Skip to main content
Erschienen in: Cancer Chemotherapy and Pharmacology 3/2020

05.11.2019 | Original Article

Interstitial lung disease in advanced pancreatic ductal adenocarcinoma patients treated with gemcitabine and nab-paclitaxel combination therapy: a retrospective analysis

verfasst von: Hiroki Irie, Rei Suzuki, Tadayuki Takagi, Mitsuru Sugimoto, Naoki Konno, Yuki Sato, Takuto Hikichi, Jun Nakamura, Minami Hashimoto, Hiromasa Ohira

Erschienen in: Cancer Chemotherapy and Pharmacology | Ausgabe 3/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Gemcitabine and nab-paclitaxel (GnP) combination therapy is a standard regimen for advanced pancreatic ductal adenocarcinoma (PDAC) worldwide; however, concerns regarding the unexpectedly high incidence of interstitial lung disease (ILD) have emerged. We investigated the incidence and predictive factors of ILD in PDAC patients who were treated with GnP combination therapy.

Methods

Thirty-seven patients treated with GnP therapy as either 1st or 2nd line treatment were included, among whom seven developed ILD (18.9%). The clinical characteristics (age, etc.) were compared between patients with and without ILD. The diagnostic yield of the markers to predict the presence of ILD was calculated. The clinical course of the seven patients with ILD was summarized. Survival analysis was performed using the Kaplan–Meier method and log-rank test.

Results

The median age was higher in patients with ILD (73.0 vs. 65.0 years old, p = 0.03), while no differences were observed in the other clinical characteristics. Among the three investigated markers, SP-D showed the best diagnostic yield (AUC = 0.94) for diagnosing ILD. Though one patient required steroid therapy and the discontinuation of GnP therapy, all patients could undergo subsequent treatment. In the survival analysis, the median survival time of PDAC patients with ILD was comparable to that of patients without ILD (25.1 vs. 24.5 months, p = 0.98).

