Niwa Hideyuki, Nakahara Yoshiro, Yokoba Masanori, Mitsufuji Hisashi, Sasaki Jiichiro, Masuda Noriyuki
Department of Respiratory Medicine, Kitasato University Hospital, Sagamihara, Kanagawa 252-0374, Japan.
Mol Clin Oncol. 2017 Oct;7(4):604-608. doi: 10.3892/mco.2017.1359. Epub 2017 Aug 3.
There are few established treatments for patients with non-small-cell lung cancer (NSCLC) with interstitial lung disease (ILD). The safety and efficacy of albumin-bound paclitaxel (nab-paclitaxel) in combination with carboplatin is uncertain, although the combination of carboplatin and paclitaxel is the most common regimen for treating NSCLC patients with ILD. A total of 9 NSCLC patients with ILD, treated between April 2013 and March 2016, were retrospectively investigated. Carboplatin (AUC 5-6) was administered on day 1 and nab-paclitaxel on days 1, 8 and 15, every 4-6 weeks. The median age of the patients upon initiating chemotherapy was 67 years. The pathological examination revealed 6 patients with squamous cell carcinoma, and 6 patients exhibited the typical pattern of ILD. The response rate was 55.6%, and the median progression-free and overall survival time was 174 and 344 days, respectively. Acute exacerbation of ILD was not observed in any of the patients, and febrile neutropenia developed in 3 patients (3/9, 33.3%). Thus, treatment with carboplatin plus nab-paclitaxel was found to be safe and effective for NSCLC patients with ILD, although management of hematological adverse events, such as febrile neutropenia, was required. However, these encouraging results require confirmation by a large-scale clinical trial.
对于合并间质性肺疾病(ILD)的非小细胞肺癌(NSCLC)患者,目前已确立的治疗方法较少。虽然卡铂和紫杉醇联合使用是治疗合并ILD的NSCLC患者最常用的方案,但白蛋白结合型紫杉醇(纳米紫杉醇)与卡铂联合使用的安全性和有效性尚不确定。我们对2013年4月至2016年3月期间接受治疗的9例合并ILD的NSCLC患者进行了回顾性研究。卡铂(AUC 5 - 6)在第1天给药,纳米紫杉醇在第1、8和15天给药,每4 - 6周重复一次。开始化疗时患者的中位年龄为67岁。病理检查显示6例为鳞状细胞癌,6例表现出典型的ILD模式。缓解率为55.6%,中位无进展生存期和总生存期分别为174天和344天。所有患者均未观察到ILD急性加重,3例患者(3/9,33.3%)出现发热性中性粒细胞减少。因此,虽然需要对血液学不良事件(如发热性中性粒细胞减少)进行管理,但发现卡铂加纳米紫杉醇治疗对合并ILD的NSCLC患者是安全有效的。然而,这些令人鼓舞的结果需要通过大规模临床试验来证实。