Risk factors for interstitial lung disease and predictive factors for tumor response in patients with advanced non-small cell lung cancer treated with gefitinib
Risk factors for interstitial lung disease and predictive factors for tumor response in patients with advanced non-small cell lung cancer treated with gefitinib
复制标题
DOI：
10.1016/j.lungcan.2004.01.010
复制
发表时间：
2004-07-01
期刊：
影响因子：
5.3
通讯作者：
Saijo, N
中科院分区：
文献类型：
--
作者：
Takano, T;Ohe, Y;Saijo, N
据报道，在日本接受吉非替尼治疗的非小细胞肺癌（NSCLC）患者中间质性肺疾病（ILD）的发病率很高。我们回顾性分析了 112 名接受吉非替尼单药治疗的晚期 NSCLC 患者。使用单变量和多变量分析来确定吉非替尼相关 ILD 的危险因素和吉非替尼肿瘤反应的预测因素。 ILD 的发生率为 5.4%，并且在已有肺纤维化的患者中更高（33% vs 2%；P < 0.001）。多变量分析结果显示，肺纤维化是ILD的显着危险因素（比值比：177，95%置信区间：4.53-6927，P = 0.006）。 98 名可评估患者的缓解率为 33%，女性（53% 对比 23%；P = 0.003）、腺癌患者（38% 对比 6%；P = 0.010）、从不吸烟者（63% 对比 18%；P < 0.001）以及无胸部放射治疗史的患者（39% 对比 13%；P = 0.010）的缓解率为 33%。 = 0.015）。多变量分析结果显示，肿瘤反应的预测因素是“无吸烟史”和“无胸部放射治疗史”。从不吸烟者的生存时间明显长于吸烟者（P = 0.007）。虽然吉非替尼治疗对晚期 NSCLC 患者（尤其是女性、腺癌患者、从不吸烟者和无胸部放疗史的患者）具有临床益处，但它也带来 ILD 的高风险，尤其是肺纤维化患者。必须仔细考虑风险收益比。 (C) 2004 Elsevier Ireland Ltd. 保留所有权利。
A high incidence of interstitial lung disease (ILD) has been reported in patients with non-small cell lung cancer (NSCLC) treated with gefitinib in Japan. We retrospectively analyzed 112 patients with advanced NSCLC who received gefitinib monotherapy. Univariate and multivariate analyses were used to identify risk factors for gefitinib-related ILD and predictive factors for tumor response to gefitinib. The incidence of ILD was 5.4%, and it was higher in the patients with pre-existing pulmonary fibrosis (33% versus 2%; P < 0.001). The results of a multivariate analysis showed that pulmonary fibrosis was a significant risk factor for ILD (odds ratio: 177, 95% confidence interval: 4.53-6927, P = 0.006). The response rate was 33% in the 98 evaluable patients and higher in women (53% versus 23%; P = 0.003), patients with adenocarcinoma (38% versus 6%; P = 0.010), never-smokers (63% versus 18%; P < 0.001), and the patients with no history of thoracic radiotherapy (39% versus 13%; P = 0.015). The results of a multivariate analysis showed that the predictors of tumor response were "no history of smoking" and "no history of thoracic radiotherapy". Never-smokers had a significantly longer survival time than smokers (P = 0.007). Although gefitinib therapy confers a clinical benefit on patients with advanced NSCLC, especially on women, patients with adenocarcinoma, never-smokers, and patients with no history of thoracic radiotherapy, it also poses a high risk of ILD, especially to patients with pulmonary fibrosis. The risk-benefit ratio must be carefully considered. (C) 2004 Elsevier Ireland Ltd. All rights reserved.