Conclusion

ILD was observed in 18.9% of PDAC patients treated with GnP therapy. With appropriate management, no prognostic influence was observed.
Literatur
1.
Zurück zum Zitat Siegel R, Ma J, Zou Z, Jemal A (2014) Cancer statistics, 2014. CA Cancer J Clin 64:9–29CrossRef Siegel R, Ma J, Zou Z, Jemal A (2014) Cancer statistics, 2014. CA Cancer J Clin 64:9–29CrossRef
2.
Zurück zum Zitat Sener SF, Fremgen A, Menck HR, Winchester DP (1999) Pancreatic cancer: a report of treatment and survival trends for 100,313 patients diagnosed from 1985–1995, using the National Cancer Database. J Am Coll Surg 189:1–7CrossRef Sener SF, Fremgen A, Menck HR, Winchester DP (1999) Pancreatic cancer: a report of treatment and survival trends for 100,313 patients diagnosed from 1985–1995, using the National Cancer Database. J Am Coll Surg 189:1–7CrossRef
3.
Zurück zum Zitat Conroy T, Desseigne F, Ychou M et al (2011) FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med 364:1817–1825CrossRef Conroy T, Desseigne F, Ychou M et al (2011) FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med 364:1817–1825CrossRef
4.
Zurück zum Zitat Von Hoff DD, Ervin T, Arena FP et al (2013) Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. N Engl J Med 369:1691–1703CrossRef Von Hoff DD, Ervin T, Arena FP et al (2013) Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. N Engl J Med 369:1691–1703CrossRef
5.
Zurück zum Zitat Tahara J, Shimizu K, Otsuka N et al (2018) Gemcitabine plus nab-paclitaxel vs. FOLFIRINOX for patients with advanced pancreatic cancer. Cancer Chemother Pharmacol 82:245–250CrossRef Tahara J, Shimizu K, Otsuka N et al (2018) Gemcitabine plus nab-paclitaxel vs. FOLFIRINOX for patients with advanced pancreatic cancer. Cancer Chemother Pharmacol 82:245–250CrossRef
6.
Zurück zum Zitat Saito T, Ishido K, Kudo D et al (2017) Combination therapy with gemcitabine and nab-paclitaxel for locally advanced unresectable pancreatic cancer. Mol Clin Oncol 6:963–967CrossRef Saito T, Ishido K, Kudo D et al (2017) Combination therapy with gemcitabine and nab-paclitaxel for locally advanced unresectable pancreatic cancer. Mol Clin Oncol 6:963–967CrossRef
7.
Zurück zum Zitat Pusceddu S, Ghidini M, Torchio M et al (2019) Comparative effectiveness of gemcitabine plus nab-paclitaxel and folfirinox in the first-line setting of metastatic pancreatic cancer: a systematic review and meta-analysis. Cancers (Basel) 11:484CrossRef Pusceddu S, Ghidini M, Torchio M et al (2019) Comparative effectiveness of gemcitabine plus nab-paclitaxel and folfirinox in the first-line setting of metastatic pancreatic cancer: a systematic review and meta-analysis. Cancers (Basel) 11:484CrossRef
8.
Zurück zum Zitat Hiyoshi M, Nanashima A, Wada T et al (2017) A successful case of locally advanced pancreatic cancer undergoing curative distal pancreatectomy with en bloc celiac axis resection after combination chemotherapy of nab-paclitaxel with gemcitabine. Clin J Gastroenterol 10:551–557CrossRef Hiyoshi M, Nanashima A, Wada T et al (2017) A successful case of locally advanced pancreatic cancer undergoing curative distal pancreatectomy with en bloc celiac axis resection after combination chemotherapy of nab-paclitaxel with gemcitabine. Clin J Gastroenterol 10:551–557CrossRef
9.
Zurück zum Zitat Ielpo B, Duran H, Diaz E et al (2016) Preoperative treatment with gemcitabine plus nab-paclitaxel is a safe and effective chemotherapy for pancreatic adenocarcinoma. Eur J Surg Oncol 42:1394–1400CrossRef Ielpo B, Duran H, Diaz E et al (2016) Preoperative treatment with gemcitabine plus nab-paclitaxel is a safe and effective chemotherapy for pancreatic adenocarcinoma. Eur J Surg Oncol 42:1394–1400CrossRef
10.
Zurück zum Zitat Okada KI, Hirono S, Kawai M et al (2017) Phase I study of nab-paclitaxel plus gemcitabine as neoadjuvant therapy for borderline resectable pancreatic cancer. Anticancer Res 37:853–858CrossRef Okada KI, Hirono S, Kawai M et al (2017) Phase I study of nab-paclitaxel plus gemcitabine as neoadjuvant therapy for borderline resectable pancreatic cancer. Anticancer Res 37:853–858CrossRef
