Outcome Following Nivolumab Treatment in Patients with Advanced Non-small Cell Lung Cancer and Comorbid Interstitial Lung Disease in a Real-world Setting

Overview

Journal Ther Adv Med Oncol

Specialty Oncology

Date 2023 Feb 6

PMID 36743523

Authors

Jean-Baptiste Assie

Christos Chouaid

Hilario Nunes

Dorothee Reynaud

Anne-Francoise Gaudin

Valentine Grumberg

Ronan Jolivel

Baptiste Jouaneton

Francois-Emery Cotte

Boris Duchemann

Affiliations

Soon will be listed here.

Abstract

Background: Up to 10% of patients with advanced non-small cell lung cancer (aNSCLC) have pre-existing interstitial lung disease (ILD). These patients are usually excluded from immunotherapy clinical trials. Consequently, knowledge on outcomes following nivolumab treatment in these patients remains limited. The primary objective of this study was to evaluate survival outcome following nivolumab treatment in ILD patients with pre-treated aNSCLC in the real-world setting.

Patients And Methods: The study included all patients with aNSCLC recorded in the French hospital database, starting nivolumab in 2015-2016. Patients were stratified by pre-existing ILD and three subgroups were studied [auto-immune or granulomatous (AI/G) ILD, other known causes ILD and idiopathic ILD]. Time to discontinuation of nivolumab treatment [time to treatment duration (TTD)] and overall survival (OS) were estimated using Kaplan-Meier survival analysis.

Results: Of 10,452 aNSCLC patients initiating nivolumab, 148 (1.4%) had pre-existing ILD. Mean age at nivolumab initiation was 64.6 ± 9.4 years in ILD and 63.8 ± 9.6 years in non-ILD. Compared to non-ILD, patients in the ILD group were more frequently men ( < 0.05) and had more comorbidities ( < 0.001). There was no significant difference between ILD and non-ILD groups for median TTD (2.5 2.8 months; = 0.6) or median OS (9.6 11.9 months; = 0.1). Median OS in AI/G ILD ( = 14), other known causes ILD ( = 75), and idiopathic ILD ( = 59) were 8.6, 10.7, and 9.6 months, respectively.

Conclusion: In this large cohort of aNSCLC patients with ILD, outcomes are similar to those obtained in the non-ILD population. Immunotherapy could be beneficial for these patients.

Citing Articles

Drug-induced lung disease: a narrative review.

Bridi G, Fonseca E, Kairalla R, Amaral A, Baldi B J Bras Pneumol. 2024; 50(4):e20240110.

PMID: 39356911 PMC: 11449616. DOI: 10.36416/1806-3756/e20240110.

Lung Cancer and Interstitial Lung Diseases.

Drakopanagiotakis F, Krauss E, Michailidou I, Drosos V, Anevlavis S, Gunther A Cancers (Basel). 2024; 16(16).

PMID: 39199608 PMC: 11352559. DOI: 10.3390/cancers16162837.

Treatment and Prognosis of Patients with Lung Cancer and Combined Interstitial Lung Disease.

Mauclet C, Dupont M, Roelandt K, Regnier M, Delos M, Pirard L Cancers (Basel). 2023; 15(15).

PMID: 37568692 PMC: 10417812. DOI: 10.3390/cancers15153876.

References

Nabel C, Severgnini M, Hung Y, Cunningham-Bussel A, Gjini E, Kleinsteuber K . Anti-PD-1 Immunotherapy-Induced Flare of a Known Underlying Relapsing Vasculitis Mimicking Recurrent Cancer. Oncologist. 2019; 24(8):1013-1021. PMC: 6693726. DOI: 10.1634/theoncologist.2018-0633. View

Haratani K, Hayashi H, Chiba Y, Kudo K, Yonesaka K, Kato R . Association of Immune-Related Adverse Events With Nivolumab Efficacy in Non-Small-Cell Lung Cancer. JAMA Oncol. 2017; 4(3):374-378. PMC: 6583041. DOI: 10.1001/jamaoncol.2017.2925. View

Yamakawa H, Oba T, Ohta H, Tsukahara Y, Kida G, Tsumiyama E . Nintedanib allows retreatment with atezolizumab of combined non-small cell lung cancer/idiopathic pulmonary fibrosis after atezolizumab-induced pneumonitis: a case report. BMC Pulm Med. 2019; 19(1):156. PMC: 6704625. DOI: 10.1186/s12890-019-0920-9. View

Ni K, Liu M, Zheng J, Wen L, Chen Q, Xiang Z . PD-1/PD-L1 Pathway Mediates the Alleviation of Pulmonary Fibrosis by Human Mesenchymal Stem Cells in Humanized Mice. Am J Respir Cell Mol Biol. 2017; 58(6):684-695. DOI: 10.1165/rcmb.2017-0326OC. View

