Takahashi Saeko, Murata Saori, Yoshino Yudai, Kobayashi Yosuke, Nakamura Morio
Department of Pulmonary Medicine Tokyo Saiseikai Central Hospital Tokyo Japan.
Department of Surgery Tokyo Saiseikai Central Hospital Tokyo Japan.
Respirol Case Rep. 2018 Nov 8;7(1):e00383. doi: 10.1002/rcr2.383. eCollection 2019 Jan.
The prevalence of lung cancer in idiopathic pulmonary fibrosis (IPF) patients ranges from 9.8 to 38%. Nintedanib, a small molecule receptor tyrosine kinase inhibitor (TKI) of platelet-derived growth factor receptor (PDGFR), fibroblast growth factor receptor (FGFR), and vascular endothelial growth factor receptor (VEGFR), has been approved for IPF after phase III INPULSIS trials in 2014. Ramucirumab, a monoclonal antibody for VEGFR-2, combined with docetaxcel, has been approved for advanced non-small cell lung cancer (NSCLC) after the phase III REVEL trail in 2014. Physicians will have more IPF patients being treated with nintedanib, who subsequently develop NSCLC, and therefore will likely be treated with ramucirumab plus docetaxel. We report the first case of 70-year-old man taking nintedanib for his IPF and treated with ramucirumab plus docetaxel as a seventh-line therapy for his pulmonary adenocarcinoma. On day 15 of his chemotherapy treatment cycle 2, after taking nintedanib for nine days, he developed gastric perforation.
特发性肺纤维化（IPF）患者中肺癌的患病率在9.8%至38%之间。尼达尼布是一种血小板衍生生长因子受体（PDGFR）、成纤维细胞生长因子受体（FGFR）和血管内皮生长因子受体（VEGFR）的小分子受体酪氨酸激酶抑制剂（TKI），在2014年进行III期INPULSIS试验后已被批准用于IPF治疗。雷莫西尤单抗是一种VEGFR-2单克隆抗体，与多西他赛联合使用，在2014年III期REVEL试验后已被批准用于晚期非小细胞肺癌（NSCLC）治疗。医生将会治疗更多使用尼达尼布的IPF患者，这些患者随后可能会患上NSCLC，因此可能会接受雷莫西尤单抗加量多西他赛治疗。我们报告了首例70岁男性患者，该患者因IPF服用尼达尼布，并接受雷莫西尤单抗加多西他赛作为其肺腺癌的七线治疗。在其化疗第2周期的第15天，服用尼达尼布9天后，他发生了胃穿孔。