11.
Zurück zum Zitat Ielpo B, Caruso R, Duran H et al (2017) A comparative study of neoadjuvant treatment with gemcitabine plus nab-paclitaxel versus surgery first for pancreatic adenocarcinoma. Surg Oncol 26:402–410CrossRef Ielpo B, Caruso R, Duran H et al (2017) A comparative study of neoadjuvant treatment with gemcitabine plus nab-paclitaxel versus surgery first for pancreatic adenocarcinoma. Surg Oncol 26:402–410CrossRef
12.
Zurück zum Zitat Ueno H, Ikeda M, Ueno M et al (2016) Phase I/II study of nab-paclitaxel plus gemcitabine for chemotherapy-naive Japanese patients with metastatic pancreatic cancer. Cancer Chemother Pharmacol 77:595–603CrossRef Ueno H, Ikeda M, Ueno M et al (2016) Phase I/II study of nab-paclitaxel plus gemcitabine for chemotherapy-naive Japanese patients with metastatic pancreatic cancer. Cancer Chemother Pharmacol 77:595–603CrossRef
13.
Zurück zum Zitat Ogawa Y, Suzuki E, Mikata R et al (2018) Five cases of interstitial pneumonitis due to gemcitabine and nab-paclitaxel combination treatment in pancreatic cancer patients. Pancreas 47:e42–e43CrossRef Ogawa Y, Suzuki E, Mikata R et al (2018) Five cases of interstitial pneumonitis due to gemcitabine and nab-paclitaxel combination treatment in pancreatic cancer patients. Pancreas 47:e42–e43CrossRef
14.
Zurück zum Zitat Kudoh S, Kato H, Nishiwaki Y et al (2008) Interstitial lung disease in Japanese patients with lung cancer: a cohort and nested case-control study. Am J Respir Crit Care Med 177:1348–1357CrossRef Kudoh S, Kato H, Nishiwaki Y et al (2008) Interstitial lung disease in Japanese patients with lung cancer: a cohort and nested case-control study. Am J Respir Crit Care Med 177:1348–1357CrossRef
15.
Zurück zum Zitat Ohnishi H, Yokoyama A, Yasuhara Y et al (2003) Circulating KL-6 levels in patients with drug induced pneumonitis. Thorax 58:872–875CrossRef Ohnishi H, Yokoyama A, Yasuhara Y et al (2003) Circulating KL-6 levels in patients with drug induced pneumonitis. Thorax 58:872–875CrossRef
16.
Zurück zum Zitat Matsuno O (2012) Drug-induced interstitial lung disease: mechanisms and best diagnostic approaches. Respir Res 13:39CrossRef Matsuno O (2012) Drug-induced interstitial lung disease: mechanisms and best diagnostic approaches. Respir Res 13:39CrossRef
17.
Zurück zum Zitat Shitara K, Takashima A, Fujitani K et al (2017) Nab-paclitaxel versus solvent-based paclitaxel in patients with previously treated advanced gastric cancer (ABSOLUTE): an open-label, randomised, non-inferiority, phase 3 trial. Lancet Gastroenterol Hepatol 2:277–287CrossRef Shitara K, Takashima A, Fujitani K et al (2017) Nab-paclitaxel versus solvent-based paclitaxel in patients with previously treated advanced gastric cancer (ABSOLUTE): an open-label, randomised, non-inferiority, phase 3 trial. Lancet Gastroenterol Hepatol 2:277–287CrossRef
18.
Zurück zum Zitat Socinski MA, Bondarenko I, Karaseva NA et al (2012) Weekly nab-paclitaxel in combination with carboplatin versus solvent-based paclitaxel plus carboplatin as first-line therapy in patients with advanced non-small-cell lung cancer: final results of a phase III trial. J Clin Oncol 30:2055–2062CrossRef Socinski MA, Bondarenko I, Karaseva NA et al (2012) Weekly nab-paclitaxel in combination with carboplatin versus solvent-based paclitaxel plus carboplatin as first-line therapy in patients with advanced non-small-cell lung cancer: final results of a phase III trial. J Clin Oncol 30:2055–2062CrossRef
19.
Zurück zum Zitat Gradishar WJ, Tjulandin S, Davidson N et al (2005) Phase III trial of nanoparticle albumin-bound paclitaxel compared with polyethylated castor oil-based paclitaxel in women with breast cancer. J Clin Oncol 23:7794–7803CrossRef Gradishar WJ, Tjulandin S, Davidson N et al (2005) Phase III trial of nanoparticle albumin-bound paclitaxel compared with polyethylated castor oil-based paclitaxel in women with breast cancer. J Clin Oncol 23:7794–7803CrossRef
