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International Journal of Clinical Oncology

, Volume 24, Issue 12, pp 1543–1548 | Cite as

Weekly paclitaxel in combination with carboplatin for advanced non-small-cell lung cancer complicated by idiopathic interstitial pneumonias: a single-arm phase II study

  • Aya Fukuizumi
  • Yuji MinegishiEmail author
  • Miwako Omori
  • Kenichiro Atsumi
  • Natsuki Takano
  • Kakeru Hisakane
  • Satoshi Takahashi
  • Kenichi Kobayashi
  • Teppei Sugano
  • Susumu Takeuchi
  • Rintaro Noro
  • Masahiro Seike
  • Kaoru Kubota
  • Arata Azuma
  • Akihiko Gemma
Original Article
  • 182 Downloads

Abstract

Background

Idiopathic interstitial pneumonias (IIPs) are associated with increased risk of lung cancer. In Japan, acute exaberation of IIPs induced by anticancer treatment is a critical issue. For this reason, there is limited available evidence regarding the optimal treatment approach for lung cancer patients complicated with IIPs. Our previous prospective pilot study demonstrated the safety and efficacy of weekly paclitaxel in combination with carboplatin for advanced non-small-cell lung cancer (NSCLC) with IIPs. The current study was conducted to confirm the results of the same combination therapy used in a larger patient population.

Methods

Chemotherapy-naïve patients with advanced stage or post-operative recurrent NSCLC patients complicated by IIPs were enrolled. Patients received paclitaxel (100 mg/m2) on days 1, 8, and 15, and carboplatin (AUC 5.0) once every 4 weeks.

Results

Thirty-three of 35 enrolled patients were evaluable for analysis and received a median of four treatment cycles (range 1–6). Four patients (12.1%; 95% confidence interval 3.4–28.2%) had acute exacerbation (AEx)-related IIPs to the study treatment. However, no fatalities due to AEx were observed. The overall response was 69.7%. The median progression-free survival, median survival time, and 1-year survival were 6.3 months, 19.8 months, and 55.4%, respectively.

Conclusions

The efficacy of carboplatin plus weekly paclitaxel treatment for advanced NSCLC patients with IIPs was comparable to that of conventional chemotherapy in advanced NSCLC patients without IIPs. Moreover, the primary endpoint was set to the frequency of treatment-related acute exacerbation, and the primary endpoint was met. These results suggest that patients with advanced NSCLC complicated by IIPs may benefit from this combination chemotherapy.

Keywords

Idiopathic pulmonary fibrosis Acute exacerbation Chemotherapy Paclitaxel Re-challenge 

Notes

Acknowledgements

This research did not receive any specific grant from funding agencies in the public, commercial, or non-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Supplementary material

10147_2019_1516_MOESM1_ESM.docx (24 kb)
Supplementary file1 (DOCX 23 kb)

