Efficacy and safety of nivolumab in non-small cell lung cancer with preexisting interstitial lung disease

Autor: Osamu Kanai, Masaya Akai, Hironori Yoshida, Kohei Fujita, Tsuyoshi Ito, Tadashi Mio, Young Hak Kim, Makiko Kanai, Yoshiki Demura, Toyohiro Hirai
Rok vydání: 2018
Předmět:
Zdroj: Thoracic Cancer. 9:847-855
ISSN: 1759-7706
DOI: 10.1111/1759-7714.12759
Popis: Background The risk of developing lung cancer is high in patients with interstitial lung disease (ILD), as few treatment options are available. Immune checkpoint inhibitors (ICI) are used for the treatment of non-small cell lung cancer (NSCLC) in clinical practice; however, in patients with preexisting ILD, the risk of ICI-related pneumonitis is unknown. We evaluated the efficacy and lung toxicity of nivolumab in patients with NSCLC and ILD. Methods We retrospectively reviewed the medical records of 216 NSCLC patients who had received nivolumab therapy. The existence of ILD in these patients was determined by lung computed tomography findings; 26 patients had ILD. We evaluated the efficacy of nivolumab by measuring the response rate (RR), progression-free survival (PFS) duration, and lung toxicity by incidence, severity, and outcome of nivolumab-related ILD. Results The RR and median PFS of the ILD and non-ILD groups were 27% versus 13% (P = 0.078) and 2.7 (95% confidence interval [CI], 1.7-5.3) versus 2.9 months (95% CI 2.1-3.4; P = 0.919), respectively. The incidences of total and severe nivolumab-related pneumonitis were significantly higher in the ILD group than in the non-ILD group (31% vs. 12%, P = 0.014 and 19% vs. 5%, P = 0.022, respectively). No death from nivolumab-related pneumonitis occurred. Over 50% of the patients in both groups with nivolumab-related pneumonitis showed improvement over time. Conclusion Relative to the non-ILD group, nivolumab-related pneumonitis was observed more frequently in the ILD group; however, most cases were manageable.
Databáze: OpenAIRE
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