Acute exacerbation of idiopathic interstitial pneumonias related to chemotherapy for lung cancer: nationwide surveillance in Japan

Yuji Minegishi¹, Akihiko Gemma¹, Sakae Homma², Kazuma Kishi³, Arata Azuma¹, Takashi Ogura⁴, Naoki Hamada⁵, Hiroyuki Taniguchi⁶, Noboru Hattori⁷, Yasuhiko Nishioka⁸, Kiminobu Tanizawa⁹, Takeshi Johkoh¹⁰, Takuma Yokoyama¹¹, Kazutaka Mori¹², Yoshio Taguchi¹³, Masahito Ebina¹⁴, Naohiko Inase¹⁵, Koichi Hagiwara¹⁶, Hiroshi Ohnishi¹⁷, Hiroshi Mukae¹⁸, Yoshikazu Inoue¹⁹, Kazuyoshi Kuwano²⁰, Hirofumi Chiba²¹, Ken Ohta²², Yoshinori Tanino²³, Fumikazu Sakai²⁴, Yukihiko Sugiyama²⁵

Affiliations

¹ Dept of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
² Dept of Respiratory Medicine, Toho University Graduate School of Medicine, Tokyo, Japan.
³ Dept of Respiratory Medicine, Respiratory Center Toranomon Hospital, Tokyo, Japan.
⁴ Dept of Respiratory medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan.
⁵ Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
⁶ Dept of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, Aichi, Japan.
⁷ Dept of Molecular and Internal Medicine Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
⁸ Dept of Respiratory Medicine and Rheumatology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan.
⁹ Dept of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
¹⁰ Dept of Radiology, Kinki Central Hospital of Mutual Aid Association of Public Teachers, Hyogo, Japan.
¹¹ Dept of Respiratory Medicine, Kyorin University School of Medicine, Tokyo, Japan.
¹² Second Dept of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan.
¹³ Dept of Respiratory Medicine, Tenri Hospital, Tenri, Japan.
¹⁴ Tohoku Medical and Pharmaceutical University School of Medicine, Dept of Respiratory Medicine, Sendai, Japan.
¹⁵ Tokyo Medical and Dental University, Tokyo, Japan.
¹⁶ Division of Pulmonary Medicine, Jichi Medical University, Shimono, Japan.
¹⁷ Dept of Hematology and Respiratory Medicine, Kochi Medical School, Kochi University, Kochi, Japan.
¹⁸ Dept of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
¹⁹ Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan.
²⁰ Division of Respiratory Diseases, Dept of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
²¹ Dept of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo, Japan.
²² Japan Anti-Tuberculosis Association Fukujuji Hospital, Tokyo, Japan.
²³ Dept of Pulmonary Medicine, Fukushima Medical University, Fukushima, Japan.
²⁴ Dept of Diagnostic Radiology, Saitama International Medical Center, Saitama Medical University, Saitama, Japan.
²⁵ Nerima-Hikarigaoka Hospital, Tokyo, Japan.

PMID: 32494570
PMCID: PMC7248335
DOI: 10.1183/23120541.00184-2019

Acute exacerbation of idiopathic interstitial pneumonias related to chemotherapy for lung cancer: nationwide surveillance in Japan

Yuji Minegishi et al. ERJ Open Res. 2020.

. 2020 May 26;6(2):00184-2019.

doi: 10.1183/23120541.00184-2019. eCollection 2020 Apr.

Authors

Affiliations

¹ Dept of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
² Dept of Respiratory Medicine, Toho University Graduate School of Medicine, Tokyo, Japan.
³ Dept of Respiratory Medicine, Respiratory Center Toranomon Hospital, Tokyo, Japan.
⁴ Dept of Respiratory medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan.
⁵ Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
⁶ Dept of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, Aichi, Japan.
⁷ Dept of Molecular and Internal Medicine Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
⁸ Dept of Respiratory Medicine and Rheumatology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan.
⁹ Dept of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
¹⁰ Dept of Radiology, Kinki Central Hospital of Mutual Aid Association of Public Teachers, Hyogo, Japan.
¹¹ Dept of Respiratory Medicine, Kyorin University School of Medicine, Tokyo, Japan.
¹² Second Dept of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan.
¹³ Dept of Respiratory Medicine, Tenri Hospital, Tenri, Japan.
¹⁴ Tohoku Medical and Pharmaceutical University School of Medicine, Dept of Respiratory Medicine, Sendai, Japan.
¹⁵ Tokyo Medical and Dental University, Tokyo, Japan.
¹⁶ Division of Pulmonary Medicine, Jichi Medical University, Shimono, Japan.
¹⁷ Dept of Hematology and Respiratory Medicine, Kochi Medical School, Kochi University, Kochi, Japan.
¹⁸ Dept of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
¹⁹ Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan.
²⁰ Division of Respiratory Diseases, Dept of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
²¹ Dept of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo, Japan.
²² Japan Anti-Tuberculosis Association Fukujuji Hospital, Tokyo, Japan.
²³ Dept of Pulmonary Medicine, Fukushima Medical University, Fukushima, Japan.
²⁴ Dept of Diagnostic Radiology, Saitama International Medical Center, Saitama Medical University, Saitama, Japan.
²⁵ Nerima-Hikarigaoka Hospital, Tokyo, Japan.

