Department of Respiratory Medicine, Graduate School of Medicine, Juntendo University, Tokyo, Japan.
Thorac Cancer. 2024 Nov;15(32):2291-2297. doi: 10.1111/1759-7714.15457. Epub 2024 Oct 7.
This study aimed to investigate the characteristics of patients with recurrent or advanced non-small cell lung cancer (NSCLC) treated with tyrosine kinase inhibitors (TKIs) or immune-checkpoint inhibitors (ICIs) who developed secondary malignancies, as well as evaluate the impact of these secondary malignancies on the course of lung cancer.
This study included 112 patients with postoperative recurrent or advanced NSCLC, who received TKIs, ICIs, or immune combination therapy as the primary treatment modality between April 1, 2013, and March 31, 2020, and achieved long-term survival (≥2 years). Secondary malignancies were defined as newly diagnosed cancers in other organs occurring after NSCLC treatment initiation.
Among the 112 patients, 10 (8.9%) developed 12 carcinomas, including third primary malignancies. Univariate analysis, considering secondary malignancies as the outcome, revealed a non-significant trend towards a higher incidence of secondary malignancies in smokers compared to non-smokers.
This study found that 8.9% of patients with advanced NSCLC who received TKIs, ICIs, or immune combination therapy and survived ≥2 years developed secondary malignancies. This underscores the importance of early diagnosis and treatment, even during lung cancer treatment, to identify suspicious lesions in other organs either via imaging or physical examinations.
本研究旨在探讨接受酪氨酸激酶抑制剂（TKI）或免疫检查点抑制剂（ICI）治疗的复发性或晚期非小细胞肺癌（NSCLC）患者发生继发性恶性肿瘤的特征，并评估这些继发性恶性肿瘤对肺癌病程的影响。
本研究纳入了 112 例术后复发性或晚期 NSCLC 患者，这些患者在 2013 年 4 月 1 日至 2020 年 3 月 31 日期间接受了 TKI、ICI 或免疫联合治疗作为初始治疗方案，并实现了长期生存（≥2 年）。继发性恶性肿瘤定义为在 NSCLC 治疗开始后新诊断的其他器官癌症。
在这 112 例患者中，有 10 例（8.9%）发生了 12 例癌，包括第三原发性恶性肿瘤。单因素分析，将继发性恶性肿瘤作为结局，结果显示吸烟者发生继发性恶性肿瘤的比例虽高于不吸烟者，但无统计学意义。
本研究发现，8.9%接受 TKI、ICI 或免疫联合治疗并生存≥2 年的晚期 NSCLC 患者发生了继发性恶性肿瘤。这突显了早期诊断和治疗的重要性，即使在肺癌治疗期间，也需要通过影像学或体检来识别其他器官中的可疑病变。
