Impact of pre‐existing interstitial lung abnormal shadow on lung injury development and severity in patients of non‐small cell lung cancer treated with osimertinib

Shibaki, Ryota; Ozawa, Yuichi; Noguchi, Susumu; Murakami, Yusuke; Takase, Eri; Azuma, Yuichiro; Maebeya, Masaru; Sugimoto, Takeya; Hayata, Atsushi; Hayakawa, Takahiro; Tamaki, Shinya; Nakanishi, Masayoshi; Teraoka, Shunsuke; Akamatsu, Hiroaki

doi:10.1002/cam4.4750

Cited by 9 publications

(4 citation statements)

References 24 publications

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“…In the present study, cause-specific HRs for AEIP were observed to increase sequentially with an increase in the ILA score. These findings are consistent with those shown in prior research that reported increased odds ratios for AEIP in patients with lung cancer complicated by either IPF or ILA [6,7,33,34]. Our study also revealed that even equivocal ILA was associated with increased HRs for the development of AEIP.…”

Section: Discussionsupporting

confidence: 93%

“…Our study also revealed that even equivocal ILA was associated with increased HRs for the development of AEIP. In previous studies, analyses of AEIP in patients with lung cancer were reported with frequencies or odds ratios based on logistic regression analyses [ 6 , 7 , 33 , 34 ]. However, studies of lung cancer generally censor their data.…”

Section: Discussionmentioning

confidence: 99%

“…Our findings have important clinical implications. In patients with lung cancer complicated by interstitial pneumonia, there is inadequate evidence of improved prognosis with any treatment [ 35 ], and any intervention can trigger AEIP [ 6 , 7 , 33 , 34 ]. Using our results, physicians can estimate individual HRs for all-cause mortality and AEIP based on the ILA and Goddard scores before proceeding with a treatment for lung cancer.…”

Section: Discussionmentioning

confidence: 99%

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Deleterious impact of trivial to severe interstitial pneumonia and emphysema on mortality and acute exacerbation of interstitial pneumonia in patients with lung cancer: a retrospective cohort study

Tomishima,

Kitamura,

Imai

et al. 2024

BMC Pulm Med

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Background Interstitial pneumonia and emphysema may complicate patients with lung cancer. However, clinical significance of trivial and mild pulmonary abnormalities remains unclear. In this study, we aimed to investigate whether trivial and mild interstitial pneumonia and emphysema, in addition to their advanced forms, impact the prognosis and lead to acute exacerbation of interstitial pneumonia (AEIP) in patients with lung cancer. Methods This retrospective cohort study was conducted at a tertiary hospital and included patients with lung cancer. Computed tomography images were evaluated using the interstitial lung abnormality (ILA) score for interstitial pneumonia, which included no ILA, equivocal ILA, ILA, interstitial lung disease (ILD), and the Goddard score for emphysema. Cox analyses were performed using the ILA and Goddard scores as the main explanatory variables, adjusting for multiple covariates. Results Among 1,507 patients with lung cancer, 1,033 had no ILA, 160 had equivocal ILA, 174 had ILA, and 140 had ILD. In total, 474 patients (31.5%) exhibited interstitial pneumonia and 638 (42.3%) showed emphysema. The log-rank trend test showed that survival probability was significantly better in patients with no ILA, followed by those with equivocal ILA, ILA, and ILD (P < 0.001). After adjustment, the ILA and Goddard scores remained significant variables for increased hazard ratios (HR) for mortality: no ILA (HR, 1.00: reference), equivocal ILA (HR, 1.31; 95% confidence interval [CI], 1.18–1.46; P < 0.001), ILA (HR, 1.71; 95% CI, 1.39–2.12; P < 0.001), ILD (HR, 2.24; 95% CI, 1.63–3.09; P < 0.001), and Goddard score (HR, 1.03; 95% CI, 1.01–1.06; P < 0.010). Moreover, both scores were associated with increased cause-specific HRs for AEIP. Conclusion Our results revealed that approximately one-third of patients with lung cancer had interstitial pneumonia when incorporating trivial and mild cases. Because interstitial pneumonia and emphysema, ranging from trivial to severe, significantly impact mortality and AEIP in patients with lung cancer, we should identify even trivial and mild cases of these pulmonary abnormalities among patients with lung cancer in addition to the advanced ones.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Deleterious impact of trivial to severe interstitial pneumonia and emphysema on mortality and acute exacerbation of interstitial pneumonia in patients with lung cancer: a retrospective cohort study

