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对敏感复发小细胞肺癌合并间质性肺疾病患者进行再挑战化疗。

Re-challenge chemotherapy in patients with sensitive relapse small-cell lung cancer and interstitial lung disease.

作者信息

Nasu Shingo, Suzuki Hidekazu, Moriizumi Kazunori, Hara Yuki, Tanaka Satoshi, Takada Hiromune, Morita Satomu, Tanaka Ayako, Shiroyama Takayuki, Morishita Naoko, Okamoto Norio, Hirashima Tomonori

机构信息

Department of Thoracic Oncology, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan.

出版信息

J Thorac Dis. 2019 Feb;11(2):514-520. doi: 10.21037/jtd.2019.01.26.

Abstract

BACKGROUND

Treatment modalities for small-cell lung cancer (SCLC) with pre-existing interstitial lung disease (ILD) are limited. Although re-challenge with first-line chemotherapy can be effective for sensitive relapse SCLC, its safety and efficacy are uncertain in cases with ILD. This study aimed to investigate both the efficacy and safety of re-challenge chemotherapy in patients with sensitive relapse SCLC with ILD.

METHODS

Patients with sensitive relapse SCLC with ILD who received re-challenge chemotherapy were studied retrospectively. Sensitive relapse was defined as a treatment-free interval (TFI) of more than 60 days after first-line platinum-based treatment. The endpoints were progression-free survival (PFS), overall survival (OS), and safety.

RESULTS

Re-challenge platinum and etoposide were administered in 11 patients, with the median re-challenge cycle of 3. The overall response rate was 55%. The median PFS and OS from the time of re-challenge treatment were 4 months (95% CI, 2.9-NA) and 9.2 months (95% CI, 8.0-NA), respectively. One patient developed acute exacerbation of ILD 173 days after the last course of re-challenge treatment.

CONCLUSIONS

Re-challenge chemotherapy can be effective and considered in SCLC patients with pre-existing ILD.

摘要

背景

对于合并有间质性肺疾病(ILD)的小细胞肺癌(SCLC),其治疗方式有限。尽管一线化疗再次挑战对敏感复发的SCLC可能有效,但在合并ILD的情况下,其安全性和有效性尚不确定。本研究旨在探讨再次挑战化疗对合并ILD的敏感复发SCLC患者的疗效和安全性。

方法

对接受再次挑战化疗的合并ILD的敏感复发SCLC患者进行回顾性研究。敏感复发定义为一线铂类治疗后无治疗间隔(TFI)超过60天。终点指标为无进展生存期(PFS)、总生存期(OS)和安全性。

结果

11例患者接受了再次挑战铂类和依托泊苷治疗,再次挑战化疗的中位周期数为3个周期。总缓解率为55%。再次挑战治疗后的中位PFS和OS分别为4个月(95%CI,2.9 - 无可用数据)和9.2个月(95%CI,8.0 - 无可用数据)。1例患者在最后一个周期再次挑战治疗后173天发生ILD急性加重。

结论

再次挑战化疗对合并ILD的SCLC患者可能有效,可予以考虑。

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