Ichihara Eiki, Miyahara Nobuaki, Maeda Yoshinobu, Kiura Katsuyuki
Department of Allergy and Respiratory Medicine, Okayama University Hospital, Japan.
Department of Medical Technology, Okayama University Graduate School of Health Sciences, Japan.
Intern Med. 2020 Jan 15;59(2):163-167. doi: 10.2169/internalmedicine.3481-19. Epub 2019 Sep 18.
Systemic therapy for advanced non-small cell lung cancer (NSCLC) has dramatically changed in the latest 15 years. Molecular-targeted therapy has brought about an era of precision medicine, and immune checkpoint inhibitors have brought hope for a cure for advanced NSCLC. In the wake of this remarkable advancement, lung cancer with comorbid interstitial pneumonia (IP) has been completely left behind, as most clinical trials exclude patients with comorbid IP. IP, especially idiopathic pulmonary fibrosis (IPF), is often accompanied by lung cancer, and acute exacerbation can develop during various cancer therapies, including surgery, radiotherapy and pharmacotherapy. In this review, we focus on the clinical questions concerning pharmacotherapy in cases of advanced lung cancer with comorbid IP and discuss what we can do with the currently available data.
在过去15年中，晚期非小细胞肺癌（NSCLC）的全身治疗发生了巨大变化。分子靶向治疗开启了精准医学时代，免疫检查点抑制剂为晚期NSCLC的治愈带来了希望。在这一显著进展之后，合并间质性肺炎（IP）的肺癌却被完全忽视了，因为大多数临床试验都排除了合并IP的患者。IP，尤其是特发性肺纤维化（IPF），常与肺癌伴发，并且在包括手术、放疗和药物治疗在内的各种癌症治疗过程中可能会发生急性加重。在本综述中，我们聚焦于合并IP的晚期肺癌患者药物治疗方面的临床问题，并基于现有数据进行讨论。
