Weekly Paclitaxel in Combination with Carboplatin for Advanced Non-small-cell Lung Cancer Complicated by Idiopathic Interstitial Pneumonias: a Single-arm Phase II Study

Overview

Journal Int J Clin Oncol

Specialty Oncology

Date 2019 Jul 29

PMID 31352631

Citations 11

Authors

Aya Fukuizumi

Yuji Minegishi

Miwako Omori

Kenichiro Atsumi

Natsuki Takano

Kakeru Hisakane

Satoshi Takahashi

Kenichi Kobayashi

Teppei Sugano

Susumu Takeuchi

Rintaro Noro

Masahiro Seike

Kaoru Kubota

Arata Azuma

Akihiko Gemma

Affiliations

Soon will be listed here.

Abstract

Background: Idiopathic interstitial pneumonias (IIPs) are associated with increased risk of lung cancer. In Japan, acute exaberation of IIPs induced by anticancer treatment is a critical issue. For this reason, there is limited available evidence regarding the optimal treatment approach for lung cancer patients complicated with IIPs. Our previous prospective pilot study demonstrated the safety and efficacy of weekly paclitaxel in combination with carboplatin for advanced non-small-cell lung cancer (NSCLC) with IIPs. The current study was conducted to confirm the results of the same combination therapy used in a larger patient population.

Methods: Chemotherapy-naïve patients with advanced stage or post-operative recurrent NSCLC patients complicated by IIPs were enrolled. Patients received paclitaxel (100 mg/m) on days 1, 8, and 15, and carboplatin (AUC 5.0) once every 4 weeks.

Results: Thirty-three of 35 enrolled patients were evaluable for analysis and received a median of four treatment cycles (range 1-6). Four patients (12.1%; 95% confidence interval 3.4-28.2%) had acute exacerbation (AEx)-related IIPs to the study treatment. However, no fatalities due to AEx were observed. The overall response was 69.7%. The median progression-free survival, median survival time, and 1-year survival were 6.3 months, 19.8 months, and 55.4%, respectively.

Conclusions: The efficacy of carboplatin plus weekly paclitaxel treatment for advanced NSCLC patients with IIPs was comparable to that of conventional chemotherapy in advanced NSCLC patients without IIPs. Moreover, the primary endpoint was set to the frequency of treatment-related acute exacerbation, and the primary endpoint was met. These results suggest that patients with advanced NSCLC complicated by IIPs may benefit from this combination chemotherapy.

Citing Articles

Carboplatin in combination with etoposide for advanced small cell lung cancer complicated with idiopathic interstitial pneumonia: a single-arm phase II study.

Matsumoto M, Minegishi Y, Higa K, Fukuizumi A, Onda N, Takeuchi S BMC Pulm Med. 2025; 25(1):9.

PMID: 39780119 PMC: 11707951. DOI: 10.1186/s12890-024-03459-y.

Treatment Strategies for Non-Small-Cell Lung Cancer with Comorbid Respiratory Disease; Interstitial Pneumonia, Chronic Obstructive Pulmonary Disease, and Tuberculosis.

Otoshi R, Ikeda S, Kaneko T, Sagawa S, Yamada C, Kumagai K Cancers (Basel). 2024; 16(9).

PMID: 38730686 PMC: 11083871. DOI: 10.3390/cancers16091734.

Acute exacerbation predicting poor outcomes in idiopathic interstitial pneumonia and advanced lung cancer patients undergoing cytotoxic chemotherapy.

Miyamoto A, Michimae H, Nakahara Y, Akagawa S, Nakagawa K, Minegishi Y Sci Rep. 2024; 14(1):10162.

PMID: 38702426 PMC: 11068886. DOI: 10.1038/s41598-024-60833-w.

Case report: Idiopathic pulmonary fibrosis induced by nab-paclitaxel: A rare complication.

Shen J, Wen Z, Lin J, Su H Front Pharmacol. 2023; 14:1094844.

PMID: 36909189 PMC: 9995582. DOI: 10.3389/fphar.2023.1094844.

Management of Lung Cancer in the Patient with Interstitial Lung Disease.

Frank A, Dagogo-Jack I, Dobre I, Tait S, Schumacher L, Fintelmann F Oncologist. 2022; 28(1):12-22.

PMID: 36426803 PMC: 9847545. DOI: 10.1093/oncolo/oyac226.

References

Gemma A, Seike M, Kosaihira S, Minegishi Y, Noro R, Nara M . Phase I/II study of paclitaxel + carboplatin for refractory or recurrent non-small cell lung cancer. Anticancer Res. 2006; 26(4B):3083-7. View

Eisenhauer E, Therasse P, Bogaerts J, Schwartz L, Sargent D, Ford R . New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2008; 45(2):228-47. DOI: 10.1016/j.ejca.2008.10.026. View

Kawasaki H, Nagai K, Yokose T, Yoshida J, Nishimura M, Takahashi K . Clinicopathological characteristics of surgically resected lung cancer associated with idiopathic pulmonary fibrosis. J Surg Oncol. 2001; 76(1):53-7. DOI: 10.1002/1096-9098(200101)76:1<53::aid-jso1009>3.0.co;2-t. View

