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Irie H, Suzuki R, Okubo Y, Asama H, Konno N, Noguchi Y, Watanabe K, Shibukawa G, Imamura H, Takagi T, Sugimoto M, Sato Y, Nakamura J, Kato T, Hashimoto M, Yanagita T, Hikichi T, Ohira H. Clinical benefit of subsequent chemotherapy after drug-induced interstitial lung disease in pancreatic cancer patients: a multicenter retrospective study from Japan. BMC Cancer 2023; 23:316. [PMID: 37024781 PMCID: PMC10080831 DOI: 10.1186/s12885-023-10781-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/28/2023] [Indexed: 04/08/2023] Open
Abstract
PURPOSE Drug-induced interstitial lung disease (ILD) is not a rare adverse event in the current chemotherapy strategy for pancreatic ductal adenocarcinoma (PDAC). Thus, we aimed to find the optimal management for PDAC patients with a history of ILD induced by a gemcitabine-based regimen. METHODS We conducted a multicenter retrospective study. The primary endpoint was the overall survival (OS) of patients who underwent either S-1 monotherapy or FOLFOX after the onset of ILD. Toxicity data was also analyzed in the 2 groups. RESULTS Twenty-four patients were diagnosed with ILD and 17 patients who received subsequent chemotherapy were enrolled in the study. Among 17 patients who were managed with subsequent chemotherapy after recovering from ILD, we did not observe significant difference in OS between S-1 and FOLFOX (290.0 days vs. undefined, p = 0.39). Relapse of drug-induced ILD was not observed in all cases during the course. Overall, severe adverse events (CTCAE Grade 3 or 4) were observed in 3 patients (23.1%) in S-1 treatment group and 1 patient (25.0%) in FOLFOX treatment group (p = 0.93). CONCLUSIONS S-1 monotherapy and FOLFOX are comparable as the subsequent chemotherapy after gemcitabine-based chemotherapy-induced ILD in unresectable PDAC.
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Affiliation(s)
- Hiroki Irie
- Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Rei Suzuki
- Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
| | - Yoshinori Okubo
- Department of Gastroenterology, Fukushima Rosai Hospital, Fukushima, Japan
| | - Hiroyuki Asama
- Department of Gastroenterology, Fukushima Red Cross Hospital, Fukushima, Japan
| | - Naoki Konno
- Department of Gastroenterology, Fukushima Red Cross Hospital, Fukushima, Japan
| | - Yuki Noguchi
- Department of Gastroenterology, Ohta Nishinouchi Hospital, Fukushima, Japan
| | - Ko Watanabe
- Department of Gastroenterology, Ohara General Hospital, Fukushima, Japan
| | - Goro Shibukawa
- Department of Gastroenterology, Fukushima Medical University Aizu Medical Center, Fukushima, Japan
| | - Hidemichi Imamura
- Department of Gastroenterology, Ohta Nishinouchi Hospital, Fukushima, Japan
| | - Tadayuki Takagi
- Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Mitsuru Sugimoto
- Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Yuki Sato
- Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Jun Nakamura
- Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan
| | - Tsunetaka Kato
- Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan
| | - Minami Hashimoto
- Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan
| | - Takumi Yanagita
- Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Takuto Hikichi
- Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan
| | - Hiromasa Ohira
- Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
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Miyagahara T, Fujimori N, Ueda K, Takamatsu Y, Matsumoto K, Teramatsu K, Takaoka T, Suehiro Y, Shimokawa Y, Omori K, Niina Y, Tachibana Y, Akashi T, Oono T, Ogawa Y. Incidence and appropriate management of drug‐induced interstitial lung disease in Japanese patients with unresectable pancreatic cancer: A multicenter retrospective study. Asia Pac J Clin Oncol 2022. [DOI: 10.1111/ajco.13903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 10/27/2022] [Accepted: 11/07/2022] [Indexed: 12/12/2022]
Affiliation(s)
| | - Nao Fujimori
- Department of Medicine and Bioregulatory Science Graduate School of Medical Sciences Kyushu University Fukuoka Japan
| | - Keijiro Ueda
- Department of Medicine and Bioregulatory Science Graduate School of Medical Sciences Kyushu University Fukuoka Japan
- Department of Gastroenterology Kitakyushu Municipal Medical Center Fukuoka Japan
| | - Yu Takamatsu
- Department of Medicine and Bioregulatory Science Graduate School of Medical Sciences Kyushu University Fukuoka Japan
| | - Kazuhide Matsumoto
- Department of Medicine and Bioregulatory Science Graduate School of Medical Sciences Kyushu University Fukuoka Japan
| | - Katsuhito Teramatsu
- Department of Medicine and Bioregulatory Science Graduate School of Medical Sciences Kyushu University Fukuoka Japan
| | - Takehiro Takaoka
- Department of Medicine and Bioregulatory Science Graduate School of Medical Sciences Kyushu University Fukuoka Japan
| | - Yuta Suehiro
- Department of Gastroenterology Nakatsu Municipal Hospital Nakatsu Japan
| | - Yuzo Shimokawa
- Department of Gastroenterology Nakatsu Municipal Hospital Nakatsu Japan
- Department of Gastroenterology Kitakyushu Municipal Medical Center Fukuoka Japan
| | - Kaoru Omori
- Department of Gastroenterology Nakatsu Municipal Hospital Nakatsu Japan
| | - Yusuke Niina
- Department of Gastroenterology Kitakyushu Municipal Medical Center Fukuoka Japan
| | - Yuichi Tachibana
