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Takahara Y, Abe R, Sumito N, Tanaka T, Ishige Y, Shionoya I, Yamamura K, Nishiki K, Nojiri M, Kato R, Shinomiya S, Oikawa T. Disease control in patients with non-small cell lung cancer using pemetrexed: Investigating the best treatment strategy. Thorac Cancer 2024; 15:987-993. [PMID: 38485287 PMCID: PMC11045330 DOI: 10.1111/1759-7714.15286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/01/2024] [Accepted: 03/06/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Pemetrexed (PEM) is the primary chemotherapy for non-small cell lung cancer (NSCLC), showing potential for long-term disease stability in certain cases. However, studies examining disease control with PEM therapy are lacking. This study aimed to pinpoint clinical traits in patients with NSCLC responding well to PEM therapy, predict factors influencing disease control, and suggest optimal treatment approaches. METHODS A retrospective analysis of patients with NSCLC treated with PEM was performed to compare patients who achieved disease control after treatment with those who did not. RESULTS Of 73 patients, 56 (76.7%) achieved disease control with PEM therapy. In the disease control group, a significantly higher proportion of patients exhibited good performance status (PS) and received PEM doses without reduction after the second cycle. Multivariate analysis identified bevacizumab (Bev) noncompliance, PEM dose reduction, and thyroid transcription factor-1 (TTF-1) negativity as significant independent risk factors for disease progression during PEM therapy. Additionally, overall survival was significantly longer in the disease control group (p < 0.001). CONCLUSIONS Our findings indicated that maintaining the dose of PEM after the second treatment cycle in patients with NSCLC, along with concurrent use of Bev and the presence of TTF-1 positivity, could enhance disease control rates and extend survival.
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Affiliation(s)
- Yutaka Takahara
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
| | - Ryudai Abe
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
| | - Nagae Sumito
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
| | - Takuya Tanaka
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
| | - Yoko Ishige
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
| | - Ikuyo Shionoya
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
| | - Kouichi Yamamura
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
| | - Kazuaki Nishiki
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
| | - Masafumi Nojiri
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
| | - Ryo Kato
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
| | - Shohei Shinomiya
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
| | - Taku Oikawa
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
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Takahara Y, Abe R, Nagae S, Tanaka T, Ishige Y, Shionoya I, Yamamura K, Nishiki K, Nojiri M, Kato R, Shinomiya S, Oikawa T. Investigation of response of patients with non-small cell lung cancer to docetaxel (plus ramucirumab) therapy in second-line treatment. Thorac Cancer 2023; 14:3549-3555. [PMID: 37964501 PMCID: PMC10733157 DOI: 10.1111/1759-7714.15161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Several options for second-line therapy are available for patients with advanced non-small cell lung cancer (NSCLC); however, the optimal therapy remains unclear. Docetaxel (DTX) monotherapy and DTX plus ramucirumab (RAM) are the recommended second-line treatment options. However, the efficacy of these treatments remains unsatisfactory. The aim of this study was to identify the clinical characteristics of patients with NSCLC who respond to DTX or DTX + RAM and factors that predict response. METHODS Patients with NSCLC treated with DTX or DTX + RAM after second-line therapy were retrospectively analyzed. Patients were compared with those who responded or did not respond to the post-treatment efficacy assessment. RESULTS Of 53 patients, 12 (22.6%) had lung cancer that responded to DTX or DTX + RAM therapy (response group). Multivariate analysis identified the absence of immune checkpoint inhibitors (ICIs) in the immediate prior therapy and a reduced dose of DTX after the second cycle as significant independent risk factors predicting nonresponse to DTX and DTX + RAM therapy in patients with NSCLC. The overall survival was significantly longer in the response group compared to the nonresponse group (p = 0.016). CONCLUSIONS Our results suggest that DTX and DTX + RAM therapies immediately after treatment with ICI-containing regimens as well as continuation of DTX without dose reduction after the second cycle may increase the response rate and prolong survival in patients with NSCLC.
