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A Phase 2 Study of Atezolizumab for Pretreated NSCLC With Idiopathic Interstitial Pneumonitis
INTRODUCTION: Interstitial pneumonia (IP) is one of the most common and poor prognostic comorbidities in patients with NSCLC and a known risk factor for pneumonitis. Atezolizumab monotherapy is an established treatment for recurrent NSCLC and reported to have a lower risk of pneumonitis than program...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International Association for the Study of Lung Cancer. Published by Elsevier Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7446731/ https://www.ncbi.nlm.nih.gov/pubmed/32858235 http://dx.doi.org/10.1016/j.jtho.2020.08.018 |
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author | Ikeda, Satoshi Kato, Terufumi Kenmotsu, Hirotsugu Ogura, Takashi Iwasawa, Shunichiro Sato, Yuki Harada, Toshiyuki Kubota, Kaoru Tokito, Takaaki Okamoto, Isamu Furuya, Naoki Yokoyama, Toshihide Hosokawa, Shinobu Iwasawa, Tae Yamanaka, Takeharu Okamoto, Hiroaki |
author_facet | Ikeda, Satoshi Kato, Terufumi Kenmotsu, Hirotsugu Ogura, Takashi Iwasawa, Shunichiro Sato, Yuki Harada, Toshiyuki Kubota, Kaoru Tokito, Takaaki Okamoto, Isamu Furuya, Naoki Yokoyama, Toshihide Hosokawa, Shinobu Iwasawa, Tae Yamanaka, Takeharu Okamoto, Hiroaki |
author_sort | Ikeda, Satoshi |
collection | PubMed |
description | INTRODUCTION: Interstitial pneumonia (IP) is one of the most common and poor prognostic comorbidities in patients with NSCLC and a known risk factor for pneumonitis. Atezolizumab monotherapy is an established treatment for recurrent NSCLC and reported to have a lower risk of pneumonitis than programmed cell death protein 1 inhibitors. This study aimed to assess the safety and efficacy of atezolizumab monotherapy in patients with pretreated advanced or recurrent NSCLC with idiopathic IP. METHODS: Patients with advanced or recurrent NSCLC with comorbid idiopathic, chronic fibrotic IP with % forced vital capacity of greater than 70% and no history of immune checkpoint inhibitors were enrolled. The patients received atezolizumab (1200 mg) every 3 weeks until the discontinuation criteria were met. The primary end point of this study was the 1-year survival rate. A sample size of 38 patients was set. RESULTS: This study was terminated early owing to high incidence of pneumonitis. A total of 17 patients were enrolled, with a median age of 70 years. The median % forced vital capacity and % diffusing capacity for carbon monoxide at baseline were 85.4% and 54.4%, respectively. The incidence of pneumonitis was 29.4% (5 of 17) for all grades, 23.5% (4 of 17) for grade greater than or equal to 3, and 5.9% (1 of 17) for grade 5. A total of 57.1% patients (4 of 7) with honeycomb lung developed pneumonitis with a grade greater than or equal to 3, whereas only one patient (10%) without honeycomb lung (n = 10) with grade 1 pneumonitis was found. CONCLUSIONS: Patients with NSCLC with comorbid IP as defined by the selection criteria for this study might have an increased risk of immune checkpoint inhibitor–induced pneumonitis. |
format | Online Article Text |
id | pubmed-7446731 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | International Association for the Study of Lung Cancer. Published by Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-74467312020-08-26 A Phase 2 Study of Atezolizumab for Pretreated NSCLC With Idiopathic Interstitial Pneumonitis Ikeda, Satoshi Kato, Terufumi Kenmotsu, Hirotsugu Ogura, Takashi Iwasawa, Shunichiro Sato, Yuki Harada, Toshiyuki Kubota, Kaoru Tokito, Takaaki Okamoto, Isamu Furuya, Naoki Yokoyama, Toshihide Hosokawa, Shinobu Iwasawa, Tae Yamanaka, Takeharu Okamoto, Hiroaki J Thorac Oncol Brief Report INTRODUCTION: Interstitial pneumonia (IP) is one of the most common and poor prognostic comorbidities in patients with NSCLC and a known risk factor for pneumonitis. Atezolizumab monotherapy is an established treatment for recurrent NSCLC and reported to have a lower risk of pneumonitis than programmed cell death protein 1 inhibitors. This study aimed to assess the safety and efficacy of atezolizumab monotherapy in patients with pretreated advanced or recurrent NSCLC with idiopathic IP. METHODS: Patients with advanced or recurrent NSCLC with comorbid idiopathic, chronic fibrotic IP with % forced vital capacity of greater than 70% and no history of immune checkpoint inhibitors were enrolled. The patients received atezolizumab (1200 mg) every 3 weeks until the discontinuation criteria were met. The primary end point of this study was the 1-year survival rate. A sample size of 38 patients was set. RESULTS: This study was terminated early owing to high incidence of pneumonitis. A total of 17 patients were enrolled, with a median age of 70 years. The median % forced vital capacity and % diffusing capacity for carbon monoxide at baseline were 85.4% and 54.4%, respectively. The incidence of pneumonitis was 29.4% (5 of 17) for all grades, 23.5% (4 of 17) for grade greater than or equal to 3, and 5.9% (1 of 17) for grade 5. A total of 57.1% patients (4 of 7) with honeycomb lung developed pneumonitis with a grade greater than or equal to 3, whereas only one patient (10%) without honeycomb lung (n = 10) with grade 1 pneumonitis was found. CONCLUSIONS: Patients with NSCLC with comorbid IP as defined by the selection criteria for this study might have an increased risk of immune checkpoint inhibitor–induced pneumonitis. International Association for the Study of Lung Cancer. Published by Elsevier Inc. 2020-12 2020-08-25 /pmc/articles/PMC7446731/ /pubmed/32858235 http://dx.doi.org/10.1016/j.jtho.2020.08.018 Text en © 2020 International Association for the Study of Lung Cancer. Published by Elsevier Inc. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Brief Report Ikeda, Satoshi Kato, Terufumi Kenmotsu, Hirotsugu Ogura, Takashi Iwasawa, Shunichiro Sato, Yuki Harada, Toshiyuki Kubota, Kaoru Tokito, Takaaki Okamoto, Isamu Furuya, Naoki Yokoyama, Toshihide Hosokawa, Shinobu Iwasawa, Tae Yamanaka, Takeharu Okamoto, Hiroaki A Phase 2 Study of Atezolizumab for Pretreated NSCLC With Idiopathic Interstitial Pneumonitis |
title | A Phase 2 Study of Atezolizumab for Pretreated NSCLC With Idiopathic Interstitial Pneumonitis |
title_full | A Phase 2 Study of Atezolizumab for Pretreated NSCLC With Idiopathic Interstitial Pneumonitis |
title_fullStr | A Phase 2 Study of Atezolizumab for Pretreated NSCLC With Idiopathic Interstitial Pneumonitis |
title_full_unstemmed | A Phase 2 Study of Atezolizumab for Pretreated NSCLC With Idiopathic Interstitial Pneumonitis |
title_short | A Phase 2 Study of Atezolizumab for Pretreated NSCLC With Idiopathic Interstitial Pneumonitis |
title_sort | phase 2 study of atezolizumab for pretreated nsclc with idiopathic interstitial pneumonitis |
topic | Brief Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7446731/ https://www.ncbi.nlm.nih.gov/pubmed/32858235 http://dx.doi.org/10.1016/j.jtho.2020.08.018 |
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