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TOPLINE:

Acute exacerbations of idiopathic interstitial pneumonia (IIP) were associated with lower survival in adults with advanced lung cancer who underwent chemotherapy.

METHODOLOGY:

• Previous research suggests worse outcomes for lung cancer patients with IIP who have acute exacerbations during chemotherapy, but data on this relationship are limited.
• The researchers compared overall survival among patients with lung cancer who developed acute exacerbations during first-line chemotherapy and those who did not, using a landmark analysis at 30, 60, 90, and 120 days from the start of treatment.
• The study population included 708 adults (492 with non–small cell lung cancer and 216 with small cell lung cancer) from 110 facilities worldwide; the mean age was 70.4 years, 645 were men, and 689 had no history of acute exacerbation.

TAKEAWAY:

• The overall median survival rate for the entire study population was 9.9 months; patients with acute exacerbations had significantly worse survival than those without exacerbations at all time points (hazard ratios of 5.191, 2.351, 2.416, and 2.521 at 30, 60, 90, and 120 days, respectively).
• The incidence of acute exacerbation was greater in patients with non–small cell lung cancer than in those with small cell lung cancer (12.6% vs 4.2%; odds ratio, 3.316).
• Treatment regimens specifically for non–small cell lung cancer were significant independent predictors of acute exacerbations triggered by the therapies in a multivariate analysis (odds ratio, 3.316; P = .016).

IN PRACTICE:

"If acute exacerbation occurs during first-line chemotherapy, switching to the best supportive care instead of continuing chemotherapy may be a possible option," the researchers wrote.

SOURCE:

The lead author on the study was Atsushi Miyamoto, MD, of Toranomon Hospital, Tokyo, Japan. This study was published online in Scientific Reports on May 3, 2024.

LIMITATIONS:

The retrospective design, small sample size, and variation in treatments were among the limitations of the findings, as was the inclusion only of patients treated with purely cytotoxic agents.

DISCLOSURES:

The study received no outside funding. Miyamoto disclosed a lecture fee from Boehringer Ingelheim Japan Inc.