Idiopathic Pulmonary Fibrosis Diagnosed Concomitantly with Diffuse Squamous Cell Lung Cancer on Surgical Lung Biopsy: A case Report

Overview

Journal J Med Case Rep

Publisher Biomed Central

Specialty General Medicine

Date 2021 Dec 15

PMID 34906240

Citations 1

Authors

C Niel

C Ricordel

T Guy

M Kerjouan

B De Latour

D Chiforeanu

M Lederlin

S Jouneau

Affiliations

Soon will be listed here.

Abstract

Background: Idiopathic pulmonary fibrosis is a disease with a poor prognosis and has been associated with increased lung cancer incidence.

Case Presentation: We report the case of a Caucasian 75-year-old woman, a former smoker, hospitalized for breathlessness with a chest computed tomography scan showing an interstitial lung disease. A surgical lung biopsy was performed, confirming a pattern of usual interstitial pneumonia but also numerous disseminated foci of well-differentiated focally invasive squamous cell carcinoma without hypermetabolic lung nodule, mass, or enlarged lymph node visualized on chest computed tomography or positron emission tomography scan. Nintedanib was started for its antifibrotic and antitumor properties, without any other antineoplastic treatment. Three years after initiation of nintedanib, clinical, functional, and computed tomography scan evaluations were stable, and there was no evidence for evolution of the squamous cell carcinoma.

Conclusions: Data are scarce regarding the benefit of nintedanib in patients with idiopathic pulmonary fibrosis-associated lung cancer, and it is unclear whether nintedanib could have a preventive role in lung carcinogenesis in idiopathic pulmonary fibrosis patients. This experience could help the scientific community in case of similar incidental findings.

Citing Articles

Electrochemical Biosensors Based on Carbon Nanomaterials for Diagnosis of Human Respiratory Diseases.

Li C, Che B, Deng L Biosensors (Basel). 2023; 13(1).

PMID: 36671847 PMC: 9855565. DOI: 10.3390/bios13010012.

References

Ozawa Y, Suda T, Naito T, Enomoto N, Hashimoto D, Fujisawa T . Cumulative incidence of and predictive factors for lung cancer in IPF. Respirology. 2009; 14(5):723-8. DOI: 10.1111/j.1440-1843.2009.01547.x. View

Wind S, Schmid U, Freiwald M, Marzin K, Lotz R, Ebner T . Clinical Pharmacokinetics and Pharmacodynamics of Nintedanib. Clin Pharmacokinet. 2019; 58(9):1131-1147. PMC: 6719436. DOI: 10.1007/s40262-019-00766-0. View

Karampitsakos T, Tzilas V, Tringidou R, Steiropoulos P, Aidinis V, Papiris S . Lung cancer in patients with idiopathic pulmonary fibrosis. Pulm Pharmacol Ther. 2017; 45:1-10. DOI: 10.1016/j.pupt.2017.03.016. View

Otsubo K, Kishimoto J, Kenmotsu H, Minegishi Y, Ichihara E, Shiraki A . Treatment Rationale and Design for J-SONIC: A Randomized Study of Carboplatin Plus Nab-paclitaxel With or Without Nintedanib for Advanced Non-Small-cell Lung Cancer With Idiopathic Pulmonary Fibrosis. Clin Lung Cancer. 2017; 19(1):e5-e9. DOI: 10.1016/j.cllc.2017.06.003. View

Hanna N, Kaiser R, Sullivan R, Aren O, Ahn M, Tiangco B . Nintedanib plus pemetrexed versus placebo plus pemetrexed in patients with relapsed or refractory, advanced non-small cell lung cancer (LUME-Lung 2): A randomized, double-blind, phase III trial. Lung Cancer. 2016; 102:65-73. DOI: 10.1016/j.lungcan.2016.10.011. View

Brown S, Dobelle M, Padilla M, Agovino M, Wisnivesky J, Hashim D . Idiopathic Pulmonary Fibrosis and Lung Cancer. A Systematic Review and Meta-analysis. Ann Am Thorac Soc. 2019; 16(8):1041-1051. DOI: 10.1513/AnnalsATS.201807-481OC. View

Tzouvelekis A, Gomatou G, Bouros E, Trigidou R, Tzilas V, Bouros D . Common Pathogenic Mechanisms Between Idiopathic Pulmonary Fibrosis and Lung Cancer. Chest. 2019; 156(2):383-391. DOI: 10.1016/j.chest.2019.04.114. View

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

Watanabe Y, Kawabata Y, Koyama N, Ikeya T, Hoshi E, Takayanagi N . A clinicopathological study of surgically resected lung cancer in patients with usual interstitial pneumonia. Respir Med. 2017; 129:158-163. DOI: 10.1016/j.rmed.2017.06.015. View

10.

Ballester B, Milara J, Cortijo J . Idiopathic Pulmonary Fibrosis and Lung Cancer: Mechanisms and Molecular Targets. Int J Mol Sci. 2019; 20(3). PMC: 6387034. DOI: 10.3390/ijms20030593. View

11.

Reck M, Kaiser R, Mellemgaard A, Douillard J, Orlov S, Krzakowski M . Docetaxel plus nintedanib versus docetaxel plus placebo in patients with previously treated non-small-cell lung cancer (LUME-Lung 1): a phase 3, double-blind, randomised controlled trial. Lancet Oncol. 2014; 15(2):143-55. DOI: 10.1016/S1470-2045(13)70586-2. View

12.

Raghu G, Rochwerg B, Zhang Y, Garcia C, Azuma A, Behr J . An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline: Treatment of Idiopathic Pulmonary Fibrosis. An Update of the 2011 Clinical Practice Guideline. Am J Respir Crit Care Med. 2015; 192(2):e3-19. DOI: 10.1164/rccm.201506-1063ST. View