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Translational lung cancer research
Jul, 2021;10 (7): 3132-3143.

Subsequent systemic therapy for non-small cell lung cancer patients with immune checkpoint inhibitor-related interstitial lung disease.

Yusuke Sato, Satoshi Watanabe, Takeshi Ota, Kohei Kushiro, Toshiya Fujisaki, Miho Takahashi, Aya Ohtsubo, Satoshi Shoji, Koichiro Nozaki, Kosuke Ichikawa, Satoshi Hokari, Rie Kondo, Masachika Hayashi, Hiroyuki Ishikawa, Takao Miyabayashi, Tetsuya Abe, Satoru Miura, Hiroshi Tanaka, Masaaki Okajima, Masaki Terada, Takashi Ishida, Akira Iwashima, Kazuhiro Sato, Hirohisa Yoshizawa, Nobumasa Aoki, Yasuyoshi Ohshima, Toshiyuki Koya, Toshiaki Kikuchi
Author Information
  1. Yusuke Sato: Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
  2. Satoshi Watanabe: Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
  3. Takeshi Ota: Niigata Prefectural Shibata Hospital, Niigata, Japan.
  4. Kohei Kushiro: Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
  5. Toshiya Fujisaki: Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
  6. Miho Takahashi: Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
  7. Aya Ohtsubo: Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
  8. Satoshi Shoji: Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
  9. Koichiro Nozaki: Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
  10. Kosuke Ichikawa: Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
  11. Satoshi Hokari: Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
  12. Rie Kondo: Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
  13. Masachika Hayashi: Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
  14. Hiroyuki Ishikawa: Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
  15. Takao Miyabayashi: Niigata City General Hospital, Niigata, Japan.
  16. Tetsuya Abe: Niigata City General Hospital, Niigata, Japan.
  17. Satoru Miura: Niigata Cancer Center Hospital, Niigata, Japan.
  18. Hiroshi Tanaka: Niigata Cancer Center Hospital, Niigata, Japan.
  19. Masaaki Okajima: Saiseikai Niigata Hospital, Niigata, Japan.
  20. Masaki Terada: Saiseikai Niigata Hospital, Niigata, Japan.
  21. Takashi Ishida: Niigata Prefectural Central Hospital, Joetsu, Japan.
  22. Akira Iwashima: Nagaoka Chuo General Hospital, Nagaoka, Japan.
  23. Kazuhiro Sato: Nagaoka Red Cross Hospital, Nagaoka, Japan.
  24. Hirohisa Yoshizawa: Niigata Medical Center, Niigata, Japan.
  25. Nobumasa Aoki: Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
  26. Yasuyoshi Ohshima: Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
  27. Toshiyuki Koya: Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
  28. Toshiaki Kikuchi: Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
PMID: 34430353 DOI: 10.21037/tlcr-21-198

Abstract

BACKGROUND: Although immune checkpoint inhibitors (ICIs) are effective for advanced non-small cell lung cancer (NSCLC), ICIs may cause interstitial lung disease (ILD), which results in treatment discontinuation and is sometimes fatal. Despite the high incidence of ICI-related ILD, there are few cancer treatment options for patients. This study aimed to evaluate the safety and efficacy of subsequent systemic cancer therapy in NSCLC patients with ICI-related ILD.
METHODS: We retrospectively assessed NSCLC patients who received programmed cell death-1 (PD-1) inhibitors as first- to third-line therapy at participating institutions of the Niigata Lung Cancer Treatment Group from January 2016 to October 2017.
RESULTS: This analysis included 231 patients, 32 (14%) of whom developed ICI-related ILD. Of these patients, 16 (7%) received subsequent systemic cancer treatments. The median overall survival (OS) tended to be longer in the systemic cancer therapy group than in the no systemic cancer therapy group [22.2 months (95% CI: 1-NE) 4.5 months (95% CI: 1-NE); P=0.067]. ICI-related ILD recurred in half of the patients who received systemic cancer therapy, and the median OS tended to be shorter in patients with recurrent ICI-related ILD [22.0 months (95% CI: 1-NE) 7.0 months (95% CI: 1-NE); P=0.3154].
CONCLUSIONS: According to the current study, systemic cancer treatment is effective in patients with ICI-related ILD; however, its safety is uncertain because of the high risk of ICI-related ILD recurrence and poor survival outcome following ILD recurrence.

Keywords

Non-small cell lung cancer (NSCLC) PD-1 PD-L1 immune-related adverse event (irAE) interstitial lung disease (ILD)

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Journal Article
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Word Cloud

Created with Highcharts 10.0.0cancerILDpatientsICI-relatedsystemiclungtherapycellNSCLCmonths95%CI:1-NEinterstitialdiseasetreatmentreceivedimmunecheckpointinhibitorsICIseffectivenon-smallhighstudysafetysubsequentPD-1mediansurvivalOStendedgroup[22P=00recurrenceBACKGROUND:AlthoughadvancedmaycauseresultsdiscontinuationsometimesfatalDespiteincidenceoptionsaimedevaluateefficacyMETHODS:retrospectivelyassessedprogrammeddeath-1first-third-lineparticipatinginstitutionsNiigataLungCancerTreatmentGroupJanuary2016October2017RESULTS:analysisincluded2313214%developed167%treatmentsoveralllonger245067]recurredhalfshorterrecurrent73154]CONCLUSIONS:AccordingcurrenthoweveruncertainriskpooroutcomefollowingSubsequentinhibitor-relatedNon-smallPD-L1immune-relatedadverseeventirAE

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