Matsumoto Masaru, Minegishi Yuji, Higa Katsuyuki, Fukuizumi Aya, Onda Naomi, Takeuchi Susumu, Miyanaga Akihiko, Gemma Akihiko, Seike Masahiro
Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
Department of Respiratory Medicine, Mitsui Memorial Hospital, Tokyo, Japan.
BMC Pulm Med. 2025 Jan 8;25(1):9. doi: 10.1186/s12890-024-03459-y.
Acute exacerbation (AEx) of interstitial pneumonia is the most common lethal adverse event related to the pharmacological treatment of patients with lung cancer complicated with interstitial pneumonia. Although small cell lung cancer (SCLC) is linked to poor prognosis, it exhibits good response to chemotherapy. Few previous research studies have investigated the safety and efficacy of treatment for advanced SCLC complicated with idiopathic interstitial pneumonia (IIP). We conducted a single-arm phase II study to evaluate the safety and efficacy of carboplatin plus etoposide for the treatment of patients with SCLC complicated with IIP.
Chemotherapy-naïve patients with advanced SCLC complicated with IIP were enrolled. Patients received carboplatin every 21-28 days at a dose of area under the curve 4-6 on day 1 and etoposide at a dose of 80-100 mg/m on days 1-3.
Thirty-one patients were enrolled between December 2009 and December 2022. A median of four cycles of carboplatin plus etoposide were administered. Acute exacerbation of idiopathic interstitial pneumonia was not observed; the rate of AEx was 0% (95% confidence interval [CI]: 0-9.6%, p = 0.038). The objective response rate was 83.9% (95% CI: 82.5-85.2). The median progression-free survival and overall survival were 5.9 (95% CI: 4.7-6.8) months and 14.0 (95% CI: 7.6-27.6) months, respectively. The 1-year survival rate was 61% (95% CI 41-76).
The carboplatin plus etoposide treatment was tolerable and effective in SCLC patients complicated with IIP.
间质性肺炎急性加重（AEx）是肺癌合并间质性肺炎患者药物治疗最常见的致死性不良事件。尽管小细胞肺癌（SCLC）预后较差，但对化疗反应良好。既往很少有研究探讨晚期SCLC合并特发性间质性肺炎（IIP）的治疗安全性和有效性。我们开展了一项单臂II期研究，以评估卡铂联合依托泊苷治疗SCLC合并IIP患者的安全性和有效性。
纳入未接受过化疗的晚期SCLC合并IIP患者。患者每21 - 28天接受一次卡铂治疗，第1天剂量为曲线下面积4 - 6，依托泊苷在第1 - 3天剂量为80 - 100 mg/m。
2009年12月至2022年12月共纳入31例患者。卡铂联合依托泊苷的中位给药周期数为4个。未观察到特发性间质性肺炎急性加重；AEx发生率为0%（95%置信区间[CI]：0 - 9.6%，p = 0.038）。客观缓解率为83.9%（95% CI：82.5 - 85.2）。中位无进展生存期和总生存期分别为5.9（95% CI：4.7 - 6.8）个月和14.0（95% CI：7.6 - 27.6）个月。1年生存率为61%（95% CI 41 - 76）。
卡铂联合依托泊苷治疗对SCLC合并IIP患者耐受性良好且有效。
