Clinical benefit of subsequent chemotherapy after drug-induced interstitial lung disease in pancreatic cancer patients: a multicenter retrospective study from Japan
Hiroki Irie,
Rei Suzuki,
Yoshinori Okubo,
Hiroyuki Asama,
Naoki Konno,
Yuki Noguchi,
Ko Watanabe,
Goro Shibukawa,
Hidemichi Imamura,
Tadayuki Takagi,
Mitsuru Sugimoto,
Yuki Sato,
Jun Nakamura,
Tsunetaka Kato,
Minami Hashimoto,
Takumi Yanagita,
Takuto Hikichi,
Hiromasa Ohira
Affiliations
Hiroki Irie
Department of Gastroenterology, Fukushima Medical University School of Medicine
Rei Suzuki
Department of Gastroenterology, Fukushima Medical University School of Medicine
Yoshinori Okubo
Department of Gastroenterology, Fukushima Rosai Hospital
Hiroyuki Asama
Department of Gastroenterology, Fukushima Red Cross Hospital
Naoki Konno
Department of Gastroenterology, Fukushima Red Cross Hospital
Yuki Noguchi
Department of Gastroenterology, Ohta Nishinouchi Hospital
Ko Watanabe
Department of Gastroenterology, Ohara General Hospital
Goro Shibukawa
Department of Gastroenterology, Fukushima Medical University Aizu Medical Center
Hidemichi Imamura
Department of Gastroenterology, Ohta Nishinouchi Hospital
Tadayuki Takagi
Department of Gastroenterology, Fukushima Medical University School of Medicine
Mitsuru Sugimoto
Department of Gastroenterology, Fukushima Medical University School of Medicine
Yuki Sato
Department of Gastroenterology, Fukushima Medical University School of Medicine
Jun Nakamura
Department of Endoscopy, Fukushima Medical University Hospital
Tsunetaka Kato
Department of Endoscopy, Fukushima Medical University Hospital
Minami Hashimoto
Department of Endoscopy, Fukushima Medical University Hospital
Takumi Yanagita
Department of Gastroenterology, Fukushima Medical University School of Medicine
Takuto Hikichi
Department of Endoscopy, Fukushima Medical University Hospital
Hiromasa Ohira
Department of Gastroenterology, Fukushima Medical University School of Medicine
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.
