Abstract

Background: The safety and efficacy of chemotherapy for relapsed small cell lung cancer (SCLC) with interstitial lung disease (ILD) is uncertain. ILD is a risk factor for acute exacerbation (AE)-ILD.

Methods: From January 2009 to December 2017, we retrospectively analyzed relapsed SCLC patients with ILD who received chemotherapy at Nagoya Medical Center. ILD was diagnosed from the clinical features and highresolution computed tomography (HRCT). The objectives were to evaluate the incidence of AE-ILD for relapsed SCLC with each agent and overall survival (OS) of the patients from second-line chemotherapy.

Results: In total, 16 relapsed SCLC patients with ILD were treated. In the process of receiving chemotherapy, six patients (regimens: amrubicin/topotecan 5/1, usual interstitial pneumonia (UIP) pattern/non-UIP pattern 4/2) developed AE-ILD. None of the patients administered paclitaxel (PTX) or nanoparticle albumin bound paclitaxel (nab-PTX) developed AE-ILD. The incidence of AE-ILD treated with amrubicin was 45.5% (5/11). Median overall survival of the patients with and without AE from the start of second-line chemotherapy was 131 days and 165 days, respectively; the difference between the two groups was not statistically significant (p=0.324).

Conclusions: Our results indicated that amrubicin may have a higher risk of AE-ILD. However, PTX regimens could be a safe option for relapsed SCLC with ILD

Keywords: Small cell lung cancer; Interstitial lung disease; Acute exacerbation; Amrubicin