Watanabe Naohiro, Niho Seiji, Kirita Keisuke, Umemura Shigeki, Matsumoto Shingo, Yoh Kiyotaka, Ohmatsu Hironobu, Goto Koichi
Department of Thoracic Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
Cancer Chemother Pharmacol. 2015 Jul;76(1):69-74. doi: 10.1007/s00280-015-2775-y. Epub 2015 May 15.
The role of second-line chemotherapy in patients with non-small cell lung cancer (NSCLC) and preexisting interstitial pneumonia (IP) previously treated with platinum-based chemotherapy remains uncertain. This study was conducted to elucidate the efficacy and tolerability of second-line docetaxel monotherapy for patients with platinum-refractory advanced (stage IIIB, IV, or relapse) NSCLC and preexisting IP.
A total of 35 patients (median age, 67 years) treated with docetaxel monotherapy in a second-line setting following first-line platinum-based chemotherapy between January 2002 and December 2013 were retrospectively reviewed.
The overall response rate and disease control rate were 8.6 % [95 % confidence interval (CI) 0-17.9 %] and 37.1 % (95 % CI 21.1-53.1 %), respectively. The median progression-free survival and median overall survival periods were 1.6 months (95 % CI 1.2-2.0 months) and 5.1 months (95 % CI 3.2-6.7 months), respectively. The incidence of acute exacerbation (AE) of IP following docetaxel monotherapy was 14.3 % (5/35 patients). Of the five patients who developed AE of IP, three patients died. The toxicity of this regimen was substantial, with treatment-related deaths occurring in 5 (14.3 %) patients (AE of IP: 3, sepsis: 2).
Docetaxel monotherapy has a poor activity and substantial risks when used for the treatment of platinum-resistant NSCLC with IP. Novel therapeutic approaches should be explored in this setting.
二线化疗在非小细胞肺癌（NSCLC）且先前接受过铂类化疗并已存在间质性肺炎（IP）患者中的作用仍不明确。本研究旨在阐明二线多西他赛单药治疗铂类难治性晚期（ⅢB期、Ⅳ期或复发）NSCLC且已存在IP患者的疗效和耐受性。
回顾性分析了2002年1月至2013年12月期间在一线铂类化疗后接受二线多西他赛单药治疗的35例患者（中位年龄67岁）。
总缓解率和疾病控制率分别为8.6%[95%置信区间（CI）0 - 17.9%]和37.1%（95%CI 21.1 - 53.1%）。中位无进展生存期和中位总生存期分别为1.6个月（95%CI 1.2 - 2.0个月）和5.1个月（95%CI 3.2 - 6.7个月）。多西他赛单药治疗后IP急性加重（AE）的发生率为14.3%（5/35例患者）。在发生IP AE的5例患者中，3例死亡。该方案毒性较大，5例（14.3%）患者出现治疗相关死亡（IP AE：3例，脓毒症：2例）。
多西他赛单药用于治疗伴有IP的铂类耐药NSCLC时活性较差且风险较大。在此情况下应探索新的治疗方法。
