Dataset Information

Immunotherapy for combined pulmonary fibrosis and emphysema with advanced lung cancer: two case reports and a concise review.

ABSTRACT:

Background

It is unclear whether immunotherapy for combined pulmonary fibrosis and emphysema (CPFE) with advanced lung cancer (CPFE-LC) is safe.

Case description

We reported on two cases of primary CPFE-LC, where the initial focus was on the lung cancer and not on the CPFE. The two patients underwent surgical resections of the lung cancer, and were placed on a combination of immunotherapy and chemotherapy after progressive lung cancer was observed. One patient showed a worsening of respiratory symptoms with increased consolidation and ground-glass shadows, and an increased extent of honeycombing and other fibrosis on high-resolution computed tomography (HRCT) (>10%). He suffered acute exacerbations of interstitial lung disease (AE-ILD) after successful treatment with radiotherapy and follow-up immunotherapy and developed a progressive-fibrosing phenotype. The other patient had a tumor that had shrunk with no progression of the CPFE fibrosis. The two patients died of AE-ILD and tumor invasion, respectively.

Conclusions

Immunotherapy combined with comprehensive therapy may provide benefits for patients with CPFE-LC to a certain extent. However, immune-related adverse effects may limit the use of immunotherapy in CPFE-LC, and the choice of immunotherapy should be cautious in CPFE-LC with a history of radiation pneumonitis or AE-ILD.

SUBMITTER: Tan X

PROVIDER: S-EPMC9745352 | biostudies-literature | 2022 Nov

REPOSITORIES: biostudies-literature

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Publications

Immunotherapy for combined pulmonary fibrosis and emphysema with advanced lung cancer: two case reports and a concise review.

Tan Xianglan X Tang Xi X Jiang Yu Y

Translational cancer research 20221101 11

<h4>Background</h4>It is unclear whether immunotherapy for combined pulmonary fibrosis and emphysema (CPFE) with advanced lung cancer (CPFE-LC) is safe.<h4>Case description</h4>We reported on two cases of primary CPFE-LC, where the initial focus was on the lung cancer and not on the CPFE. The two patients underwent surgical resections of the lung cancer, and were placed on a combination of immunotherapy and chemotherapy after progressive lung cancer was observed. One patient showed a worsening o ...[more]

PMID: 36523303

Similar Datasets

Project description:BackgroundNo single pulmonary function test captures the functional effect of emphysema in idiopathic pulmonary fibrosis (IPF). Without experienced radiologists, other methods are needed to determine emphysema extent. Here, we report the development and validation of a formula to predict emphysema extent in patients with IPF and emphysema.MethodsThe development cohort included 76 patients with combined IPF and emphysema at the Royal Brompton Hospital, London, United Kingdom. The formula was derived using stepwise regression to generate the weighted combination of pulmonary function data that fitted best with emphysema extent on high-resolution computed tomography. Test cohorts included patients from two clinical trials (n = 455 [n = 174 with emphysema]; NCT00047645, NCT00075998) and a real-world cohort from the Royal Brompton Hospital (n = 191 [n = 110 with emphysema]). The formula is only applicable for patients with IPF and concomitant emphysema and accordingly was not used to detect the presence or absence of emphysema.ResultsThe formula was: predicted emphysema extent = 12.67 + (0.92 x percent predicted forced vital capacity) - (0.65 x percent predicted forced expiratory volume in 1 second) - (0.52 x percent predicted carbon monoxide diffusing capacity). A significant relationship between the formula and observed emphysema extent was found in both cohorts (R2 = 0.25, P < 0.0001; R2 = 0.47, P < 0.0001, respectively). In both, the formula better predicted observed emphysema extent versus individual pulmonary function tests. A 15% emphysema extent threshold, calculated using the formula, identified a significant difference in absolute changes from baseline in forced vital capacity at Week 48 in patients with baseline-predicted emphysema extent < 15% versus ≥ 15% (P = 0.0105).ConclusionThe formula, designed for use in patients with IPF and emphysema, demonstrated enhanced ability to predict emphysema extent versus individual pulmonary function tests.Trial registrationNCT00047645; NCT00075998.

Dataset Information

Immunotherapy for combined pulmonary fibrosis and emphysema with advanced lung cancer: two case reports and a concise review.

Background

Case description

Conclusions

Publications

Immunotherapy for combined pulmonary fibrosis and emphysema with advanced lung cancer: two case reports and a concise review.

Similar Datasets

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