P2.01-037 Clinical Impact of Interstitial Lung Disease on Advanced Non-Small Cell Lung Cancer

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The advanced non-small cell lung cancer (NSCLC) is well known of poor survival. The advanced NSCLC patients with interstitial lung disease (ILD) to be expected poorer survival. The clinical features of patients with advanced NSCLC and interstitial lung disease (ILD) are not fully elucidated, and the role of chemotherapy in advanced NSCLC with ILD remain controversial. The aim of this study was to investigate the prevalence and clinical features of advanced NSCLC patients with ILD, particularly with idiopathic pulmonary fibrosis (IPF). We retrospectively analyzed the patients diagnosed with advanced (i.e. stage IIIB and IV) NSCLC at Tosei general hospital, from January 2008 to December 2014. The diagnosis of ILD and IPF were made according to the 2013 and 2011 research statement respectively. A total of 899 patients of lung cancer were reviewed, 282 patients were advanced NSCLC. Of these 282 patients, 34 (12%) received the diagnosis of ILD. 22 NSCLC patients (8%) had IPF in 34 ILD. 199/248 of non-ILD NSCLC patients (80%) and 26/34 of ILD NSCLC patients (76%), which includes 17 IPF patients, received chemotherapy. 49/248 (20%) of non-ILD NSCLC and 8 (24%) of ILD NSCLC were treated with best supportive care. There was no significant difference in disease control rate and objective response rate between non-ILD NSCLC and ILD NSCLC patients (72% vs 77%, p=0.696; 33% vs 23%, p=0.271). Overall survival in patients with ILD NSCLC was significantly worse than that in non-ILD NSCLC patients (median survival, 7 months vs 10.1 months; log-rank P=0.013). In patients who received chemotherapy, ILD NSCLC patients had significantly worse survival than non-ILD NSCLC patients (median survival, 7 months vs 10.1 months; log-rank P=0.013). However, there were no significant difference in overall survivals in ILD NSCLC patients between IPF and non-IPF (median survival, IPF-NSCLC vs non-IPF NSCLC: 6.1 months vs 8.2 months; log-rank P=0.375). Among ILD NSCLC patients who received chemotherapy, we found no significant difference in overall survival between IPF NSCLC and non-IPF (median survival, 9.6 months vs 9.7 months; log-rank P=0.275). Among advanced NSCLC patients in this cohort, 12% of them had a diagnosis of ILD including 8% with IPF. Survival in advanced NSCLC patients with ILD was worse than that without ILD. We found no significant difference between ILD NSCLC patients with IPF or without IPF in survival.