Department of Respiratory Medicine, CHU Rennes, Rennes 1 University, Rennes, France.
INSERM U1242, Chemistry Oncogenesis Stress and signaling, CLCC Eugène Marquis, Rennes, France.
J Med Case Rep. 2021 Dec 15;15(1):595. doi: 10.1186/s13256-021-03177-7.
Idiopathic pulmonary fibrosis is a disease with a poor prognosis and has been associated with increased lung cancer incidence.
We report the case of a Caucasian 75-year-old woman, a former smoker, hospitalized for breathlessness with a chest computed tomography scan showing an interstitial lung disease. A surgical lung biopsy was performed, confirming a pattern of usual interstitial pneumonia but also numerous disseminated foci of well-differentiated focally invasive squamous cell carcinoma without hypermetabolic lung nodule, mass, or enlarged lymph node visualized on chest computed tomography or positron emission tomography scan. Nintedanib was started for its antifibrotic and antitumor properties, without any other antineoplastic treatment. Three years after initiation of nintedanib, clinical, functional, and computed tomography scan evaluations were stable, and there was no evidence for evolution of the squamous cell carcinoma.
Data are scarce regarding the benefit of nintedanib in patients with idiopathic pulmonary fibrosis-associated lung cancer, and it is unclear whether nintedanib could have a preventive role in lung carcinogenesis in idiopathic pulmonary fibrosis patients. This experience could help the scientific community in case of similar incidental findings.
特发性肺纤维化是一种预后不良的疾病,与肺癌发病率增加有关。
我们报告了一例 75 岁白人女性病例,该患者为既往吸烟者,因呼吸困难住院,胸部计算机断层扫描显示间质性肺病。进行了外科肺活检,证实为寻常型间质性肺炎,但也有许多弥漫性、分化良好的局灶性侵袭性鳞状细胞癌病灶,胸部计算机断层扫描或正电子发射断层扫描未显示高代谢性肺结节、肿块或增大的淋巴结。鉴于其抗纤维化和抗肿瘤特性,开始使用尼达尼布治疗,未进行其他抗肿瘤治疗。尼达尼布治疗 3 年后,临床、功能和计算机断层扫描评估稳定,无鳞状细胞癌进展的证据。
关于尼达尼布在特发性肺纤维化相关肺癌患者中的获益,数据有限,尚不清楚尼达尼布是否可预防特发性肺纤维化患者的肺癌发生。如果有类似偶然发现,这一经验可能有助于科学界。