with platinum-based chemotherapy as the first-line treatment was slightly lower than in previous reports.

Cited by 60 publications

References 25 publications

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

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

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

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

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