Clinical characteristics of nivolumab-induced radiation recall pneumonitis in patients with non-small cell lung cancer: A multicenter real-world analysis of 669 patients.

2020 ◽  
Vol 38 (5_suppl) ◽  
pp. 88-88 ◽  
Author(s):  
Tadasuke Shimokawaji ◽  
Shoko Narita ◽  
Tomoyuki Naito ◽  
Hibiki Udagawa ◽  
Koichi Goto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Clinical Characteristics ◽  
Significant Risk ◽  
Small Cell ◽  
Small Cell Lung ◽  
Radiation Recall ◽  
Lung Cancer Patients ◽  
History Of ◽  
Recall Pneumonitis

88 Background: Immune checkpoint inhibitors can cause immune-related pneumonitis in lung cancer patients. Some of those patients with history of previous thoracic radiation therapy (TRT) are reported to show radiation recall pneumonitis (RRP) pattern. In this multicenter retrospective study, we analyzed the patient background and clinical characteristics of RRP. Methods: Medical records of non-small cell lung cancer patients, who received nivolumab between December 2015 and March 2017, were retrospectively reviewed. Incidence of pneumonitis, and incidence, risk factors and clinical characteristics of RRP were analyzed at 5 institutions. Person’s chi-square test (age, sex, smoking history, performance status at the start of nivolumab treatment, background lung disease, history of previous radiation pneumonitis, total dose, volume receiving more than 20Gy, 30Gy, mean lung dose of TRT, and duration after TRT) was conducted to identify potential risk factors of RRP. RRP was defined as fibrosis or consolidation occurring in the previous TRT field, and imaging analysis was conducted by two individual radiologists. Results: A total of 669 patients were evaluated, and the incidences of all-grade and ≥ grade 3 pneumonitis were 8.8% (59/669) and 6.2% (18/669), respectively. Incidence of RRP was 5.4% (14/257) among patients with history of previous TRT. There were no significant risk factors for RRP. Although we did not find significant difference between the severity of RRP pattern and other radiological patterns of pneumonitis, patients with RRP showed better outcome. All patients recovered from RRP without no exacerbation or death, compared to 9.3% of exacerbation or death in other patterns of pneumonitis. Conclusions: Incidence of RRP was 5.4% among patients with history of previous TRT, although there were no significant risk factors of RRP. Patients with RRP pattern showed relatively better outcome.

Predictive Factors for Interstitial Lung Disease, Antitumor Response, and Survival in Non–Small-Cell Lung Cancer Patients Treated With Gefitinib

2006 ◽  
Vol 24 (16) ◽  
pp. 2549-2556 ◽  
Author(s):  
Masahiko Ando ◽  
Isamu Okamoto ◽  
Nobuyuki Yamamoto ◽  
Koji Takeda ◽  
Kenji Tamura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Adverse Effect ◽  
Interstitial Lung Disease ◽  
Small Cell Lung Cancer ◽  
Predictive Factors ◽  
Small Cell ◽  
Small Cell Lung ◽  
Antitumor Response ◽  
History Of

Purpose Interstitial lung disease (ILD) is a serious adverse effect of gefitinib, but its prevalence and risk factors remain largely unknown. We examined the prevalence of and risk factors for gefitinib-induced ILD associated with practical use of the drug in Japanese with non–small-cell lung cancer (NSCLC). Patients and Methods Clinical information was retrospectively assembled for NSCLC patients who started gefitinib treatment at affiliated institutions of the West Japan Thoracic Oncology Group between August 31 and December 31, 2002. Medical records of patients who developed pulmonary infiltrates were reviewed by a central committee of extramural experts for identification of patients with gefitinib-induced ILD. Multivariate logistic or Cox regression analysis was performed to identify independent predictive factors for ILD, antitumor response, and survival. Results Seventy cases of and 31 deaths from gefitinib-induced ILD were identified among 1,976 consecutively treated patients at 84 institutions, corresponding to a prevalence of 3.5% and mortality of 1.6%. Gefitinib-induced ILD was significantly associated with male sex, a history of smoking, and coincidence of interstitial pneumonia (odds ratios = 3.10, 4.79, and 2.89, respectively). Predictive factors for response were female sex, no history of smoking, adenocarcinoma histology, metastatic disease, and good performance status (PS), whereas predictive factors for survival were female sex, no history of smoking, adenocarcinoma histology, nonmetastatic disease, good PS, and previous chest surgery. Conclusion ILD is a serious adverse effect of gefitinib in the clinical setting that cannot be ignored. However, patient selection based on sex and smoking history can minimize ILD risk and maximize the clinical benefit of gefitinib.

scholarly journals Aberrant Alteration of Circulating Lymphocyte Subsets in Small Cell Lung Cancer Patients Treated with Radiotherapy

2021 ◽  
Vol 20 ◽  
pp. 153303382110399
Author(s):  
Hui Li ◽  
Hong Yu ◽  
Shaowei Lan ◽  
Dandan Zhao ◽  
Yan Liu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cancer Patients ◽  
Cell Lung Cancer ◽  
Peripheral Blood ◽  
Clinical Characteristics ◽  
Lymphocyte Subsets ◽  
Small Cell ◽  
Small Cell Lung ◽  
Lung Cancer Patients

Purpose: The role of different circulating lymphocyte subsets, as well as their correlation with clinical characteristics of small cell lung cancer patients have not yet been fully understood. This study aims to evaluate the influence of the fluctuating absolute numbers of lymphocyte subpopulations in peripheral blood of patients with small cell lung cancer. Methods: The absolute counts and percentages of lymphocyte subsets in peripheral blood of 329 patients with small cell lung cancer were retrospectively analyzed. The numbers of CD3+, CD3+CD4+, and CD3+CD8+ T lymphocytes, CD3−CD19+ B lymphocytes, and CD3−CD16+CD56+ NK cells were evaluated by flow cytometry. Their relationship with the patients’ clinical characteristics were statistically evaluated. Results: The CD4/CD8 values derived from the absolute number and percentage of CD3+CD4+ cells divided by CD3+CD8+ cells were identical (1.86  ±  0.99). There was no association between any of the lymphocyte subsets levels and age/sex of the 329 patients with small cell lung cancer. The patients with advanced stage had a reduction in CD3+ and CD3+CD4+ T cell counts and a decreased CD4/CD8 ratio. The levels of CD3+CD4+ T cells, CD3−CD19+ B cells, CD3−CD16+CD56+ NK cells, and CD4/CD8 ratio were associated with advanced tumor-node-metastasis stage. Patients who had undergone radiotherapy were characterized by lymphopenia with lower numbers of CD3+, CD3+CD4+, CD3+CD8+ T lymphocyte, B lymphocyte, NK cell, and CD4/CD8 ratio. The evaluation of individual CD4/CD8 ratio should be combined with other clinical parameters. Conclusions: Patients with small cell lung cancer have altered lymphocyte homeostasis. Lymphopenia was a long-lasting feature of the enrolled patients who were treated with radiotherapy. The available lymphocyte subsets levels might be used to manage the clinical treatment scheme.

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