Exacerbation of Idiopathic Interstitial Pneumonias Associated with Lung Cancer Therapy
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OBJECTIVE AND METHODS: Idiopathic interstitial pneumonias (IIPs) frequently occur in association with lung cancer. However, there is no consensus on the best treatment of acute exacerbation of IIP in lung cancer patients (LC with IIP), including those with iatrogenic acute lung injury resulting from cancer treatments. We aimed to identify an appropriate strategy for treatment of this condition. We analyzed clinical features of 120 LC with IIP, retrospectively. RESULTS: The incidence of acute exacerbation related to anticancer treatment was 22.7%; when the incidence was examined separately for patients receiving chemotherapy or the best supportive care, the incidence was 20.0% and 31.3%, respectively. Additional investigations should be directed to finding suitable regimens for treatment of LC with IIP and the selection of appropriate patients with LC with IIP for chemotherapy. The incidence of acute exacerbation caused by combination regimens of carboplatin + paclitaxel or a platinum agent + etoposide was significantly lower than that of other regimens (0% vs. 18%, respectively; p=0.025, Fisher's Exact Test). Patients with high levels of C-reactive protein before chemotherapy had a significantly higher risk of developing acute exacerbation (odds ratio 5.60, p=0.028). CONCLUSION: There was no evidence that anticancer treatment, including chemotherapy, should be avoided in LC with IIP. To establish an appropriate cancer treatment for LC with IIP, a prospective clinical study should be performed to evaluate various treatment modalities in a larger patient population.
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Drug-induced lung injury occurs more frequently in groups with high CRP, SUVmax, or GPS.
“Furthermore, drug‑induced lung injury occurs more frequently in groups with high CRP, SUVmax, or GPS(32‑34).”
From Clinical impact of inflammatory and nutrition index based on metabolic tumor activity in non‑small cell lung cancer treated with immunotherapy. (2024) · cites this paper as [32]
The section on risk factors for chemotherapy-induced acute exacerbation of IIPs reports a significantly higher risk when pre-chemotherapy CRP exceeded 2.5 mg/dL in lung cancer patients with IIP. The cited paper does not establish this for SUVmax or GPS, and its finding concerns acute exacerbation in that specific patient group rather than drug-induced lung injury generally. (LLM, conf=0.88)
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- Authors
- Minegishi, Y., Takenaka, K., Mizutani, H., Sudoh, J., Noro, R., Okano, T., Azuma, A., Yoshimura, A., Ando, M., Tsuboi, E., Kudoh, S., & Gemma, A.
- Affiliations
- Nippon Medical School (JP)
- Division of Internal Medicine, Tsuboi Cancer Center Hospital
- Venue
- Internal Medicine
- Published
- 2009
- Volume
- 48
- Issue
- 9
- Pages
- 665-672
- ISSN
- 0918-2918 (ISSN-L)
- 1349-7235
- OpenAlex
- W2094116236
- Cited by
- 128
- References
- 34
- Citations by year
- 2025: 3 · 2024: 4 · 2023: 4 · 2022: 6 · 2021: 13 · 2020: 7 · 2019: 15 · 2018: 10 · 2017: 17 · 2016: 4 · 2015: 16 · 2014: 9 · 2013: 3 · 2012: 6
- FWCI
- 4.75
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Japan Society for the Promotion of Science (21591006)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Occupational and environmental lung diseases
- Keywords
- idiopathic interstitial pneumonia, lung cancer, acute exacerbation, chemotherapy-induced lung injury, carboplatin, paclitaxel, etoposide, platinum agents, C-reactive protein, best supportive care, treatment selection
- MeSH terms
- Aged, Aged, 80 and over, Antineoplastic Agents, Female, Humans, Lung Neoplasms, Male, Middle Aged, Retrospective Studies, Survival Rate, Idiopathic Interstitial Pneumonias
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