- Department of Internal Medicine Saiseikai Fukuoka General Hospital Fukuoka Japan
| | - Tetsuro Akashi
- Department of Internal Medicine Saiseikai Fukuoka General Hospital Fukuoka Japan
| | - Takamasa Oono
- Department of Medicine and Bioregulatory Science Graduate School of Medical Sciences Kyushu University Fukuoka Japan
| | - Yoshihiro Ogawa
- Department of Medicine and Bioregulatory Science Graduate School of Medical Sciences Kyushu University Fukuoka Japan
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Ueda R, Yamamoto N, Hori Y, Yoshida K, Ohtsubo K, Terashima T, Shimada T, Sai Y. Risk factors for interstitial lung disease induced by gemcitabine plus albumin-bound paclitaxel therapy in pancreatic ductal adenocarcinoma patients. J Pharm Health Care Sci 2022; 8:5. [PMID: 35105386 PMCID: PMC8809002 DOI: 10.1186/s40780-021-00236-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022] Open
Abstract
Background Gemcitabine plus nab-paclitaxel (GnP) therapy is used for unresectable pancreatic ductal adenocarcinoma, but may cause interstitial lung disease (ILD) as a serious side effect. However, the risk factors for ILD in patients receiving GnP therapy are not well established. Here, we retrospectively investigated the incidence of GnP-induced ILD in pancreatic ductal adenocarcinoma patients, and the risk factors. Methods We investigated the patients’ background, laboratory data, previous treatment history, concomitant medications, number of doses of GnP, cumulative dosage and administration period, and occurrence of side effects. Results Of the 105 patients included in this study, ILD occurred in 10 (9.5%). Patients with ILD had a significantly higher frequency of concomitant treatment with Kampo medicines, especially goshajinkigan, which is considered to help prevent chemotherapy-induced peripheral neuropathy (CIPN) (odds ratio: 11.5, 95% confidence interval: 2.67–49.38). No significant differences were observed in other clinical characteristics. Notably, the severity of CIPN in patients who used goshajinkigan for prevention was not significantly different from that in patients who did not use goshajinkigan in this study. Conclusions These results suggest that administration of goshajinkigan to patients receiving GnP therapy for prevention of CIPN may need to be reconsidered.
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Affiliation(s)
- Rikako Ueda
- Department of Hospital Pharmacy, University Hospital, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan.
| | - Naho Yamamoto
- Department of Hospital Pharmacy, University Hospital, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
| | - Yuki Hori
- Department of Hospital Pharmacy, University Hospital, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
| | - Kouji Yoshida
- Department of Hospital Pharmacy, University Hospital, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
| | - Koushiro Ohtsubo
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
| | - Takeshi Terashima
- Department of Gastroenterology, Graduate School of Medicine, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
| | - Tsutomu Shimada
- Department of Hospital Pharmacy, University Hospital, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
| | - Yoshimichi Sai
- Department of Hospital Pharmacy, University Hospital, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, Japan
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Risk factors for gemcitabine plus nab-paclitaxel-induced interstitial lung disease in pancreatic cancer patients. Int J Clin Oncol 2020; 26:543-551. [PMID: 33175298 DOI: 10.1007/s10147-020-01827-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/29/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Drug-induced interstitial lung disease (ILD) is one of the most serious adverse events with a high mortality rate and represents a serious clinical problem. However, gemcitabine plus nab-paclitaxel (GnP)-induced ILD in pancreatic cancer (PC) patients has not been thoroughly investigated. Therefore, we conducted this study to examine the clinical characteristics of GnP-induced ILD and identify risk factors for developing ILD. METHODS We retrospectively investigated consecutive patients with PC who received GnP between January 2015 and April 2020. We compared the clinical characteristics and overall survival (OS) according to ILD occurrence and explored risk factors including ABO blood type for developing ILD. RESULTS Of the 910 patients included in this study, ILD occurred in 20 patients (2.2%). PC patients who developed ILD had a significantly higher frequency of blood type B compared to those without ILD (42% vs. 22%, p ˂ 0.05). Other baseline characteristics including smoking history and current/previous lung disease were not different between the two groups. Median time from initiation of GnP to onset of ILD was 80 days. All patients recovered from ILD and OS was not significantly different according to ILD occurrence. Multivariate analysis revealed that blood type B was an independent risk factor for developing ILD. CONCLUSIONS We demonstrated that GnP-induced ILD occurred in 2.2% of PC patients with no mortality and OS did not differ according to ILD occurrence. Furthermore, we clarified that ABO blood type B was an independent risk factor for developing ILD in PC patients receiving GnP.
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