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Affiliation(s)
- Yutaka Takahara
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
| | - Ryudai Abe
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
| | - Sumito Nagae
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
| | - Takuya Tanaka
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
| | - Yoko Ishige
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
| | - Ikuyo Shionoya
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
| | - Kouichi Yamamura
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
| | - Kazuaki Nishiki
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
| | - Masafumi Nojiri
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
| | - Ryo Kato
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
| | - Shohei Shinomiya
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
| | - Taku Oikawa
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
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Takahara Y, Abe R, Sumito N, Tanaka T, Ishige Y, Shionoya I, Yamamura K, Nishiki K, Nojiri M, Kato R, Shinomiya S, Oikawa T. Investigation of response factors for monotherapy with immune checkpoint inhibitors in non-small cell lung cancer patients with PD-L1 expression <50. Thorac Cancer 2023; 14:2754-2760. [PMID: 37536667 PMCID: PMC10518233 DOI: 10.1111/1759-7714.15059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/18/2023] [Accepted: 07/20/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Immune checkpoint inhibitor (ICI) monotherapy is currently approved for the treatment of advanced non-small cell lung cancer (NSCLC) patients with programmed death ligand-1 (PD-L1) expression ≥50%. However, the efficacy of ICI monotherapy in patients with PD-L1 expression <50% has not yet been fully elucidated. The aim of this study was to identify the clinical characteristics of NSCLC patients with PD-L1 expression <50% who respond to single-agent ICIs and factors that predict response. METHODS Patients with advanced or recurrent NSCLC with a PD-L1 tumor proportion score (TPS) of 50% or less who received new monotherapy with an ICI between July 2012 and December 2022 were retrospectively analyzed. Patients with response were compared with those without response in the post-treatment response assessment. RESULTS Among the 37 patients, six (16.2%) NSCLC patients in the response group responded to ICI monotherapy and had a significantly lower body mass index (BMI) (p = 0.003). Significantly more patients in the response group developed immune-related adverse events (irAEs) than in the nonresponse group (p < 0.001). Multivariate analysis identified high BMI as a significant independent risk factor predicting nonresponse to ICI monotherapy in NSCLC patients with PD-L1 < 50%. CONCLUSIONS Among NSCLC patients with PD-L1 < 50%, those with a higher BMI were more likely to be nonresponders to ICI monotherapy. In addition, the group that responded to ICI monotherapy may have been at higher risk of developing irAEs, suggesting that careful follow-up is warranted.
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Affiliation(s)
- Yutaka Takahara
- Department of Respiratory MedicineKanazawa Medical UniversityKahokuJapan
| | - Ryudai Abe
- Department of Respiratory MedicineKanazawa Medical UniversityKahokuJapan
| | - Nagae Sumito
- Department of Respiratory MedicineKanazawa Medical UniversityKahokuJapan
| | - Takuya Tanaka
- Department of Respiratory MedicineKanazawa Medical UniversityKahokuJapan
| | - Yoko Ishige
- Department of Respiratory MedicineKanazawa Medical UniversityKahokuJapan
| | - Ikuyo Shionoya
- Department of Respiratory MedicineKanazawa Medical UniversityKahokuJapan
| | - Kouichi Yamamura
- Department of Respiratory MedicineKanazawa Medical UniversityKahokuJapan
| | - Kazuaki Nishiki
- Department of Respiratory MedicineKanazawa Medical UniversityKahokuJapan
| | - Masafumi Nojiri
- Department of Respiratory MedicineKanazawa Medical UniversityKahokuJapan
| | - Ryo Kato
- Department of Respiratory MedicineKanazawa Medical UniversityKahokuJapan
| | - Shohei Shinomiya
- Department of Respiratory MedicineKanazawa Medical UniversityKahokuJapan
| | - Taku Oikawa
- Department of Respiratory MedicineKanazawa Medical UniversityKahokuJapan
