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Managing Lung Cancer with Comorbid Interstitial Pneumonia

Eiki Ichihara1, Nobuaki Miyahara2, Yoshinobu Maeda3

  • 1Department of Allergy and Respiratory Medicine, Okayama University Hospital, Japan.

Internal Medicine (Tokyo, Japan)
|September 20, 2019
PubMed

Insights

Systemic therapies for advanced non-small cell lung cancer (NSCLC) show promise, but patients with interstitial pneumonia (IP) are often excluded. This review addresses pharmacotherapy challenges in advanced NSCLC with comorbid IP.

Area of Science:

  • Oncology
  • Pulmonology
  • Pharmacology

Background:

  • Systemic therapy for advanced non-small cell lung cancer (NSCLC) has advanced significantly with molecular-targeted therapy and immune checkpoint inhibitors.
  • Patients with comorbid interstitial pneumonia (IP), particularly idiopathic pulmonary fibrosis (IPF), are frequently excluded from clinical trials.
  • Acute exacerbations of IP can occur during cancer treatments, posing risks for patients with lung cancer and IP.

Purpose of the Study:

  • To review the clinical challenges of pharmacotherapy for advanced NSCLC in patients with comorbid IP.
  • To discuss current data and potential strategies for managing these complex cases.

Main Methods:

  • Literature review focusing on clinical trials and studies involving advanced NSCLC and comorbid IP.
  • Analysis of pharmacotherapy options and their impact on IP exacerbation.
  • Discussion of existing data and clinical recommendations.

Main Results:

  • Most clinical trials for advanced NSCLC treatments exclude patients with comorbid IP.
  • IP, especially IPF, is common in lung cancer patients and can be exacerbated by cancer therapies.
  • Limited data exists on the safety and efficacy of systemic therapies in this specific patient population.

Conclusions:

  • There is a critical unmet need for evidence-based guidelines for treating advanced NSCLC with comorbid IP.
  • Further research is required to understand the risks and benefits of various pharmacotherapies in this population.
  • A multidisciplinary approach is essential for managing these complex patients.
Keywords:
interstitial pneumonialung cancer

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