Tomishima,

Kitamura,

Imai

et al. 2024

BMC Pulm Med

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“…First‐line EGFR TKIs are the standard treatment in advanced EGFR ‐mutant NSCLC patients, improving response rates, progression‐free survival, and quality of life. 13 Shibaki et al 14 recently found that NSCLC patients with pre‐existing ILA shadows were more likely to develop TKI‐related lung injury, although survival curves for patients with and without lung injury were similar. This study also found that EGFR TKIs might be beneficial to EGFR ‐mutated NSCLC patients with ILA.…”

Section: Discussionmentioning

confidence: 99%

Newly diagnosed non‐small cell lung cancer with interstitial lung abnormality: Prevalence, characteristics, and prognosis

Zhu

et al. 2023

Thoracic Cancer

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Background Along with the improvement of lung cancer screening implementation, the identification of interstitial lung abnormality (ILA) is increasing. Currently, there is a limited description of the oncogenic status and ILA subtypes among newly diagnosed non‐small cell lung cancer (NSCLC) patients with ILA in the Chinese population. This study aimed to investigate the prevalence, characteristics, oncogenic status and factors associated with overall survival (OS) among NSCLC patients with ILA. Methods A total of 765 newly diagnosed NSCLC cases at our hospital were reviewed and ILA was diagnosed according to the criteria of the Fleischner Society. The characteristics, clinical pathological features and OS of NSCLC patients with ILA were retrospectively analyzed. Results Of the 765 patients included in the study, 101 (13.2%) cases experienced ILA at the time of NSCLC diagnosis. Multivariate analysis revealed that ILA was more likely to be detected in NSCLC patients who were age ≥60 (OR 2.404, p = 0.001), male gender (OR 2.476, p = 0.004), and EGFR wild‐type (OR 2.035, p = 0.007). Additionally, according to the multivariate Cox model, the presence of ILA in NSCLC patients was significantly associated with a shorter OS period than those without ILA (751 days vs. 445 days, HR 0.6, p = 0.001). Following analysis, it was determined that OS in patients with usual interstitial pneumonia (UIP) was shorter than in those without UIP (HR 1.82, p = 0.037). Conclusion ILA is a common comorbidity among newly diagnosed NSCLC patients. We found that patients with EGFR wild‐type NSCLC were more likely to develop ILA. The presence of ILA, especially UIP, was significantly associated with poor NSCLC prognosis.

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Impact of pre‐existing interstitial lung abnormal shadow on lung injury development and severity in patients of non‐small cell lung cancer treated with osimertinib

et al. 2022

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Background: First-generation epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) sometimes causes lung injury, thereby affecting survival.Although pre-existing interstitial lung abnormal shadow (pre-ILS) increases the risk of lung injury by EGFR-TKIs, its impact on osimertinib, a third-generation EGFR-TKI, remains unknown. Patients and Methods:This retrospective cohort study consecutively enrolled patients of EGFR-mutated non-small cell lung cancer treated with osimertinib.Computed tomography images were obtained and evaluated independently by three pulmonologists in a blinded manner. Factors associated with lung injury were assessed using a logistic regression model. Survival curves were calculated by the Kaplan-Meier method and compared using a log-rank test.

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Impact of pre‐existing interstitial lung abnormal shadow on lung injury development and severity in patients of non‐small cell lung cancer treated with osimertinib

Cited by 9 publications

References 24 publications

Deleterious impact of trivial to severe interstitial pneumonia and emphysema on mortality and acute exacerbation of interstitial pneumonia in patients with lung cancer: a retrospective cohort study

Deleterious impact of trivial to severe interstitial pneumonia and emphysema on mortality and acute exacerbation of interstitial pneumonia in patients with lung cancer: a retrospective cohort study

Newly diagnosed non‐small cell lung cancer with interstitial lung abnormality: Prevalence, characteristics, and prognosis

Impact of pre‐existing interstitial lung abnormal shadow on lung injury development and severity in patients of non‐small cell lung cancer treated with osimertinib

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