PMID: 32494570
PMCID: PMC7248335
DOI: 10.1183/23120541.00184-2019

Abstract

Background: Chemotherapy-induced acute exacerbation (AEx) of idiopathic interstitial pneumonias (IIPs) seriously compromises the success of treatment of Japanese lung cancer patients. Here, we conducted a nationwide surveillance to clarify the risk of AEx and compare it with the survival benefit of chemotherapy for this population.

Methods: Advanced nonsmall cell lung cancer (NSCLC) or small cell lung cancer (SCLC) patients with IIPs were retrospectively analysed. For the surveillance of first-line chemotherapy in 2009, we gathered clinical data from 396 patients who received chemotherapy at 19 institutions between January 1990 and July 2009. In a consecutive retrospective study in 2012, we analysed data from 278 patients from 17 institutions who received second-line chemotherapy between April 2002 and March 2012.

Results: Of the 396 patients analysed, 13.1% developed chemotherapy-related AEx. Combination chemotherapies of carboplatin plus paclitaxel (CP) or carboplatin plus etoposide (CE) were frequently used as first-line treatments. The lowest incidence of AEx was 3.7% in CE, followed by 8.6% in CP. In the retrospective study, 16.2% of the 278 patients developed a second-line chemotherapy-related AEx. The overall response rate by second-line chemotherapy was 7.4% in NSCLC and 25.7% in SCLC. The median overall survival from second-line and first-line chemotherapy was 8.0 and 14.3 months in NSCLC, and 8.7 and 16.0 months in SCLC, respectively.

Conclusion: Combination chemotherapies consisting of CP or CE are candidates for standard first-line treatments for patients with advanced lung cancer accompanied by IIP. Second-line chemotherapy should be considered for patients remaining fit enough to receive it.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: Y. Minegishi has nothing to disclose. Conflict of interest: A. Gemma reports grants from the Ministry of Health, Labour and Welfare, Japan, during the conduct of the study; honoraria from Boehringer Ingelheim Japan, Inc., research funding and honoraria from Ono Pharmaceutical Co., Ltd, consulting fees and honoraria from MSD K.K., a subsidiary of Merck & Co., Inc., and an honorarium from AstraZeneca K.K., outside the submitted work. Conflict of interest: S. Homma reports research funding and an honorarium from Boehringer Ingelheim Japan, Inc. Conflict of interest: K. Kishi reports grants and personal fees from Chugai, Ono and Boehringer Ingelheim, grants from Eli Lily, and personal fees from MSD and AstraZeneca, outside the submitted work. Conflict of interest: A. Azuma reports a consulting fee and an honorarium from Boehringer Ingelheim Japan, Inc., outside the submitted work. Conflict of interest: T. Ogura reports honoraria from Ono Pharmaceutical Co., Ltd, Taiho Pharmaceutical Co., Ltd, and Boehringer Ingelheim Japan, Inc., outside the submitted work. Conflict of interest: N. Hamada has research funding and an honorarium from Boehringer Ingelheim Japan, Inc., outside the submitted work. Conflict of interest: H. Taniguchi reports honoraria from Boehringer Ingelheim Japan, Inc., Asahi Kasei Pharma Corp., AstraZeneca K.K. and Kyorin Pharmaceutical Co., Ltd., outside the submitted work. Conflict of interest: N. Hattori reports grants from Taiho Pharmaceutical Co., Ltd, Eli Lilly Japan K.K., Daiichi Sankyo Co., Ltd, and Kyowa Hakko Kirin Co., Ltd, outside the submitted work. Conflict of interest: Y. Nishioka reports grants from the Ministry of Health, Labour and Welfare, Japan, during the conduct of the study; an honorarium from AstraZeneca K.K., and research funds and honoraria from Taiho Pharmaceutical Co., Ltd, Chugai Pharmaceutical Co., Ltd, Eli Lilly Japan K.K., MSD K.K., Ono Pharmaceutical Co., Ltd. and Pfizer K.K., outside the submitted work. Conflict of interest: K. Tanizawa reports that the Dept of Respiratory Care and Sleep Control Medicine at Kyoto University is funded by endowments from Philips Respironics, Teijin Pharma Ltd., Fukuda Denshi Inc., and Fukuda Lifetec Keiji; and personal fees from Ono Pharmaceutical Co., Ltd, Kyowa Hakko Kirin Co., Ltd, Eizai Co., Ltd, Shionogi & Co., Ltd, Actelion Pharmaceutical Co., Ltd, MSD, and Boehringer Ingelheim GmbH, outside the submitted work. Conflict of interest: T. Johkoh has nothing to disclose. Conflict of interest: T. Yokoyama has nothing to disclose. Conflict of interest: K. Mori has nothing to disclose. Conflict of interest: Y. Taguchi has nothing to disclose. Conflict of interest: M. Ebina has nothing to disclose. Conflict of interest: N. Inase has nothing to disclose. Conflict of interest: K. Hagiwara has nothing to disclose. Conflict of interest: H. Ohnishi reports honoraria from AstraZeneca K.K., Boehringer Ingelheim Japan, Inc., Chugai Pharmaceutical Co., Ltd, Ono Pharmaceutical Co., Ltd, and Taiho Pharma, outside the submitted work. Conflict of interest: H. Mukae reports grants and lecture honoraia from Daiichi Sankyo, MSD, Sumitomo Dainippon Pharma, Taisho Toyama Pharmaceutical, Astellas Pharma, Boehringer Ingelheim and Shionogi; grants from Taiho Pharmaceutical, Ono Pharmaceutical, Takeda Pharmaceutical, Eli Lilly Japan, Novartis Pharma, Fujifilm Pharma, Meiji Seika Pharma, Toyama Chemical, Eisai and Chugai Pharmaceutical; and lecture honoraria from Pfizer, Kyorin Pharmaceutical and AstraZeneca, outside the submitted work. Conflict of interest: Y. Inoue reports board member and lecture fees from Boehringer Ingelheim and Shionogi & Co., Ltd, and research funding from Ono Pharmaceutical Co., outside the submitted work. Conflict of interest: K. Kuwano reports research funding and honoraria from Boehringer Ingelheim Japan, Inc., and Ono Pharmaceutical Co., Ltd; honoraria from MSD K.K., a subsidiary of Merck & Co., Inc, AstraZeneca K.K., Pfizer and Daiichisankyo; and research funding from GlaxoSmithKline, outside the submitted work. Conflict of interest: H. Chiba has nothing to disclose. Conflict of interest: K. Ohta has nothing to disclose. Conflict of interest: Y. Tanino reports an honorarium from Boehringer Ingelheim Japan, Inc., and research funding from Eli Lilly Japan K.K., Novartis, MSD K.K. and Shionogi & Co., Ltd, outside the submitted work. Conflict of interest: F. Sakai reports personal fees from AstraZeneca, Ono Pharamaceuticals Co. Ltd., Chugai Pharamaceuticals Co. Ltd., Merck Co. Ltd, Rosch Co. Ltd and Boehringer Co. Ltd, outside the submitted work. Conflict of interest: Y. Sugiyama has nothing to disclose.