Defossez G, Uhry Z, Delafosse P, Dantony E, dAlmeida T, Plouvier S . Cancer incidence and mortality trends in France over 1990-2018 for solid tumors: the sex gap is narrowing. BMC Cancer. 2021; 21(1):726. PMC: 8223369. DOI: 10.1186/s12885-021-08261-1. View

Giaj Levra M, Cotte F, Corre R, Calvet C, Gaudin A, Penrod J . Immunotherapy rechallenge after nivolumab treatment in advanced non-small cell lung cancer in the real-world setting: A national data base analysis. Lung Cancer. 2020; 140:99-106. DOI: 10.1016/j.lungcan.2019.12.017. View

Ikeda S, Kato T, Kenmotsu H, Ogura T, Sato Y, Hino A . Atezolizumab for Pretreated Non-Small Cell Lung Cancer with Idiopathic Interstitial Pneumonia: Final Analysis of Phase II AMBITIOUS Study. Oncologist. 2022; 27(9):720-e702. PMC: 9438913. DOI: 10.1093/oncolo/oyac118. View

Yamaguchi T, Shimizu J, Hasegawa T, Horio Y, Inaba Y, Yatabe Y . Pre-existing pulmonary fibrosis is a risk factor for anti-PD-1-related pneumonitis in patients with non-small cell lung cancer: A retrospective analysis. Lung Cancer. 2018; 125:212-217. DOI: 10.1016/j.lungcan.2018.10.001. View

Duchemann B, Remon J, Naigeon M, Cassard L, Jouniaux J, Boselli L . Current and future biomarkers for outcomes with immunotherapy in non-small cell lung cancer. Transl Lung Cancer Res. 2021; 10(6):2937-2954. PMC: 8264336. DOI: 10.21037/tlcr-20-839. View

10.

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

11.

Leonardi G, Gainor J, Altan M, Kravets S, Dahlberg S, Gedmintas L . Safety of Programmed Death-1 Pathway Inhibitors Among Patients With Non-Small-Cell Lung Cancer and Preexisting Autoimmune Disorders. J Clin Oncol. 2018; 36(19):1905-1912. PMC: 6553840. DOI: 10.1200/JCO.2017.77.0305. View

12.

Vu A, Vassallo R, Ryu J . Exacerbation of Previously Undiagnosed Bird Fancier's Lung by Pembrolizumab Therapy. Chest. 2019; 155(4):e79-e82. DOI: 10.1016/j.chest.2018.12.002. View

13.

Fujimoto D, Sato Y, Morimoto T, Uehara K, Ito M, Otsuka K . Programmed Cell Death Ligand 1 Expression in Non-Small-cell Lung Cancer Patients With Interstitial Lung Disease: A Matched Case-control Study. Clin Lung Cancer. 2018; 19(5):e667-e673. DOI: 10.1016/j.cllc.2018.04.012. View

14.

Shibaki R, Murakami S, Matsumoto Y, Goto Y, Kanda S, Horinouchi H . Tumor expression and usefulness as a biomarker of programmed death ligand 1 in advanced non-small cell lung cancer patients with preexisting interstitial lung disease. Med Oncol. 2019; 36(6):49. DOI: 10.1007/s12032-019-1274-0. View

15.

Brown S, Padilla M, Mhango G, Powell C, Salvatore M, Henschke C . Interstitial Lung Abnormalities and Lung Cancer Risk in the National Lung Screening Trial. Chest. 2019; 156(6):1195-1203. DOI: 10.1016/j.chest.2019.06.041. View

16.

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

17.

Borghaei H, Gettinger S, Vokes E, Chow L, Burgio M, de Castro Carpeno J . Five-Year Outcomes From the Randomized, Phase III Trials CheckMate 017 and 057: Nivolumab Versus Docetaxel in Previously Treated Non-Small-Cell Lung Cancer. J Clin Oncol. 2021; 39(7):723-733. PMC: 8078445. DOI: 10.1200/JCO.20.01605. View

18.

Debieuvre D, Juergens R, Asselain B, Audigier-Valette C, Auliac J, Barlesi F . Two-year survival with nivolumab in previously treated advanced non-small-cell lung cancer: A real-world pooled analysis of patients from France, Germany, and Canada. Lung Cancer. 2021; 157:40-47. DOI: 10.1016/j.lungcan.2021.04.022. View

19.

Sibille A, Alfieri R, Malaise O, Detrembleur N, Pirotte M, Louis R . Granulomatosis With Polyangiitis in a Patient on Programmed Death-1 Inhibitor for Advanced Non-small-cell Lung Cancer. Front Oncol. 2019; 9:478. PMC: 6562339. DOI: 10.3389/fonc.2019.00478. View

20.

Naccache J, Gibiot Q, Monnet I, Antoine M, Wislez M, Chouaid C . Lung cancer and interstitial lung disease: a literature review. J Thorac Dis. 2018; 10(6):3829-3844. PMC: 6051867. DOI: 10.21037/jtd.2018.05.75. View