Risk Factors for Acute Exacerbation in Lung Cancer Complicated by Interstitial Lung Disease with Slight Reticular Shadows

Overview

Journal Thorac Cancer

Specialties Oncology
Pulmonary Medicine

Date 2021 Aug 19

PMID 34409749

Citations 4

Authors

Yutaka Takahara

Takuya Tanaka

Yoko Ishige

Ikuyo Shionoya

Kouichi Yamamura

Takashi Sakuma

Kazuaki Nishiki

Keisuke Nakase

Masafumi Nojiri

Ryo Kato

Shohei Shinomiya

Yuki Fujimoto

Taku Oikawa

Shiro Mizuno

Affiliations

Soon will be listed here.

Abstract

Background: The risk of cancer treatment-related acute exacerbation (AE) in patients with lung cancer and mild interstitial lung disease (ILD) on imaging, classified as indeterminate for usual interstitial pneumonia (UIP), has not previously been clarified.

Methods: We retrospectively reviewed the clinical records of 27 patients with lung cancer and ILD who were diagnosed and treated from April 2016 to March 2021.

Results: Among the 27 patients, 21 were classified as indeterminate for UIP and six as UIP/probable UIP; furthermore, 10 (46.6%) and three (50%) patients from each group, respectively, developed treatment-related AEs. No significant difference was observed regarding the incidence of AEs between the two groups. However, significantly more patients in the AE group received immune checkpoint inhibitors (ICIs) compared to the non-AE group (p = 0.021). Multivariate analysis revealed that the use of ICIs was a significant independent risk factor for treatment-related AEs.

Conclusions: Lung cancer patients with mild ILD suggestive of indeterminate for UIP and UIP patterns are at an increased risk for treatment-related AEs. Furthermore, ICI use is an independent risk factor for AEs in patients with lung cancer complicated by ILD, and ICIs should be used with great caution.

Citing Articles

The Between Lung Cancer and Interstitial Lung Diseases: A Focus on Acute Exacerbation.

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Safety and Efficacy of Single-Fraction Carbon-Ion Radiotherapy for Early-Stage Lung Cancer with Interstitial Pneumonia.

Aoki S, Ishikawa H, Nakajima M, Yamamoto N, Mori S, Omatsu T Cancers (Basel). 2024; 16(3).

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Impact of treatment line on risks and benefits of immune checkpoint inhibitor in patients with advanced non-small cell lung cancer and interstitial lung disease: a systematic review and meta-analysis of cohort studies.

Matsumoto K, Shiroyama T, Kuge T, Miyake K, Yamamoto Y, Yoneda M Transl Lung Cancer Res. 2022; 11(9):1835-1846.

PMID: 36248332 PMC: 9554685. DOI: 10.21037/tlcr-22-162.

Risk factors for acute exacerbation in lung cancer complicated by interstitial lung disease with slight reticular shadows.

Takahara Y, Tanaka T, Ishige Y, Shionoya I, Yamamura K, Sakuma T Thorac Cancer. 2021; 12(20):2758-2766.

PMID: 34409749 PMC: 8520810. DOI: 10.1111/1759-7714.14121.

References

Tasaka Y, Honda T, Nishiyama N, Tsutsui T, Saito H, Watabe H . Non-inferior clinical outcomes of immune checkpoint inhibitors in non-small cell lung cancer patients with interstitial lung disease. Lung Cancer. 2021; 155:120-126. DOI: 10.1016/j.lungcan.2021.03.014. View

Kenmotsu H, Naito T, Mori K, Ko R, Ono A, Wakuda K . Effect of platinum-based chemotherapy for non-small cell lung cancer patients with interstitial lung disease. Cancer Chemother Pharmacol. 2015; 75(3):521-6. DOI: 10.1007/s00280-014-2670-y. View

Chiba S, Tsuchiya K, Akashi T, Ishizuka M, Okamoto T, Furusawa H . Chronic Hypersensitivity Pneumonitis With a Usual Interstitial Pneumonia-Like Pattern: Correlation Between Histopathologic and Clinical Findings. Chest. 2016; 149(6):1473-81. DOI: 10.1016/j.chest.2015.12.030. 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

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

Schoenfeld A, Arbour K, Rizvi H, Iqbal A, Gadgeel S, Girshman J . Severe immune-related adverse events are common with sequential PD-(L)1 blockade and osimertinib. Ann Oncol. 2019; 30(5):839-844. PMC: 7360149. DOI: 10.1093/annonc/mdz077. View

