Takumi Sakurada1, Soji Kakiuchi2, Soichiro Tajima3, Yuya Horinouchi4, Naoto Okada4, Hirotaka Nishisako4, Toshimi Nakamura4, Kazuhiko Teraoka4, Kazuyoshi Kawazoe5, Hiroaki Yanagawa6, Yasuhiko Nishioka7, Kazuo Minakuchi5, Keisuke Ishizawa5. 1. Department of Pharmacy, Tokushima University Hospital, Tokushima, Japan sakurada@tokushima-u.ac.jp. 2. Department of Medical Oncology, Institute of Health Biosciences, University of Tokushima Graduate School, Japan Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, University of Tokushima Graduate School, Japan. 3. Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan. 4. Department of Pharmacy, Tokushima University Hospital, Tokushima, Japan. 5. Department of Pharmacy, Tokushima University Hospital, Tokushima, Japan Department of Clinical Pharmacy, Institute of Health Biosciences, University of Tokushima Graduate School, Japan. 6. Clinical Trial Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima, Japan. 7. Department of Respiratory Medicine and Rheumatology, Institute of Health Biosciences, University of Tokushima Graduate School, Japan.
Abstract
BACKGROUND: Drug-induced interstitial lung disease (DILD) is generally a serious adverse effect and almost always necessitates the discontinuation of the offending drug. Cancer pharmacotherapy is strongly associated with DILD, and the risk of DILD has been suggested to be higher in patients with lung cancer because of preexisting pneumonic disease. OBJECTIVE: The aim of this retrospective study was to identify the risk factors and prognostic factors for early death from interstitial lung disease (ILD) induced by chemotherapy for lung cancer. METHODS: The medical records of 459 patients who underwent chemotherapy for lung cancer between April 2007 and March 2013 were analyzed with regard to patient background and DILD development, initial symptoms, and prognosis. RESULTS: A total of 33 patients (7.2%) developed chemotherapy-induced ILD. The most frequently observed initial symptom was dyspnea (94.3%). Preexisting ILD was identified as a risk factor for DILD (odds ratio [OR] = 5.38; 95% CI = 2.47-11.73; P < 0.01). Among the 33 patients who developed DILD, 10 patients suffered an early death despite steroid therapy. Poor prognostic factors included epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) use (OR = 9.26; 95% CI = 1.05-82.0; P < 0.05) and 2 or more prior chemotherapy regimens (OR = 6.95; 95% CI = 1.14-42.3; P < 0.05). CONCLUSIONS: Many lung cancer patients have coexisting ILD, and these patients have a high risk of developing chemotherapy-induced ILD. In addition, patients with DILD who underwent EGFR-TKI therapy and 2 or more prior chemotherapy regimens had a higher risk of fatal outcome.
BACKGROUND: Drug-induced interstitial lung disease (DILD) is generally a serious adverse effect and almost always necessitates the discontinuation of the offending drug. Cancer pharmacotherapy is strongly associated with DILD, and the risk of DILD has been suggested to be higher in patients with lung cancer because of preexisting pneumonic disease. OBJECTIVE: The aim of this retrospective study was to identify the risk factors and prognostic factors for early death from interstitial lung disease (ILD) induced by chemotherapy for lung cancer. METHODS: The medical records of 459 patients who underwent chemotherapy for lung cancer between April 2007 and March 2013 were analyzed with regard to patient background and DILD development, initial symptoms, and prognosis. RESULTS: A total of 33 patients (7.2%) developed chemotherapy-induced ILD. The most frequently observed initial symptom was dyspnea (94.3%). Preexisting ILD was identified as a risk factor for DILD (odds ratio [OR] = 5.38; 95% CI = 2.47-11.73; P < 0.01). Among the 33 patients who developed DILD, 10 patients suffered an early death despite steroid therapy. Poor prognostic factors included epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) use (OR = 9.26; 95% CI = 1.05-82.0; P < 0.05) and 2 or more prior chemotherapy regimens (OR = 6.95; 95% CI = 1.14-42.3; P < 0.05). CONCLUSIONS: Many lung cancerpatients have coexisting ILD, and these patients have a high risk of developing chemotherapy-induced ILD. In addition, patients with DILD who underwent EGFR-TKI therapy and 2 or more prior chemotherapy regimens had a higher risk of fatal outcome.
Authors: Wei Ping Liu; Xiao Pei Wang; Wen Zheng; Yan Xie; Mei Feng Tu; Ning Jing Lin; Ling Yan Ping; Zhi Tao Ying; Chen Zhang; Li Juan Deng; Ning Ding; Xiao Gan Wang; Yu Qin Song; Jun Zhu Journal: Ann Hematol Date: 2017-10-31 Impact factor: 3.673
Authors: Sarah Skeoch; Nicholas Weatherley; Andrew J Swift; Alexander Oldroyd; Christopher Johns; Conal Hayton; Alessandro Giollo; James M Wild; John C Waterton; Maya Buch; Kim Linton; Ian N Bruce; Colm Leonard; Stephen Bianchi; Nazia Chaudhuri Journal: J Clin Med Date: 2018-10-15 Impact factor: 4.241
Authors: Tetsuro Araki; Suzanne E Dahlberg; Tomoyuki Hida; Christine A Lydon; Michael S Rabin; Hiroto Hatabu; Bruce E Johnson; Mizuki Nishino Journal: Eur J Radiol Open Date: 2019-03-29