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Takahara Y, Tanaka T, Ishige Y, Shionoya I, Yamamura K, Sakuma T, Nishiki K, Nakase K, Nojiri M, Kato R, Shinomiya S, Oikawa T, Mizuno S. Influencing factors of efficacy and long-term use of amrubicin in patients with small cell lung cancer. Thorac Cancer 2023; 14:1286-1293. [PMID: 36994539 PMCID: PMC10175028 DOI: 10.1111/1759-7714.14871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Amrubicin (AMR) has become the standard of care for post-relapse small cell lung cancer (SCLC). It has also been reported to achieve long-term disease control in patients with good treatment response. However, the optimal patient population for whom AMR is effective and the factors associated with long-term disease control are yet to be identified. The aim of the study was to identify the clinical characteristics and factors associated with long-term disease control in patients with recurrent SCLC who would benefit from AMR therapy. METHODS The clinical records of 33 patients diagnosed with recurrent SCLC and treated with AMR were retrospectively reviewed. Clinical information was compared between patients who achieved disease control (effective group) and who developed disease progression (noneffective group) on the first efficacy assessment after AMR and between patients who continued AMR for more than seven cycles (maintenance group) and those who terminated treatment after 1-6 cycles (discontinuation group). RESULTS The noneffective group included significantly more patients with AMR dose reductions after the second cycle (p = 0.006). AMR dose reduction was an independent risk factor for disease progression. The maintenance group had significantly lower pretreatment lactate dehydrogenase (LDH) levels than the discontinuation group (p = 0.046). A high LDH level was an independent risk factor for short AMR discontinuation. Overall survival was significantly longer in the effective group than in the noneffective group (p < 0.001). CONCLUSIONS In AMR therapy for patients with relapsed SCLC, continuation of AMR without dose reduction after the second cycle may contribute to disease control and prolonged survival.
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Affiliation(s)
- Yutaka Takahara
- Department of Respiratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293, Japan
| | - Takuya Tanaka
- Department of Respiratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293, Japan
| | - Yoko Ishige
- Department of Respiratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293, Japan
| | - Ikuyo Shionoya
- Department of Respiratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293, Japan
| | - Kouichi Yamamura
- Department of Respiratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293, Japan
| | - Takashi Sakuma
- Department of Respiratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293, Japan
| | - Kazuaki Nishiki
- Department of Respiratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293, Japan
| | - Keisuke Nakase
- Department of Respiratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293, Japan
| | - Masafumi Nojiri
- Department of Respiratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293, Japan
| | - Ryo Kato
- Department of Respiratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293, Japan
| | - Shohei Shinomiya
- Department of Respiratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293, Japan
| | - Taku Oikawa
- Department of Respiratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293, Japan
| | - Shiro Mizuno
- Department of Respiratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293, Japan
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Shinomiya S, Tanaka T, Shionoya I, Mura T, Nakase K, Takahara Y, Oikawa T, Mizuno S. A case of severe pneumonia caused by Legionella longbeachae with positive results by a Legionella urinary antigen detection kit. Ther Adv Infect Dis 2023; 10:20499361231179863. [PMID: 37363443 PMCID: PMC10285599 DOI: 10.1177/20499361231179863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 05/17/2023] [Indexed: 06/28/2023] Open
Abstract
Legionella longbeachae is a Legionella bacteria often detected in soil, and is known as a rare cause of Legionella infections in Japan. In addition, detection of this Legionella species is often overlooked due to negative results from Legionella urinary antigen tests, which could lead to errors in the therapeutic approach. An 80-year-old woman was admitted to our hospital because of fever and dyspnea. Her blood tests showed elevated white blood cells, increased C-reactive protein and transaminases, and hyponatremia. Chest computed tomography showed dense consolidation in the right lung. We diagnosed Legionella pneumonia because the Legionella urinary antigen test was positive on the day after her admission. The patient was intubated and mechanically ventilated on the third day of hospitalization, because of respiratory failure. However, her condition did not improve and she died on the 10th day after admission. After her death, L. longbeachae was detected from sputum culture from her tracheal tube, and was diagnosed as the causative organism of her pneumonia. L. longbeachae infection reportedly rarely produces positive urinary antigen test results. Our experience suggests that the urinary antigen test using Ribotest Legionella might be able to detect Legionella spp. other than L. pneumophila.