Omori T, Tajiri M, Baba T, Ogura T, Iwasawa T, Okudela K . Pulmonary Resection for Lung Cancer in Patients With Idiopathic Interstitial Pneumonia. Ann Thorac Surg. 2015; 100(3):954-60. DOI: 10.1016/j.athoracsur.2015.03.094. View

Takahara Y, Tanaka T, Ishige Y, Shionoya I, Yamamura K, Sakuma T . Risk factors for acute exacerbation in lung cancer complicated by interstitial lung disease with slight reticular shadows. Thorac Cancer. 2021; 12(20):2758-2766. PMC: 8520810. DOI: 10.1111/1759-7714.14121. View

Kato M, Shukuya T, Takahashi F, Mori K, Suina K, Asao T . Pemetrexed for advanced non-small cell lung cancer patients with interstitial lung disease. BMC Cancer. 2014; 14:508. PMC: 4107964. DOI: 10.1186/1471-2407-14-508. View

10.

Naqash A, Ricciuti B, Owen D, Florou V, Toi Y, Cherry C . Outcomes associated with immune-related adverse events in metastatic non-small cell lung cancer treated with nivolumab: a pooled exploratory analysis from a global cohort. Cancer Immunol Immunother. 2020; 69(7):1177-1187. PMC: 11027623. DOI: 10.1007/s00262-020-02536-5. View

11.

Shimoji K, Masuda T, Yamaguchi K, Sakamoto S, Horimasu Y, Nakashima T . Association of Preexisting Interstitial Lung Abnormalities With Immune Checkpoint Inhibitor-Induced Interstitial Lung Disease Among Patients With Nonlung Cancers. JAMA Netw Open. 2020; 3(11):e2022906. PMC: 7662135. DOI: 10.1001/jamanetworkopen.2020.22906. View

12.

Nishiyama N, Honda T, Sema M, Kawahara T, Jin Y, Natsume I . The utility of ground-glass attenuation score for anticancer treatment-related acute exacerbation of interstitial lung disease among lung cancer patients with interstitial lung disease. Int J Clin Oncol. 2019; 25(2):282-291. DOI: 10.1007/s10147-019-01576-x. View

13.

Shibaki R, Murakami S, Matsumoto Y, Yoshida T, Goto Y, Kanda S . Association of immune-related pneumonitis with the presence of preexisting interstitial lung disease in patients with non-small lung cancer receiving anti-programmed cell death 1 antibody. Cancer Immunol Immunother. 2019; 69(1):15-22. PMC: 11027879. DOI: 10.1007/s00262-019-02431-8. View

14.

Watadani T, Sakai F, Johkoh T, Noma S, Akira M, Fujimoto K . Interobserver variability in the CT assessment of honeycombing in the lungs. Radiology. 2012; 266(3):936-44. DOI: 10.1148/radiol.12112516. View

15.

Ogawa K, Takahashi Y, Murase K, Hanada S, Uruga H, Takaya H . Treatment outcome of patients with unresectable stage III non-small cell lung cancer and interstitial pneumonia. Respir Investig. 2019; 57(4):388-394. DOI: 10.1016/j.resinv.2019.02.004. View

16.

Otsubo K, Okamoto I, Hamada N, Nakanishi Y . Anticancer drug treatment for advanced lung cancer with interstitial lung disease. Respir Investig. 2018; 56(4):307-311. DOI: 10.1016/j.resinv.2018.03.002. View

17.

Belloli E, Beckford R, Hadley R, Flaherty K . Idiopathic non-specific interstitial pneumonia. Respirology. 2015; 21(2):259-68. DOI: 10.1111/resp.12674. View

18.

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

19.

Kato E, Takayanagi N, Takaku Y, Kagiyama N, Kanauchi T, Ishiguro T . Incidence and predictive factors of lung cancer in patients with idiopathic pulmonary fibrosis. ERJ Open Res. 2018; 4(1). PMC: 5795191. DOI: 10.1183/23120541.00111-2016. View

20.

Akira M, Inoue Y, Kitaichi M, Yamamoto S, Arai T, Toyokawa K . Usual interstitial pneumonia and nonspecific interstitial pneumonia with and without concurrent emphysema: thin-section CT findings. Radiology. 2009; 251(1):271-9. DOI: 10.1148/radiol.2511080917. View