Summary of the Japanese Respiratory Society statement for the treatment of lung cancer with comorbid interstitial pneumonia

Ogura, Takashi; Takigawa, Nagio; Tomii, Keisuke; Kishi, Kazuma; Inoue, Yoshikazu; Ichihara, Eiki; Homma, Sakae; Takahashi, Kazuhisa; Akamatsu, Hiroaki; Ikeda, Satoshi; Inase, Naohiko; Iwasawa, Tae; Ohe, Yuichiro; Ohta, Hiromitsu; Oda, Hiroshi; Okamoto, Isamu; Ogawa, Kazumasa; Kondo, Kazuo; Karata, Hiroki; Kishimoto, Takumi; Kitamura, Yuka; Gemma, Akihiko; Kenmotsu, Hirotsugu; Sakashita, Hiroyuki; Sakamoto, Susumu; Sekine, Katsutoshi; Takiguchi, Yuichi; Tada, Yuji; Toyooka, Shinichi; Nakayama, Yuko; Nishioka, Yasuhiko; Hagiwara, Koichi; Hashimoto, Masaki; Fukuoka, Junya; Minegishi, Yuji; Yanagihara, Toyoshi; Yamamoto, Nobuyuki; Yamamoto, Hiromasa; Gaga, Mina; Fong, Kwun M.; Powell, Charles A.; Kiura, Katsuyuki; Dld,

doi:10.1016/j.resinv.2019.06.001

Cited by 46 publications

(65 citation statements)

References 180 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…When the relationship between individual drug exposure and lung toxicity in monkeys was evaluated, no statistically significant difference in blood exposure of T‐DXd was detected in monkeys with or without lung toxicity. Susceptibility to drug‐induced ILD, then, might be related to genetic variability as some individuals could have higher sensitivity to certain anticancer drugs due to their genetic background 15 . There have been few detailed investigations of drug‐induced ILD and associated genetic variants, although some candidate genetic factors involved in drug‐induced DAD are now being considered and investigated 15,35 .…”

Section: Discussionmentioning

confidence: 99%

Interstitial pneumonitis related to trastuzumab deruxtecan, a human epidermal growth factor receptor 2‐targeting Ab–drug conjugate, in monkeys

et al. 2020

View full text Add to dashboard Cite

Trastuzumab deruxtecan (T‐DXd: DS‐8201a) is an anti‐human epidermal growth factor receptor 2 (HER2) Ab–drug conjugated with deruxtecan (DXd), a derivative of exatecan. The objective of this study was to characterize T‐DXd‐induced lung toxicity in cynomolgus monkeys. Trastuzumab deruxtecan was injected i.v. into monkeys once every 3 weeks for 6 weeks (10, 30, and 78.8 mg/kg) or for 3 months (3, 10, and 30 mg/kg). To evaluate the involvement of DXd alone in T‐DXd‐induced toxicity, DXd monohydrate was given i.v. to monkeys once a week for 4 weeks (1, 3, and 12 mg/kg). Interstitial pneumonitis was observed in monkeys given T‐DXd at 30 mg/kg or more. The histopathological features of diffuse lymphocytic infiltrates and slight fibrosis were similar to interstitial lung diseases (ILD)/pneumonitis related to anticancer drugs in patients, with an incidence that was dose‐dependent and dose‐frequency‐dependent. Monkeys receiving DXd monohydrate did not suffer lung toxicity, although the DXd exposure level was higher than that of DXd in the monkeys given T‐DXd. The HER2 expression in monkey lungs was limited to the bronchial level, although the lesions were found at the alveolar level. Immunohistochemical analysis confirmed that T‐DXd localization was mainly in alveolar macrophages, but not pulmonary epithelial cells. These findings indicate that monkeys are an appropriate model for investigating T‐DXd‐related ILD/pneumonitis. The results are also valuable for hypothesis generation regarding the possible mechanism of T‐DXd‐induced ILD/pneumonitis in which target‐independent uptake of T‐DXd into alveolar macrophages could be involved. Further evaluation is necessary to clarify the mechanism of ILD/pneumonitis in patients with T‐DXd therapy.

show abstract

Section: Discussionmentioning

confidence: 99%

Interstitial pneumonitis related to trastuzumab deruxtecan, a human epidermal growth factor receptor 2‐targeting Ab–drug conjugate, in monkeys