Figures

**FIGURE 1**
Overall survival (OS) a and b) from second-line chemotherapy and c and d) from first-line chemotherapy of a and c) nonsmall cell lung cancer (NSCLC) and b and d) small cell lung cancer (SCLC), respectively. MST: median survival time.

See this image and copyright information in PMC

References

1. Turner-Warwick M, Lebowitz M, Burrows B, et al. . Cryptogenic fibrosing alveolitis and lung cancer. Thorax 1980; 35: 496–499. doi:10.1136/thx.35.7.496 - DOI - PMC - PubMed
1. Hubbard R, Venn A, Lewis S, et al. . Lung cancer and cryptogenic fibrosing alveolitis. A population-based cohort study. Am J Respir Crit Care Med 2000; 161: 5–8. doi:10.1164/ajrccm.161.1.9906062 - DOI - PubMed
1. Ozawa Y, Suda T, Naito T, et al. . Cumulative incidence of and predictive factors for lung cancer in IPF. Respirology 2009; 14: 723–728. doi:10.1111/j.1440-1843.2009.01547.x - DOI - PubMed
1. Kawasaki H, Nagai K, Yokose T, et al. . Clinicopathological characteristics of surgically resected lung cancer associated with idiopathic pulmonary fibrosis. Surg Oncol 2001; 76: 53–57. doi:10.1002/1096-9098(200101)76:1<53::AID-JSO1009>3.0.CO;2-T - DOI - PubMed
1. Samet JM. Does idiopathic pulmonary fibrosis increase lung cancer risk? Am J Respir Crit Care Med 2000; 161: 1–2. doi:10.1164/ajrccm.161.5.16154 - DOI - PubMed

LinkOut - more resources

Full Text Sources
- Europe PubMed Central
- PubMed Central
Miscellaneous
- NCI CPTAC Assay Portal

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Acute exacerbation of idiopathic interstitial pneumonias related to chemotherapy for lung cancer: nationwide surveillance in Japan

Affiliations

Acute exacerbation of idiopathic interstitial pneumonias related to chemotherapy for lung cancer: nationwide surveillance in Japan

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

LinkOut - more resources

Full Text Sources

Miscellaneous