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Affiliation(s)
| | - Takuya Tanaka
- Department of Respiratory Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Ikuyo Shionoya
- Department of Respiratory Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Tatsuki Mura
- Department of Clinical Laboratory, Kanazawa Medical University Hospital, Uchinada, Japan
| | - Keisuke Nakase
- Department of Respiratory Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Yutaka Takahara
- Department of Respiratory Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Taku Oikawa
- Department of Respiratory Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Shiro Mizuno
- Department of Respiratory Medicine, Kanazawa Medical University, Uchinada, Japan
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Takahara Y, Tanaka T, Ishige Y, Shionoya I, Yamamura K, Sakuma T, Nishiki K, Nakase K, Nojiri M, Kato R, Shinomiya S, Oikawa T, Mizuno S. Early recurrence factors in patients with stage III non-small cell lung cancer treated with concurrent chemoradiotherapy. Thorac Cancer 2022; 13:3451-3458. [PMID: 36281714 PMCID: PMC9750816 DOI: 10.1111/1759-7714.14704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/03/2022] [Accepted: 10/06/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The clinical characteristics and risk factors for cancer recurrence have not been well evaluated regarding early recurrence in patients with unresectable locally advanced non-small cell lung cancer (LA-NSCLC) who receive concurrent chemoradiotherapy (CRT). The aim of this study was to determine the clinical characteristics and risk factors of patients with stage III unresectable LA-NSCLC treated with CRT who developed early recurrence. METHODS We retrospectively reviewed the clinical records of 46 patients diagnosed with stage III unresectable LA-NSCLC treated with CRT at our center between July 2012 and July 2021. A tumor proportion score (TPS) < 50% was defined as "low expression" and a TPS > 50% was defined as "high expression." RESULTS A total of 17 (37.0%) patients had a confirmed recurrence within 1 year of treatment. More patients had a lower body mass index in the early recurrence group than in the later recurrence group (p = 0.038). A higher number of patients in the late recurrence group underwent surgery after CRT (p = 0.036). Patients with a higher TPS were more likely to experience late recurrence than early recurrence (p = 0.001), whereas more patients with stage N3 disease were in the early recurrence group (p = 0.011). Multivariate analysis identified lower TPS expression as an independent risk factor for early recurrence after CRT. Overall survival was prolonged in the late recurrence group (p < 0.001). CONCLUSIONS A lower TPS may be a predictor of early recurrence after CRT in patients with LA-NSCLC. These patients should be closely monitored for post-treatment recurrence.
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Affiliation(s)
- Yutaka Takahara
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
| | - Takuya Tanaka
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
| | - Yoko Ishige
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
| | - Ikuyo Shionoya
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
| | - Kouichi Yamamura
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
| | - Takashi Sakuma
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
| | - Kazuaki Nishiki
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
| | - Keisuke Nakase
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
| | - Masafumi Nojiri
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
| | - Ryo Kato
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
| | - Shohei Shinomiya
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
| | - Taku Oikawa
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
| | - Shiro Mizuno
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunJapan
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Takahara Y, Tanaka T, Ishige Y, Shionoya I, Yamamura K, Sakuma T, Nishiki K, Nakase K, Nojiri M, Kato R, Shinomiya S, Oikawa T, Mizuno S. Differential response in patients with large cell neuroendocrine carcinoma of the lung to initial therapy: A case series. Cancer Rep (Hoboken) 2022; 6:e1754. [PMID: 36366956 PMCID: PMC9875627 DOI: 10.1002/cnr2.1754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/22/2022] [Accepted: 10/30/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Large cell neuroendocrine tumors of the lung (LCNEC) are rare. Chemotherapy with the small cell lung carcinoma (SCLC) regimen is the most appropriate treatment for LCNEC. However, there is evidence that the non-small cell lung cancer regimen is also effective in some reported cases. Due to the differences in response to LCNEC treatment, a standard of care for LCNEC has not been established. CASES The clinical records of nine patients with LCNEC who were treated with anticancer drugs based on an SCLC regimen from March 2016 to March 2022 were retrospectively reviewed. The patients who responded to treatment after one cycle of systemic chemotherapy were compared to those who did not respond. All patients in the responder group had a performance status (PS) of 0 or 1. However, 5 of the 6 patients in the non-responder group had a PS of 2 or 3, indicating that many patients were in poor general condition. Although patients with multiple metastases to more than one organ prior to treatment were not identified in the responder group, five of these patients were in the non-responder group. In the non-responder group, all patients discontinued treatment due to deterioration of general condition during first-line treatment. Thus, none of them were able to start the second-line treatment. CONCLUSION The results of this study may suggest that early diagnosis and initiation of treatment before multiple organ metastasis development and PS decline may have clinical implications that could lead to improved treatment response in patients with LCNEC.