20.
Zurück zum Zitat Untch M, Jackisch C, Schneeweiss A et al (2016) Nab-paclitaxel versus solvent-based paclitaxel in neoadjuvant chemotherapy for early breast cancer (GeparSepto-GBG 69): a randomised, phase 3 trial. Lancet Oncol 17:345–356CrossRef Untch M, Jackisch C, Schneeweiss A et al (2016) Nab-paclitaxel versus solvent-based paclitaxel in neoadjuvant chemotherapy for early breast cancer (GeparSepto-GBG 69): a randomised, phase 3 trial. Lancet Oncol 17:345–356CrossRef
21.
Zurück zum Zitat Nakaya A, Kurata T, Yokoi T et al (2017) Retrospective analysis of single-agent nab-paclitaxel in patients with platinum-resistant non-small cell lung cancer. Mol Clin Oncol 7:803–807CrossRef Nakaya A, Kurata T, Yokoi T et al (2017) Retrospective analysis of single-agent nab-paclitaxel in patients with platinum-resistant non-small cell lung cancer. Mol Clin Oncol 7:803–807CrossRef
22.
Zurück zum Zitat Socinski MA, Langer CJ, Okamoto I et al (2013) Safety and efficacy of weekly nab(R)-paclitaxel in combination with carboplatin as first-line therapy in elderly patients with advanced non-small-cell lung cancer. Ann Oncol 24:314–321CrossRef Socinski MA, Langer CJ, Okamoto I et al (2013) Safety and efficacy of weekly nab(R)-paclitaxel in combination with carboplatin as first-line therapy in elderly patients with advanced non-small-cell lung cancer. Ann Oncol 24:314–321CrossRef
23.
Zurück zum Zitat Nakatani Y, Nakaya A, Kurata T et al (2017) Interstitial lung disease following single-agent nanoparticle albumin-bound paclitaxel treatment in patients with advanced non-small cell lung cancer. Case Rep Oncol 10:683–688CrossRef Nakatani Y, Nakaya A, Kurata T et al (2017) Interstitial lung disease following single-agent nanoparticle albumin-bound paclitaxel treatment in patients with advanced non-small cell lung cancer. Case Rep Oncol 10:683–688CrossRef
24.
Zurück zum Zitat Kakiuchi S, Hanibuchi M, Tezuka T et al (2017) Analysis of acute exacerbation of interstitial lung disease associated with chemotherapy in patients with lung cancer: a feasibility of S-1. Respir Investig 55:145–152CrossRef Kakiuchi S, Hanibuchi M, Tezuka T et al (2017) Analysis of acute exacerbation of interstitial lung disease associated with chemotherapy in patients with lung cancer: a feasibility of S-1. Respir Investig 55:145–152CrossRef
Metadaten
Titel
Interstitial lung disease in advanced pancreatic ductal adenocarcinoma patients treated with gemcitabine and nab-paclitaxel combination therapy: a retrospective analysis
verfasst von
Hiroki Irie
Rei Suzuki
Tadayuki Takagi
Mitsuru Sugimoto
Naoki Konno
Yuki Sato
Takuto Hikichi
Jun Nakamura
Minami Hashimoto
Hiromasa Ohira
Publikationsdatum
05.11.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Cancer Chemotherapy and Pharmacology / Ausgabe 3/2020
Print ISSN: 0344-5704
Elektronische ISSN: 1432-0843
DOI
https://doi.org/10.1007/s00280-019-03983-3

Weitere Artikel der Ausgabe 3/2020

Cancer Chemotherapy and Pharmacology 3/2020 Zur Ausgabe

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Alectinib verbessert krankheitsfreies Überleben bei ALK-positivem NSCLC

25.04.2024 NSCLC Nachrichten

Das Risiko für Rezidiv oder Tod von Patienten und Patientinnen mit reseziertem ALK-positivem NSCLC ist unter einer adjuvanten Therapie mit dem Tyrosinkinase-Inhibitor Alectinib signifikant geringer als unter platinbasierter Chemotherapie.

Bei Senioren mit Prostatakarzinom auf Anämie achten!

24.04.2024 DGIM 2024 Nachrichten

Patienten, die zur Behandlung ihres Prostatakarzinoms eine Androgendeprivationstherapie erhalten, entwickeln nicht selten eine Anämie. Wer ältere Patienten internistisch mitbetreut, sollte auf diese Nebenwirkung achten.

ICI-Therapie in der Schwangerschaft wird gut toleriert

Müssen sich Schwangere einer Krebstherapie unterziehen, rufen Immuncheckpointinhibitoren offenbar nicht mehr unerwünschte Wirkungen hervor als andere Mittel gegen Krebs.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.