Drug-induced interstitial lung disease after chemoimmunotherapy for extensive-stage small cell lung cancer.

Autor:	Fukuda K; Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan., Katsurada N; Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan., Kawa Y; Department of Thoracic Oncology, Hyogo Cancer Center, Japan., Satouchi M; Department of Thoracic Oncology, Hyogo Cancer Center, Japan., Kaneshiro K; Department of Respiratory Medicine, Kita-harima Medical Center, Japan., Matsumoto M; Department of Respiratory Medicine, Kita-harima Medical Center, Japan., Takamiya R; Department of Respiratory Medicine, Akashi Medical Center, Japan., Hatakeyama Y; Department of Respiratory Medicine, Akashi Medical Center, Japan., Dokuni R; Department of Respiratory Medicine, Hyogo Prefectural Awaji Medical Center, Japan., Matsumura K; Department of Respiratory Medicine, Takatsuki General Hospital, Japan., Katsurada M; Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, Japan., Nakata K; Department of Respiratory Medicine, Konan Medical Center, Japan., Yoshimura S; Department of Respiratory Medicine, Steel Memorial Hirohata Hospital, Japan., Tachihara M; Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan.
Jazyk:	angličtina
Zdroj:	Heliyon [Heliyon] 2023 Sep 26; Vol. 9 (10), pp. e20463. Date of Electronic Publication: 2023 Sep 26 (Print Publication: 2023).
DOI:	10.1016/j.heliyon.2023.e20463
Abstrakt:	Objectives: The combination of chemotherapy and immune checkpoint inhibitors (chemo-ICI) has become the new standard of treatment for extensive-stage small cell lung cancer (ES-SCLC). Recently, slight changes in interstitial shadows, defined as interstitial lung abnormalities (ILA), have been identified. In patients with ES-SCLC who received chemo-ICI, there are limited data on the incidence of drug-induced interstitial lung disease (D-ILD) in daily practice and the association between the development of D-ILD and ILA in the baseline computed tomography (CT). Materials and Methods: A multicenter, retrospective study was conducted to investigate the incidence of D-ILD, the risk factors for developing D-ILD, progression-free survival (PFS), and overall survival (OS) in patients with ES-SCLC who received chemo-ICI between August 2019 and November 2021. Results: This study enrolled 70 patients (median age, 71 years; including 58 men) from nine institutions in Japan. There were 62 patients (89%) treated with carboplatin/etoposide/atezolizumab and 8 patients treated with carboplatin or cisplatin/etoposide/durvalumab. Twenty-nine patients (41.4%) were found to have ILA at baseline CT. Eleven patients (15.7%) developed D-ILD. The proportion of patients with ILA was significantly higher in the group who developed D-ILD than in the group who did not (9/11 (81.8%) vs. 20/59 (33.9%), respectively, P = 0.0057). In addition, the frequency of ground glass attenuation (GGA) and reticulation was higher in patients who developed D-ILD. There was no significant difference in PFS and OS between patients who developed D-ILD and those who did not (median PFS, 8.0 (95% confidence interval (CI), 5.5-9.5) months vs. 5.0 (95% CI, 4.5-5.6) months, respectively, P = 0.11 and median OS, not reached (NR) (95% CI, 8.7-NR) vs. 18.2 (95% CI, 13.2-NR) months, respectively, P = 0.20). Conclusion: The incidence of D-ILD in patients with ES-SCLC who received chemo-ICI in clinical practice was higher than that in clinical trials. Patients with pre-existing ILA were more likely to develop D-ILD. Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Matters requiring disclosure of COI with regard to our presentation are lecture fee by Chugai Pharmaceutical Co Ltd and research expenses from company by AstraZeneca. (© 2023 The Authors. Published by Elsevier Ltd.)
Databáze:	MEDLINE
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