Incidence and appropriate management of drug-induced interstitial lung disease in Japanese patients with unresectable pancreatic cancer: A multicenter retrospective study.

Abstract

AIM:

Drug-induced interstitial lung disease (DI-ILD) is a serious adverse event during chemotherapy. This study aimed to obtain real-world data of the incidence, clinical characteristics, predictive factors, and prognosis of patients with pancreatic cancer who developed DI-ILD.

METHODS:

In patients with locally advanced or metastatic pancreatic cancer who underwent standard chemotherapy at our hospital and its participating facilities between April 2014 and March 2019, the clinical features, occurrence rate and clinical course of DI-ILD, and prognosis were retrospectively evaluated.

RESULTS:

Altogether, 390 patients were finally enrolled. DI-ILD occurred in 24 cases (6.2%). The median period from diagnosis of pancreatic cancer to the onset of DI-ILD was 2.2 months (.6-13.3 months). The rate of DI-ILD onset according to each regimen was 5.8% of gemcitabine (GEM) plus albumin-bound paclitaxel therapy (18/308), 3.8% of GEM (4/106), and 2.3% of FOLFIRINOX (2/88). The incidence of DI-ILD in GEM-based regimens was significantly higher than that in non-GEM-based regimens (p < .01). The median overall survival (OS) of the patients with and without DI-ILD after propensity score matching was 11.5 months and 11.4 months (p = .99), respectively. After the resolution of DI-ILD, no statistical significance in the median OS of the patients with and without subsequent treatment (11.0 vs. 6.8 months, p = .18) was observed.

CONCLUSION:

DI-ILD is not a rare adverse event in the current standard chemotherapy for pancreatic cancer in Japan. With appropriate management of DI-ILD, the prognosis of patients with DI-ILD can be equivalent to that of patients without DI-ILD.

• Authors: Tsukasa Miyagahara, Nao Fujimori, Keijiro Ueda, Yu Takamatsu, Kazuhide Matsumoto, Katsuhito Teramatsu, Takehiro Takaoka, Yuta Suehiro, Yuzo Shimokawa, Kaoru Omori, Yusuke Niina, Yuichi Tachibana, Tetsuro Akashi, Takamasa Oono, Yoshihiro Ogawa
• Journal: Asia-Pacific journal of clinical oncology (Asia Pac J Clin Oncol) Vol. 19 Issue 4 Pg. 533-541 (Aug 2023) ISSN: 1743-7563 [Electronic] Australia
• PMID: 36478079 (Publication Type: Multicenter Study, Journal Article)
• Copyright: © 2022 John Wiley & Sons Australia, Ltd.

Chemical References

• Gemcitabine
• Paclitaxel

Topics

• Humans
• Retrospective Studies
• Antineoplastic Combined Chemotherapy Protocols (adverse effects)
• Pancreatic Neoplasms (pathology)
• Incidence
• East Asian People
• Gemcitabine
• Paclitaxel (therapeutic use)
• Lung Diseases, Interstitial (chemically induced, epidemiology, drug therapy)