Akira M, Hamada H, Sakatani M, Kobayashi C, Nishioka M, Yamamoto S . CT findings during phase of accelerated deterioration in patients with idiopathic pulmonary fibrosis. AJR Am J Roentgenol. 1997; 168(1):79-83. DOI: 10.2214/ajr.168.1.8976924. View

Panos R, Mortenson R, Niccoli S, King Jr T . Clinical deterioration in patients with idiopathic pulmonary fibrosis: causes and assessment. Am J Med. 1990; 88(4):396-404. DOI: 10.1016/0002-9343(90)90495-y. View

Azuma A, Nukiwa T, Tsuboi E, Suga M, Abe S, Nakata K . Double-blind, placebo-controlled trial of pirfenidone in patients with idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2005; 171(9):1040-7. DOI: 10.1164/rccm.200404-571OC. View

Kenmotsu H, Naito T, Kimura M, Ono A, Shukuya T, Nakamura Y . The risk of cytotoxic chemotherapy-related exacerbation of interstitial lung disease with lung cancer. J Thorac Oncol. 2011; 6(7):1242-6. DOI: 10.1097/JTO.0b013e318216ee6b. View

Kondoh Y, Taniguchi H, Kawabata Y, Yokoi T, Suzuki K, Takagi K . Acute exacerbation in idiopathic pulmonary fibrosis. Analysis of clinical and pathologic findings in three cases. Chest. 1993; 103(6):1808-12. DOI: 10.1378/chest.103.6.1808. View

Isobe K, Hata Y, Sakamoto S, Takai Y, Shibuya K, Homma S . Clinical characteristics of acute respiratory deterioration in pulmonary fibrosis associated with lung cancer following anti-cancer therapy. Respirology. 2009; 15(1):88-92. DOI: 10.1111/j.1440-1843.2009.01666.x. View

10.

Azuma A, Taniguchi H, Inoue Y, Kondoh Y, Ogura T, Homma S . Nintedanib in Japanese patients with idiopathic pulmonary fibrosis: A subgroup analysis of the INPULSIS® randomized trials. Respirology. 2016; 22(4):750-757. DOI: 10.1111/resp.12960. View

11.

Minegishi Y, Sudoh J, Kuribayasi H, Mizutani H, Seike M, Azuma A . The safety and efficacy of weekly paclitaxel in combination with carboplatin for advanced non-small cell lung cancer with idiopathic interstitial pneumonias. Lung Cancer. 2010; 71(1):70-4. DOI: 10.1016/j.lungcan.2010.04.014. View

12.

Hubbard R, Venn A, Lewis S, Britton J . Lung cancer and cryptogenic fibrosing alveolitis. A population-based cohort study. Am J Respir Crit Care Med. 2000; 161(1):5-8. DOI: 10.1164/ajrccm.161.1.9906062. View

13.

Minegishi Y, Takenaka K, Mizutani H, Sudoh J, Noro R, Okano T . Exacerbation of idiopathic interstitial pneumonias associated with lung cancer therapy. Intern Med. 2009; 48(9):665-72. DOI: 10.2169/internalmedicine.48.1650. View

14.

TURNER-WARWICK M, Lebowitz M, Burrows B, Johnson A . Cryptogenic fibrosing alveolitis and lung cancer. Thorax. 1980; 35(7):496-9. PMC: 471320. DOI: 10.1136/thx.35.7.496. View

15.

Ohe Y, Ohashi Y, Kubota K, Tamura T, Nakagawa K, Negoro S . Randomized phase III study of cisplatin plus irinotecan versus carboplatin plus paclitaxel, cisplatin plus gemcitabine, and cisplatin plus vinorelbine for advanced non-small-cell lung cancer: Four-Arm Cooperative Study in Japan. Ann Oncol. 2006; 18(2):317-23. DOI: 10.1093/annonc/mdl377. View

16.

Belani C, Barstis J, Perry M, La Rocca R, Nattam S, Rinaldi D . Multicenter, randomized trial for stage IIIB or IV non-small-cell lung cancer using weekly paclitaxel and carboplatin followed by maintenance weekly paclitaxel or observation. J Clin Oncol. 2003; 21(15):2933-9. DOI: 10.1200/JCO.2003.02.563. View

17.

Johkoh T, Muller N, Cartier Y, Kavanagh P, Hartman T, Akira M . Idiopathic interstitial pneumonias: diagnostic accuracy of thin-section CT in 129 patients. Radiology. 1999; 211(2):555-60. DOI: 10.1148/radiology.211.2.r99ma01555. View

18.

Richeldi L, du Bois R, Raghu G, Azuma A, Brown K, Costabel U . Efficacy and safety of nintedanib in idiopathic pulmonary fibrosis. N Engl J Med. 2014; 370(22):2071-82. DOI: 10.1056/NEJMoa1402584. View

19.

Watanabe N, Niho S, Kirita K, Umemura S, Matsumoto S, Yoh K . Second-line docetaxel for patients with platinum-refractory advanced non-small cell lung cancer and interstitial pneumonia. Cancer Chemother Pharmacol. 2015; 76(1):69-74. DOI: 10.1007/s00280-015-2775-y. View

20.

Nishimura K, Kitaichi M, Izumi T, NAGAI S, Kanaoka M, Itoh H . Usual interstitial pneumonia: histologic correlation with high-resolution CT. Radiology. 1992; 182(2):337-42. DOI: 10.1148/radiology.182.2.1732946. View