Carboplatin and weekly paclitaxel in combination with bevacizumab for the treatment of advanced non-small cell lung cancer complicated by idiopathic interstitial pneumonias: A feasibility study

Miwako Omori; Yuji Minegishi; Hironori Uruga; Aya Fukuizumi; Kazutoshi Isobe; Shinyu Izumi; Ryo Koyama; Masashi Bando; Haruhito Sugiyama; Kazuhisa Takahashi; Akihiko Gemma; Sakae Homma; Yukihiko Sugiyama; Kazuma Kishi

doi:10.1016/j.resinv.2023.06.002

Carboplatin and weekly paclitaxel in combination with bevacizumab for the treatment of advanced non-small cell lung cancer complicated by idiopathic interstitial pneumonias: A feasibility study

Respir Investig. 2023 Sep;61(5):625-631. doi: 10.1016/j.resinv.2023.06.002. Epub 2023 Jul 11.

Authors

Affiliations

¹ Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan. Electronic address: m-ohs@nms.ac.jp.
² Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan; Department of Respiratory Medicine, Mitsui Memorial Hospital, Tokyo, Japan.
³ Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Tokyo, Japan.
⁴ Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
⁵ Department of Respiratory Medicine, Toho University School of Medicine, Tokyo, Japan.
⁶ Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.
⁷ Department of Respiratory Medicine, Graduate School of Medicine, Juntendo University, Tokyo, Japan.
⁸ Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan.
⁹ Nerima-Hikarigaoka Hospital, Tokyo, Japan.

PMID: 37441903
DOI: 10.1016/j.resinv.2023.06.002

Abstract

Background: Idiopathic interstitial pneumonias are an independent risk factor of lung cancer, and a chemotherapy-induced acute exacerbation is the most common lethal complication in Japanese patients. The safety and efficacy of carboplatin and weekly paclitaxel for the treatment of non-small cell lung cancer with idiopathic interstitial pneumonias has been previously reported in prospective studies. However, carboplatin + paclitaxel with bevacizumab is currently the standard therapy. We conducted a multicenter, phase II study to confirm the safety and efficacy of carboplatin + weekly paclitaxel + bevacizumab for the treatment of patients with lung cancer complicated by idiopathic interstitial pneumonias.

Methods: Chemotherapy-naïve patients with advanced-stage or patients with post-operative recurrent non-squamous non-small cell lung cancer complicated by idiopathic interstitial pneumonias were enrolled. Patients received carboplatin (area under the curve: 5.0) and bevacizumab (15 mg/kg) on day 1 and paclitaxel (100 mg/m²) on days 1, 8, and 15 of each 4-week cycle.

Results: Seventeen patients less than the predetermined number were enrolled and received a median of four treatment cycles (range: 1-6). One patient (5.9%; 95% confidence interval: 0.1-28.7%) had acute exacerbation of interstitial pneumonia related to the study treatment which improved after corticosteroid treatment. The overall response rate was 52.9%. The median progression-free survival, median survival time, and 1-year survival were 5.7 months, 12.9 months, and 52.9%, respectively.

Conclusion: The addition of bevacizumab to carboplatin and weekly paclitaxel might be safe and effective for the treatment of advanced non-small cell lung cancer complicated by idiopathic interstitial pneumonias.

Clinical trial registration number: UMIN000008189.

Keywords: Acute exacerbation; Bevacizumab; Chemotherapy; Idiopathic interstitial pneumonia; Non-squamous cell carcinoma.

Publication types

Clinical Trial, Phase II
Multicenter Study

MeSH terms

Antineoplastic Combined Chemotherapy Protocols / adverse effects
Bevacizumab / adverse effects
Carboplatin / adverse effects
Carcinoma, Non-Small-Cell Lung* / complications
Carcinoma, Non-Small-Cell Lung* / drug therapy
Feasibility Studies
Humans
Idiopathic Interstitial Pneumonias* / complications
Idiopathic Interstitial Pneumonias* / drug therapy
Lung Neoplasms* / complications
Lung Neoplasms* / drug therapy
Neoplasm Recurrence, Local
Paclitaxel / adverse effects
Prospective Studies

Substances

Carboplatin
Paclitaxel
Bevacizumab