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Affiliation(s)
- Yutaka Takahara
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunIshikawaJapan
| | - Takuya Tanaka
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunIshikawaJapan
| | - Yoko Ishige
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunIshikawaJapan
| | - Ikuyo Shionoya
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunIshikawaJapan
| | - Kouichi Yamamura
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunIshikawaJapan
| | - Takashi Sakuma
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunIshikawaJapan
| | - Kazuaki Nishiki
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunIshikawaJapan
| | - Keisuke Nakase
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunIshikawaJapan
| | - Masafumi Nojiri
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunIshikawaJapan
| | - Ryo Kato
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunIshikawaJapan
| | - Shohei Shinomiya
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunIshikawaJapan
| | - Taku Oikawa
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunIshikawaJapan
| | - Shiro Mizuno
- Department of Respiratory MedicineKanazawa Medical UniversityKahoku‐gunIshikawaJapan
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Takahara Y, Tanaka T, Ishige Y, Shionoya I, Yamamura K, Sakuma T, Nishiki K, Nakase K, Nojiri M, Kato R, Shinomiya S, Fujimoto Y, Oikawa T, Mizuno S. Efficacy and predictors of rechallenge with immune checkpoint inhibitors in non-small cell lung cancer. Thorac Cancer 2022; 13:624-630. [PMID: 34989146 PMCID: PMC8841726 DOI: 10.1111/1759-7714.14309] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The efficacy of rechallenge with immune checkpoint inhibitors (ICIs) in non-small cell lung cancer (NSCLC) patients has not yet been fully clarified. This study aimed to identify the clinical characteristics of patients with NSCLC who benefited from rechallenge with ICIs. METHODS We retrospectively reviewed the clinical records of 24 patients who were diagnosed with NSCLC and rechallenged with ICIs between August 2016 and July 2021. RESULTS Of the 24 patients included in the study, 11 were in the responder group (45.8%) and 13 in the nonresponder group (54.2%). The number of patients who used a different ICI from that used in the initial therapy was significantly higher in the responder group than in the nonresponder group (p = 0.006). Multivariate analysis identified lung metastasis and female sex as significant independent risk factors for nonresponse to rechallenge with ICIs. Compared to the nonresponder group, the duration of treatment after rechallenge with ICIs was significantly longer in the responder group (p = 0.016), and there was a trend toward longer overall survival (p = 0.059). CONCLUSIONS Patients with lung cancer who were rechallenged with ICIs and without progressive disease after initial ICI therapy were able to continue ICI therapy for a longer period of time. This may be associated with longer survival. Patients with lung metastases and female patients are more likely to be nonresponsive to rechallenge with ICIs. Administration of a different type of ICI from that used in the initial ICI therapy may result in disease control.
