Incidence of lung cancer in patients with systemic sclerosis treated with extracorporeal photopheresis

Topuzoglu, Sabriye; Knobler, Robert; Movadat, Oliver; Petkov, Ventzislav; Foedinger, Dagmar; Just, Ulrike; Pehamberger, Hubert; Jantschitsch, Christian

doi:10.1111/phpp.12155

Cited by 7 publications

(11 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Unfortunately, in the current study, only seven patients had lung cancer of stage IIIA or lower, and six of whom had received surgery. The median survival time of SSc patients with lung cancer was 1.4 years, which was similar to that reported by Topuzoglu et al (14 months)23 but much shorter than that of non-SSc patients with lung cancer (~3 year) 24. It has been reported that EGFR gene mutation and ALK gene rearrangement are more common in non-smoking young female patients with lung adenocarcinoma 26,27.…”

supporting

confidence: 85%

“…In the present study, lung cancers were detected in three patients via regular annual chest CT for ILD. Previous study suggests that ILD usually develops and progresses during the first 8 years of SSc onset, 23 and then, ILD gradually becomes stable. Thus, the intervals between CT scanning at our centre were prolonged to reduce radiation damage from high‐resolution chest CT.…”

Section: Discussionmentioning

confidence: 91%

See 1 more Smart Citation

Risk and prognosis factors for systemic sclerosis with lung cancer: A single‐centre case‐control study in China

et al. 2020

View full text Add to dashboard Cite

Objective To analyse clinical characteristics, risk and prognosis factors for systemic sclerosis (SSc) patients with lung cancer. Methods SSc patients with lung cancer admitted to Peking Union Medical College Hospital from February 1992 to December 2018 were included. Age and sex‐matched controls were selected from a pool of SSc patients without lung cancer during the same period. Conditional logistic regression and Cox proportional‐hazard regression were used to identify risk factors and prognosis factors. The Kaplan‐Meier method was used to draw the survival curve and calculate median survival. Results Nineteen SSc patients with lung cancer and 76 controls were included. The mean age at lung cancer diagnosis was 54.4 ± 10.2 years. In all 19 cases the lung cancer had been diagnosed after SSc and the median interval between SSc onset and lung cancer onset was 10.5 years (range 2.0‐36.2 years). Among SSc patients with lung cancer, the median follow‐up time and median survival were 2.6 years and 1.4 years, respectively. In the sex and age‐matched conditional logistic multivariable regression analysis, family history of malignancy (OR 4.930, 95%CI 1.926‐12.619, P = .001), ILD (OR 7.701, 95%CI 1.009‐58.767, P = .049) were independent risk factors for lung cancer among SSc patients, and considering sex and age of SSc onset, SSc patients with more advanced staging of lung cancer (HR 3.190, 95%CI 1.127‐6.126, P = .06) had poorer prognosis. Conclusion Lung cancer is not uncommon in SSc patients, especially those with family histories of malignancy or ILD. Early detection of lung cancer is of vital importance for better prognosis.

show abstract

supporting

confidence: 85%

Section: Discussionmentioning

confidence: 91%

Risk and prognosis factors for systemic sclerosis with lung cancer: A single‐centre case‐control study in China

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Confirming larger meta‐analyses, the risk for lung cancer in SSc patients was increased by 2.34 [95% confidence interval (CI) 1.63–2.49] 20,21 . However, ECP therapy did not affect the risk of lung cancer in patients with SSc 19 …”

Section: Sclerodermamentioning

confidence: 70%

“…Finally, a retrospective study by Topuzoglu et al . evaluated the incidence of lung cancer in 71 SSc patients treated with ECP between 1991 and 2013 19 . Confirming larger meta‐analyses, the risk for lung cancer in SSc patients was increased by 2.34 [95% confidence interval (CI) 1.63–2.49] 20,21 .…”

Section: Sclerodermamentioning

confidence: 84%

European dermatology forum: Updated guidelines on the use of extracorporeal photopheresis 2020 – Part 2

