Fujimoto Kazushi, Ikeda Satoshi, Tabata Erina, Kaneko Taichi, Sagawa Shinobu, Yamada Chieri, Kumagai Kosumi, Fukushima Takashi, Haga Sanshiro, Watanabe Masayuki, Muraoka Tatsuya, Sekine Akimasa, Baba Tomohisa, Ogura Takashi
Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomioka-higashi, Kanazawa-ku, Yokohoma 236-0051, Japan.
Cancers (Basel). 2024 Mar 28;16(7):1327. doi: 10.3390/cancers16071327.
Non-small-cell lung cancer (NSCLC) with comorbid interstitial pneumonia (IP) is a population with limited treatment options and a poor prognosis. Patients with comorbid IP are at high risk of developing fatal drug-induced pneumonitis, and data on the safety and efficacy of molecularly targeted therapies are lacking. mutations have been frequently detected in patients with NSCLC with comorbid IP. However, the low detection rate of common driver gene mutations, such as epidermal growth factor receptor and anaplastic lymphoma kinase, in patients with comorbid IP frequently results in inadequate screening for driver mutations, and mutations may be overlooked. Recently, sotorasib and adagrasib were approved as treatment options for advanced NSCLC with mutations. Although patients with comorbid IP were not excluded from clinical trials of these inhibitors, the incidence of drug-induced pneumonitis was low. Therefore, inhibitors may be a safe and effective treatment option for NSCLC with comorbid IP. This review article discusses the promise and prospects of molecular-targeted therapies, especially inhibitors, for NSCLC with comorbid IP, along with our own clinical experience.
合并间质性肺炎（IP）的非小细胞肺癌（NSCLC）患者治疗选择有限且预后较差。合并IP的患者发生致命性药物性肺炎的风险很高，并且缺乏分子靶向治疗安全性和有效性的数据。在合并IP的NSCLC患者中经常检测到 突变。然而，合并IP的患者中常见驱动基因突变（如表皮生长因子受体和间变性淋巴瘤激酶）的检测率较低，这常常导致驱动突变筛查不足， 突变可能被忽视。最近，索托拉西布和阿达格拉西布被批准作为治疗具有 突变的晚期NSCLC的选择。尽管合并IP的患者未被排除在这些 抑制剂的临床试验之外，但药物性肺炎的发生率较低。因此， 抑制剂可能是合并IP的NSCLC的一种安全有效的治疗选择。这篇综述文章结合我们自己的临床经验，讨论了分子靶向治疗，尤其是 抑制剂，对于合并IP的NSCLC的前景和展望。