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Affiliation(s)
- Yutaka Takahara
- Department of Respiratory Medicine, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
| | - Takuya Tanaka
- Department of Respiratory Medicine, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
| | - Yoko Ishige
- Department of Respiratory Medicine, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
| | - Ikuyo Shionoya
- Department of Respiratory Medicine, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
| | - Kouichi Yamamura
- Department of Respiratory Medicine, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
| | - Takashi Sakuma
- Department of Respiratory Medicine, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
| | - Kazuaki Nishiki
- Department of Respiratory Medicine, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
| | - Keisuke Nakase
- Department of Respiratory Medicine, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
| | - Masafumi Nojiri
- Department of Respiratory Medicine, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
| | - Ryo Kato
- Department of Respiratory Medicine, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
| | - Shohei Shinomiya
- Department of Respiratory Medicine, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
| | - Yuki Fujimoto
- Department of Respiratory Medicine, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
| | - Taku Oikawa
- Department of Respiratory Medicine, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
| | - Shiro Mizuno
- Department of Respiratory Medicine, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
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Takahara Y, Tanaka T, Ishige Y, Shionoya I, Yamamura K, Sakuma T, Nishiki K, Nakase K, Nojiri M, Kato R, Shinomiya S, Fujimoto Y, Oikawa T, Mizuno S. Risk factors for acute exacerbation in lung cancer complicated by interstitial lung disease with slight reticular shadows. Thorac Cancer 2021; 12:2758-2766. [PMID: 34409749 PMCID: PMC8520810 DOI: 10.1111/1759-7714.14121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/05/2021] [Accepted: 08/06/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND The risk of cancer treatment-related acute exacerbation (AE) in patients with lung cancer and mild interstitial lung disease (ILD) on imaging, classified as indeterminate for usual interstitial pneumonia (UIP), has not previously been clarified. METHODS We retrospectively reviewed the clinical records of 27 patients with lung cancer and ILD who were diagnosed and treated from April 2016 to March 2021. RESULTS Among the 27 patients, 21 were classified as indeterminate for UIP and six as UIP/probable UIP; furthermore, 10 (46.6%) and three (50%) patients from each group, respectively, developed treatment-related AEs. No significant difference was observed regarding the incidence of AEs between the two groups. However, significantly more patients in the AE group received immune checkpoint inhibitors (ICIs) compared to the non-AE group (p = 0.021). Multivariate analysis revealed that the use of ICIs was a significant independent risk factor for treatment-related AEs. CONCLUSIONS Lung cancer patients with mild ILD suggestive of indeterminate for UIP and UIP patterns are at an increased risk for treatment-related AEs. Furthermore, ICI use is an independent risk factor for AEs in patients with lung cancer complicated by ILD, and ICIs should be used with great caution.
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Affiliation(s)
- Yutaka Takahara
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
| | - Takuya Tanaka
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
| | - Yoko Ishige
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
| | - Ikuyo Shionoya
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
| | - Kouichi Yamamura
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
| | - Takashi Sakuma
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
| | - Kazuaki Nishiki
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
| | - Keisuke Nakase
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
| | - Masafumi Nojiri
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
| | - Ryo Kato
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
| | - Shohei Shinomiya
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
| | - Yuki Fujimoto
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
| | - Taku Oikawa
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
| | - Shiro Mizuno
- Department of Respiratory MedicineKanazawa Medical UniversityIshikawaJapan
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Takahara Y, Ishige Y, Shionoya I, Fujimoto Y, Oikawa T, Mizuno S. Second SVC stent treatment for tumour ingrowth. Respirol Case Rep 2020; 8:e00619. [PMID: 32642067 PMCID: PMC7330812 DOI: 10.1002/rcr2.619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 11/07/2022] Open
Abstract
We herein report a case of lung cancer with recurrent superior vena cava (SVC) syndrome, which was treated with additional stent placement. Our report suggests the possibility that additional SVC stent placement is an option for treatment of tumour ingrowth, even in patients with poor performance status.
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Affiliation(s)
- Yutaka Takahara
- Department of Respiratory MedicineKanazawa Medical UniversityUchinadaJapan
| | - Yoko Ishige
- Department of Respiratory MedicineKanazawa Medical UniversityUchinadaJapan
| | - Ikuyo Shionoya
- Department of Respiratory MedicineKanazawa Medical UniversityUchinadaJapan
| | - Yuki Fujimoto
- Department of Respiratory MedicineKanazawa Medical UniversityUchinadaJapan
| | - Taku Oikawa
- Department of Respiratory MedicineKanazawa Medical UniversityUchinadaJapan
| | - Shiro Mizuno
- Department of Respiratory MedicineKanazawa Medical UniversityUchinadaJapan
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