Knobler

Arenberger

Arun

et al. 2020

Acad Dermatol Venereol

View full text Add to dashboard Cite

BackgroundFollowing the first investigational study on the use of extracorporeal photopheresis for the treatment of cutaneous T‐cell lymphoma published in 1983, this technology has received continued use and further recognition for additional earlier as well as refractory forms. After the publication of the first guidelines for this technology in the JEADV in 2014, this technology has maintained additional promise in the treatment of other severe and refractory conditions in a multidisciplinary setting. It has confirmed recognition in well‐known documented conditions such as graft‐vs.‐host disease after allogeneic bone marrow transplantation, systemic sclerosis, solid organ transplant rejection including lung, heart and liver and to a lesser extent inflammatory bowel disease.Materials and methodsIn order to further provide recognized expert practical guidelines for the use of this technology for all indications, the European Dermatology Forum (EDF) again proceeded to address these questions in the hands of the recognized experts within and outside the field of dermatology. This was done using the recognized and approved guidelines of EDF for this task. All authors had the opportunity to review each contribution as it was added.Results and conclusionThese updated 2020 guidelines provide at present the most comprehensive available expert recommendations for the use of extracorporeal photopheresis based on the available published literature and expert consensus opinion. The guidelines were divided into two parts: PART I covers Cutaneous T‐cell lymphoma, chronic graft‐vs.‐host disease and acute graft‐vs.‐host disease, while PART II will cover scleroderma, solid organ transplantation, Crohn’s disease, use of ECP in paediatric patients, atopic dermatitis, type 1 diabetes, pemphigus, epidermolysis bullosa acquisita and erosive oral lichen planus.

show abstract

“…The effect of ECP was also investigated in randomized, double blind, placebo controlled studies with varying outcome, ranging from no improvement against no treatment, improvement over no treatment but no improvement against sham to a superiority of ECP against D-penicillamine treatment (53–60). Patients with scleroderma may have a higher risk in developing lung cancer, but no difference was found between patients with ECP and patients without ECP treatment (61). …”

Section: Indicationsmentioning

confidence: 99%

Extracorporeal Photopheresis—An Overview

2018

Self Cite

View full text Add to dashboard Cite

Extracorporeal photopheresis (ECP) has been in clinical use for over three decades after receiving FDA approval for the palliative treatment of the Sézary Syndrome variant of cutaneous T-cell lymphoma (CTCL) in 1988. After the first positive experiences with CTCL, additional indications have been successfully explored including areas such as graft-vs.-host disease (GVHD), scleroderma, and solid organ transplantation. The mechanism of action is still not fully resolved, but important steps in understanding ECP in recent years have been very informative. Originally, the primary hypothesis stated that psoralen and ultraviolet A (UVA) in combination induce apoptosis in the treated immune cells. This view shifted in favor of dendritic cell initiation, modification of the cytokine profile and stimulation of several T-cell lineages, in particular regulatory T-cells. A number of ECP guidelines have been produced to optimize treatment regimens in the clinical context. In CTCL, enough evidence is available for the use of ECP as a first line treatment for Sézary Syndrome (SS), but also as a second line or rescue treatment in therapy-refractory forms of mycosis fungoides (MF). ECP in the treatment of acute and chronic GVHD has shown promising results as second line therapy in steroid-refractory presentations. In solid organ transplantation, ECP has been used to increase tissue tolerance and decrease infections with opportunistic pathogens, attributed to the use of high doses of immunosuppressive medication. Infection with cytomegalovirus (CMV) remains a limiting factor affecting survival in solid organ transplantation and the role of ECP will be discussed in this review. A trend toward prophylactic use of ECP can be observed and may further contribute to improve the outcome in many patients. To further deepen our knowledge of ECP and thus facilitate its use in patients that potentially benefit most from it, future prospective randomized trials are urgently needed in this rapidly growing field. The aim of this review is to (1) introduce the method, (2) give an overview where ECP has shown promising effects and has become an essential part of treatment protocols, and (3) to give recommendations on how to proceed in numerous indications.

show abstract

Incidence of lung cancer in patients with systemic sclerosis treated with extracorporeal photopheresis

Abstract: We confirm that SSc patients are at significantly increased risk for lung cancer. However, ECP does not influence this risk. NSIP may be a risk factor for lung cancer in SSc patients.

Cited by 7 publications

References 32 publications

Risk and prognosis factors for systemic sclerosis with lung cancer: A single‐centre case‐control study in China

Risk and prognosis factors for systemic sclerosis with lung cancer: A single‐centre case‐control study in China

European dermatology forum: Updated guidelines on the use of extracorporeal photopheresis 2020 – Part 2

Extracorporeal Photopheresis—An Overview

Contact Info

Product

Resources

About