Impact of COPD Treatment on Survival in Patients with Advanced Non-Small Cell Lung Cancer

Abstract

Chronic obstructive pulmonary disease (COPD) is associated with a poor prognosis in patients with non-small cell lung cancer (NSCLC). However, the impact of COPD treatment on the survival of patients with advanced NSCLC remains uncertain. We retrospectively investigated COPD patients among patients newly diagnosed with advanced NSCLC between September 2005 and August 2019 at a university hospital. The clinical characteristics, lung function, and survival outcomes were analyzed and compared between patients who did and did not receive COPD treatment. Among 221 patients with advanced NSCLC and COPD, 124 patients received treatment for COPD and 97 patients did not receive treatment for COPD. Forced expiratory volume in 1 s (FEV1) % predicted value was greater in the no-treatment group than in the COPD treatment group (p < 0.001). The median overall survival (OS) of the treatment group was 10.7 months, while that of the no-treatment group was 8.7 months (p = 0.007). In the multivariate analysis, COPD treatment was independently associated with improved OS (hazard ratio 0.71, 95% confidence interval 0.53−0.95, and p = 0.021). COPD treatment was associated with improved OS in patients with advanced NSCLC and COPD. Therefore, pretreatment spirometry and maximal treatment for COPD may offer a chance of optimal management for patients with advanced NSCLC.

Keywords: bronchodilator; chronic obstructive pulmonary disease; inhaled corticosteroids; non-small cell lung cancer; survival.

Figure 1

Study design. COPD, chronic obstructive pulmonary disease; SCLC, small cell lung cancer; PFT, pulmonary function test; NSCLC, non-small cell lung cancer; TKI, tyrosine kinase inhibitor.

Figure 2

Kaplan–Meier curves of overall survival of advanced NCSLC: (A) Overall survival curves by COPD treatment; (B) overall survival curves by use of inhaler; (C) overall survival curves by use of ICS; (D) overall survival curves by use of theophylline.