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Interstitial lung disease in advanced pancreatic ductal adenocarcinoma patients treated with gemcitabine and nab-paclitaxel combination therapy: a retrospective analysis

  • Hiroki Irie
  • Rei SuzukiEmail author
  • Tadayuki Takagi
  • Mitsuru Sugimoto
  • Naoki Konno
  • Yuki Sato
  • Takuto Hikichi
  • Jun Nakamura
  • Minami Hashimoto
  • Hiromasa Ohira
Original Article
  • 30 Downloads

Abstract

Purpose

Gemcitabine and nab-paclitaxel (GnP) combination therapy is a standard regimen for advanced pancreatic ductal adenocarcinoma (PDAC) worldwide; however, concerns regarding the unexpectedly high incidence of interstitial lung disease (ILD) have emerged. We investigated the incidence and predictive factors of ILD in PDAC patients who were treated with GnP combination therapy.

Methods

Thirty-seven patients treated with GnP therapy as either 1st or 2nd line treatment were included, among whom seven developed ILD (18.9%). The clinical characteristics (age, etc.) were compared between patients with and without ILD. The diagnostic yield of the markers to predict the presence of ILD was calculated. The clinical course of the seven patients with ILD was summarized. Survival analysis was performed using the Kaplan–Meier method and log-rank test.

Results

The median age was higher in patients with ILD (73.0 vs. 65.0 years old, p = 0.03), while no differences were observed in the other clinical characteristics. Among the three investigated markers, SP-D showed the best diagnostic yield (AUC = 0.94) for diagnosing ILD. Though one patient required steroid therapy and the discontinuation of GnP therapy, all patients could undergo subsequent treatment. In the survival analysis, the median survival time of PDAC patients with ILD was comparable to that of patients without ILD (25.1 vs. 24.5 months, p = 0.98).

Conclusion

ILD was observed in 18.9% of PDAC patients treated with GnP therapy. With appropriate management, no prognostic influence was observed.

Keywords

Pancreatic ductal adenocarcinoma Chemotherapy Interstitial lung disease Gemcitabine Nab-paclitaxel 

Abbreviations

PDAC

Pancreatic ductal adenocarcinoma

ILD

Interstitial lung disease

GEM

Gemcitabine

Nab-PTX

Nab-paclitaxel

KL-6

Krebs von den Lungen-6 antigen

SP-A

Surfactant protein A

SP-D

Surfactant protein D

BI

Brinkman index

OS

Overall survival

FEV

Forced expiratory volume

VC

Vital capacity

Notes

Acknowledgements

The authors would like to acknowledge and are grateful to Dr. Shyuko Suzuki (Kamimachi Naika-Hifuka Clinic) for the intellectual discussion.

Author contributions

HI and RS designed the study, wrote the manuscript, and analysed the data. All authors contributed to patient care and read and approved the final manuscript.

Funding

No funding relevant to this study was received.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Ethics approval

The study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki and was approved by the institutional review committee of Fukushima Medical University (Fukushima, Japan; IRB number#19254).

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of GastroenterologyFukushima Medical University School of MedicineFukushimaJapan
  2. 2.Department of EndoscopyFukushima Medical University HospitalFukushimaJapan
  3. 3.Department of Gastroenterology and RheumatologyFukushima Medical University School of MedicineFukushimaJapan

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