References

  1. 1.
    Hubbard R, Venn A, Lewis S et al (2000) Lung cancer and cryptogenic fibrosing alveolitis. Population-based cohort study. Am J Respir Crit Care Med 161:5–8CrossRefGoogle Scholar
  2. 2.
    Turner-Warwick M, Lebowits M, Burrows B et al (1980) Cryptogenic fibrosing alveolitis and lung cancer. Thorax 35:496–499CrossRefGoogle Scholar
  3. 3.
    Panos RJ, Mortenson RL, Niccoli SA et al (1990) Clinical deterioration in patients with idiopathic pulmonary fibrosis: caused and assessment. Am J Med 88:396–404CrossRefGoogle Scholar
  4. 4.
    Park J, Kim DS, Shim TS et al (2001) Lung cancer in patients with idiopathic pulmonary fibrosis. Eur Respir J 17:1216–1219CrossRefGoogle Scholar
  5. 5.
    American Thoracic Society/European Respiratory Society (2002) International multidisciplinary consensus classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med 165:277–304CrossRefGoogle Scholar
  6. 6.
    Kawasaki H, Nagai K, Yokose T et al (2001) Clinicopathological characteristics of surgically resected lung cancer associated with idiopathic pulmonary fibrosis. Surg Oncol 76:53–57CrossRefGoogle Scholar
  7. 7.
    Minegishi Y, Takenaka K, Mizutani H et al (2009) Exacerbation of idiopathic interstitial pneumonias associated with lung cancer therapy. Intern Med 48:665–672CrossRefGoogle Scholar
  8. 8.
    Isobe K, Hata Y, Sakamoto S et al (2010) Clinical characteristics of acute respiratory deterioration in pulmonary fibrosis associated with lung cancer following anti-cancer therapy. Respirology 15:88–92CrossRefGoogle Scholar
  9. 9.
    Kenmotsu K, Naito T, Kimura M et al (2011) The risk of cytotoxic chemotherapy-related exacerbation of interstitial lung disease with lung cancer. J Thorac Oncol 6:1242–1246CrossRefGoogle Scholar
  10. 10.
    Minegishi Y, Sudoh J, Kuribayashi H et al (2011) The safety and efficacy of weekly paclitaxel in combination with carboplatin for advanced non-small cell lung cancer with idiopathic interstitial pneumonias. Lung Cancer 71:70–74CrossRefGoogle Scholar
  11. 11.
    Raghu G, Mageto YM, Lockhart D et al (1999) The accuracy of the clinical diagnosis of new-onset idiopathic pulmonary fibrosis and other interstitial lung disease: a prospective study. Chest 116:1168–1174CrossRefGoogle Scholar
  12. 12.
    Nishimura K, Kitaichi M, Izumi T et al (1992) Usual interstitial pneumonia: histologic correlation with high-resolution CT. Radiology 182:337–342CrossRefGoogle Scholar
  13. 13.
    Johkoh T, Muller NL, Cartier Y et al (1999) Idiopathic interstitial pneumonias: diagnostic accuracy of thin-section CT in 129 patients. Radiology 211:555–560CrossRefGoogle Scholar
  14. 14.
    Kondoh Y, Taniguchi H, Kawabata Y et al (1993) Acute exacerbation in idiopathic pulmonary fibrosis: analysis of clinical and pathological findings in three cases. Chest 103:1808–1812CrossRefGoogle Scholar
  15. 15.
    Akira M, Hamada H, Sakatani M et al (1997) CT findings during phase of accelerated deterioration in patients with idiopathic pulmonary fibrosis. Am J Roentgenol 168:79–83CrossRefGoogle Scholar
  16. 16.
    Eisenhauer EA, Therasse P, Bogaerts J et al (2009) New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 45:228–247CrossRefGoogle Scholar
  17. 17.
    Kondoh S, Chiba H, Nishikiori H et al (2016) Validation of the Japanese disease severity classification and the GAP model in Japanese patients with idiopathic pulmonary fibrosis. Respir Investig 54:327–333CrossRefGoogle Scholar
  18. 18.
    Azuma A, Nukiwa T, Tsuboi E et al (2005) Double-blind, placebo-controlled trial of pirfenidone in patients with idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 171:1040–1047CrossRefGoogle Scholar
  19. 19.
    Taniguchi H, Ebina M, Kondoh Y et al (2010) Pirfenidone in idiopathic pulmonary fibrosis. Eur Respir J 35:821–829CrossRefGoogle Scholar
  20. 20.
    Richeldi L, du Bois RM, Raghu G et al (2014) Efficacy and safety of nintedanib in idiopathic pulmonary fibrosis. N Engl J Med 370:2071–2082CrossRefGoogle Scholar
  21. 21.
    Azuma A, Taniguchi H, Inoue Y et al (2017) Nintedanib in Japanese patients with idiopathic pulmonary fibrosis: a subgroup analysis of the INPULSIS® randomized trials. Respirology 22:750–757CrossRefGoogle Scholar
  22. 22.
    Natsuizaka M, Chiba H, Kuronuma K et al (2014) Epidemiologic survey of Japanese patients with idiopathic pulmonary fibrosis and investigation of ethnic difference. Am J Respir Crit Care Med 190:773–779CrossRefGoogle Scholar
  23. 23.
    Belani CP, Barstis J, Perry MC et al (2003) Multicenter, randomized trial for stage IIIB or IV non-small-cell lung cancer using weekly paclitaxel and carboplatin followed by maintenance weekly paclitaxel or observation. J Clin Oncol 21:2933–2939CrossRefGoogle Scholar
  24. 24.
    Watanabe N, Niho S, Kirita K et al (2007) Second-line docetaxel for patients with platinum-refractory advanced non-small cell lung cancer and interstitial pneumonia. Cancer Chemother Pharmacol 76:69–74CrossRefGoogle Scholar
  25. 25.
    Ohe Y, Ohashi Y, Kubota K et al (2007) Randomized phase III study of cisplatin plus irinotecan versus carboplatin plus paclitaxel, cisplatin plus gemcitabine, and cisplatin plus vinorelbine for advanced non-small-cell lung cancer: Four-Arm Cooperative Study in Japan. Ann Oncol 18:317–323CrossRefGoogle Scholar
  26. 26.
    Gemma A, Seike M, Kosaihira S et al (2006) Phase I/II study of paclitaxel + carboplatin for refractory or recurrent non-small cell lung cancer. Anticancer Res 26:3083–3087PubMedGoogle Scholar

Copyright information

© Japan Society of Clinical Oncology 2019

Authors and Affiliations

  • Aya Fukuizumi
    • 1
  • Yuji Minegishi
    • 1
    Email author
  • Miwako Omori
    • 1
  • Kenichiro Atsumi
    • 1
  • Natsuki Takano
    • 1
  • Kakeru Hisakane
    • 1
  • Satoshi Takahashi
    • 1
  • Kenichi Kobayashi
    • 1
  • Teppei Sugano
    • 1
  • Susumu Takeuchi
    • 1
  • Rintaro Noro
    • 1
  • Masahiro Seike
    • 1
  • Kaoru Kubota
    • 1
  • Arata Azuma
    • 1
  • Akihiko Gemma
    • 1
  1. 1.Department of Pulmonary Medicine and OncologyGraduate School of Medicine, Nippon Medical SchoolTokyoJapan

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