Protective effect of bevacizumab on chemotherapy-related acute exacerbation of interstitial lung disease in patients with advanced non-squamous non-small cell lung cancer

Autor: Sho Saeki, Takeshi Yoshinaga, Yusuke Tomita, Koichi Saruwatari, Kimitaka Akaike, Nahoko Sato, Shohei Hamada, Kazuhiko Fujii, Megumi Inaba, Hiroko Okabayashi, Tomoki Sadamatsu, Tokunori Ikeda, Naomi Hirata, Hidenori Ichiyasu, Kosuke Kashiwabara
Rok vydání: 2019
Předmět:
Male
Oncology
Lung Neoplasms
Exacerbation
medicine.medical_treatment
chemistry.chemical_compound
0302 clinical medicine
Japan
Non-small cell lung cancer
Risk Factors
Carcinoma
Non-Small-Cell Lung
Antineoplastic Combined Chemotherapy Protocols
030212 general & internal medicine
Interstitial lung disease
Middle Aged
respiratory system
Bevacizumab
Acute exacerbation
Pemetrexed
Disease Progression
Female
Research Article
medicine.drug
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Antibodies
Monoclonal
Humanized
behavioral disciplines and activities
Disease-Free Survival
03 medical and health sciences
Internal medicine
medicine
Humans
Lung cancer
Aged
Retrospective Studies
lcsh:RC705-779
Chemotherapy
business.industry
lcsh:Diseases of the respiratory system
medicine.disease
Carboplatin
respiratory tract diseases
body regions
Regimen
030228 respiratory system
chemistry
Vascular endothelial growth factor
Lung Diseases
Interstitial
business
Zdroj: BMC Pulmonary Medicine, Vol 19, Iss 1, Pp 1-10 (2019)
BMC Pulmonary Medicine
ISSN: 1471-2466
DOI: 10.1186/s12890-019-0838-2
Popis: Background Acute exacerbation of interstitial lung disease (AE-ILD) is the most serious complication in lung cancer patients with pre-existing ILD receiving chemotherapy. The role of vascular endothelial growth factor (VEGF) in pathogenesis of AE-ILD is conflicting. The influence of bevacizumab (Bev), a monoclonal antibody against VEGF, on lung cancer patients with pre-existing ILD remains unclear. We examined the effect of Bev on reducing AE-ILD risk in non-squamous non-small cell lung cancer (NSCLC) patients receiving chemotherapy. Methods We analysed incidence of AE-ILD and outcomes of 48 patients with advanced non-squamous NSCLC with ILD who received first-line chemotherapy with (Bev group, n = 17) and without (non-Bev group, n = 31) Bev between July 2011 and July 2016. Gray’s test, which was competing risk analysis during the study period, was performed for both groups. Results The most common regimen used for first-line chemotherapy was the combination of carboplatin plus pemetrexed (PEM) in both groups. The incidences of chemotherapy-related AE-ILD 120 days after first-line chemotherapy initiation were significantly lower in the Bev than in the non-Bev groups (0% vs. 22.6%, p = 0.037, Gray’s test). However, there were no differences in development of progressive disease of lung cancer and other events as the competing risk factors of AE-ILD between the two groups. Only patients receiving PEM-containing regimens also showed a significant difference in the incidence of AE-ILD between the two groups (p = 0.044). The overall-cumulative incidence of AE-ILD during the first-line and subsequent chemotherapy was 29.2% (14 of the 48). The median progression-free survival was significantly longer in the Bev than in the non-Bev groups (8.0 vs. 4.3 months, p = 0.026). Conclusions The addition of Bev to chemotherapy regimens may reduce the risk of chemotherapy-related AE-ILD in patients with lung cancer. Electronic supplementary material The online version of this article (10.1186/s12890-019-0838-2) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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