The examination of the second-line chemotherapy in SCLC patients with interstitial lung disease

Abstract

<b>Background and Aims:</b> The platinum-doublet chemotherapy is regarded as the standard first-line chemotherapy in extensive-disease small cell lung cancer (ED-SCLC) even the patients with interstitial lung disease (ILD). However, the significance of second-line chemotherapy in ED-SCLC patients with ILD is still unclear. In this study, we compared the efficacy and safety of second-line chemotherapy in ED-SCLC patients with and without ILD. <b>Methods:</b> We retrospectively reviewed 129 patients of ED-SCLC among 217 patients of total SCLC who were admitted in our institution between April 2007 and December 2020. <b>Results and Conclusion:</b> Among 129 ED-SCLC patients, 46 (36%) have ILD as a comorbidity and 83 (64%) have not. The median age of the patients with and without ILD was 72 (57-87) years and 68 (43-89) years, respectively. Among the 119 patients who received first-line chemotherapy, 24 of 41 patients with ILD (59%) and 55 of 78 patients without ILD (71%) received second-line chemotherapy. The objective response rates of second-line chemotherapy in the patients with and without ILD were 29% and 49%, respectively. Median progression-free survival (mPFS) after second-line chemotherapy of the patients with and without ILD was 2.5 months and 4.1 months (P = 0.02), and the median overall survival (mOS) was 5.4 months and 11.1 months (P = 0.008), respectively. In the patients with ILD, acute exacerbation of ILD was observed in 21% during the second-line chemotherapy. These results suggest that the indication of second-line chemotherapy in the ED-SCLC patients with ILD should be carefully considered.