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Docetaxel and ramucirumab chemotherapy was reported to induce ILD (10.5%) in a Japanese phase II trial, although the docetaxel dose was lower (60 mg/m 2 ) in the Japanese regimen than in the REVEL trial (75 mg/m 2 ) . Drug‐induced ILD was reported to frequently develop in Japanese patients compared to that in patients from other countries . A series of treatments including radiotherapy is associated with various types of damage and immune modification among patients.…”

Section: Discussionmentioning

confidence: 99%

Interstitial lung disease induced by docetaxel and ramucirumab chemotherapy after nivolumab treatment

Okeya

Kawagishi

Yamoto

et al. 2020

Respirology Case Reports

View full text Add to dashboard Cite

Three men (aged 64, 65, and 67 years) with advanced lung cancer who had been treated with nivolumab developed interstitial lung disease (ILD) during chemotherapy with docetaxel and ramucirumab. The treatment was clinically effective; however, the patients experienced immune-related adverse effects due to nivolumab therapy: two patients developed ILD and the third developed psoriasis. Because the patients showed progression, docetaxel and ramucirumab chemotherapy was administered. Although two patients showed a clinical response, all patients developed grade 3 ILD during therapy. Furthermore, the patients developed respiratory failure and needed corticosteroid therapy. Although their condition improved owing to the therapy, the patients could not receive additional cancer treatment and died of cancer. On the basis of the results obtained, we speculated that although the regimen of docetaxel and ramucirumab after nivolumab therapy might be effective against non-small cell lung cancer, it might increase the risk for ILD in some patients.

show abstract

“…According to Japanese package inserts, irinotecan is contraindicated for IP-complicated cases, and amrubicin and gemcitabine are contraindicated in cases with symptomatic IP that can be detected by chest X-ray (8). Several small studies have shown the tolerability of regimens including paclitaxel (27), nab-paclitaxel (44), and S-1 (25).…”

Section: Cytotoxic Chemotherapymentioning

confidence: 99%

“…IP, especially idiopathic pulmonary fibrosis (IPF), often accompanies lung cancer, and its frequency reaches up to 10-20% (8). The biggest problem regarding lung cancer with comorbid IP is AE, which can be fatal and makes cancer treatment difficult during the clinical course.…”

Section: Introductionmentioning

confidence: 99%

“…The biggest problem regarding lung cancer with comorbid IP is AE, which can be fatal and makes cancer treatment difficult during the clinical course. In addition, Japanese people are prone to drug-induced pulmonary toxicity, even in those without comorbid IP (8). Therefore, the establishment of a treatment strategy for lung cancer with comorbid IP is an urgent issue.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Managing Lung Cancer with Comorbid Interstitial Pneumonia

et al. 2020

Self Cite

View full text Add to dashboard Cite

Systemic therapy for advanced non-small cell lung cancer (NSCLC) has dramatically changed in the latest 15 years. Molecular-targeted therapy has brought about an era of precision medicine, and immune checkpoint inhibitors have brought hope for a cure for advanced NSCLC. In the wake of this remarkable advancement, lung cancer with comorbid interstitial pneumonia (IP) has been completely left behind, as most clinical trials exclude patients with comorbid IP. IP, especially idiopathic pulmonary fibrosis (IPF), is often accompanied by lung cancer, and acute exacerbation can develop during various cancer therapies, including surgery, radiotherapy and pharmacotherapy. In this review, we focus on the clinical questions concerning pharmacotherapy in cases of advanced lung cancer with comorbid IP and discuss what we can do with the currently available data.

show abstract

Summary of the Japanese Respiratory Society statement for the treatment of lung cancer with comorbid interstitial pneumonia

Cited by 46 publications

References 180 publications

Interstitial pneumonitis related to trastuzumab deruxtecan, a human epidermal growth factor receptor 2‐targeting Ab–drug conjugate, in monkeys

Interstitial pneumonitis related to trastuzumab deruxtecan, a human epidermal growth factor receptor 2‐targeting Ab–drug conjugate, in monkeys

Interstitial lung disease induced by docetaxel and ramucirumab chemotherapy after nivolumab treatment

Managing Lung Cancer with Comorbid Interstitial Pneumonia

Contact Info

Product

Resources

About