Predictive factors for interstitial lung disease, antitumor response, and survival in non-small-cell lung cancer patients treated with gefitinib

Masahiko Ando, Isamu Okamoto, Nobuyuki Yamamoto, Koji Takeda, Kenji Tamura, Takashi Seto, Yutaka Ariyoshi, Masahiro Fukuoka

Research output: Contribution to journalArticle

266 Citations (Scopus)

Abstract

Purpose: Interstitial lung disease (ILD) is a serious adverse effect of gefitinib, but its prevalence and risk factors remain largely unknown. We examined the prevalence of and risk factors for gefitinib-induced ILD associated with practical use of the drug in Japanese with non-small-cell lung cancer (NSCLC). Patients and Methods: Clinical information was retrospectively assembled for NSCLC patients who started gefitinib treatment at affiliated institutions of the West Japan Thoracic Oncology Group between August 31 and December 31, 2002. Medical records of patients who developed pulmonary infiltrates were reviewed by a central committee of extramural experts for identification of patients with gefitinib-induced ILD. Multivariate logistic or Cox regression analysis was performed to identify independent predictive factors for ILD, antitumor response, and survival. Results: Seventy cases of and 31 deaths from gefitinib-induced ILD were identified among 1,976 consecutively treated patients at 84 institutions, corresponding to a prevalence of 3.5% and mortality of 1.6%. Gefitinib-induced ILD was significantly associated with male sex, a history of smoking, and coincidence of interstitial pneumonia (odds ratios = 3.10, 4.79, and 2.89, respectively). Predictive factors for response were female sex, no history of smoking, adenocarcinoma histology, metastatic disease, and good performance status (PS), whereas predictive factors for survival were female sex, no history of smoking, adenocarcinoma histology, nonmetastatic disease, good PS, and previous chest surgery. Conclusion: ILD is a serious adverse effect of gefitinib in the clinical setting that cannot be ignored. However, patient selection based on sex and smoking history can minimize ILD risk and maximize the clinical benefit of gefitinib.

Original languageEnglish
Pages (from-to)2549-2556
Number of pages8
JournalJournal of Clinical Oncology
Volume24
Issue number16
DOIs
Publication statusPublished - Jun 1 2006
Externally publishedYes

Fingerprint

Interstitial Lung Diseases
Non-Small Cell Lung Carcinoma
Survival
Smoking
Histology
Adenocarcinoma
Thorax
gefitinib
Patient Selection
Medical Records
Japan
History
Odds Ratio
Regression Analysis
Lung
Mortality

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Predictive factors for interstitial lung disease, antitumor response, and survival in non-small-cell lung cancer patients treated with gefitinib. / Ando, Masahiko; Okamoto, Isamu; Yamamoto, Nobuyuki; Takeda, Koji; Tamura, Kenji; Seto, Takashi; Ariyoshi, Yutaka; Fukuoka, Masahiro.

In: Journal of Clinical Oncology, Vol. 24, No. 16, 01.06.2006, p. 2549-2556.

Research output: Contribution to journalArticle

Ando, Masahiko ; Okamoto, Isamu ; Yamamoto, Nobuyuki ; Takeda, Koji ; Tamura, Kenji ; Seto, Takashi ; Ariyoshi, Yutaka ; Fukuoka, Masahiro. / Predictive factors for interstitial lung disease, antitumor response, and survival in non-small-cell lung cancer patients treated with gefitinib. In: Journal of Clinical Oncology. 2006 ; Vol. 24, No. 16. pp. 2549-2556.
@article{ed16b99286e340328464c6f1b0507256,
title = "Predictive factors for interstitial lung disease, antitumor response, and survival in non-small-cell lung cancer patients treated with gefitinib",
abstract = "Purpose: Interstitial lung disease (ILD) is a serious adverse effect of gefitinib, but its prevalence and risk factors remain largely unknown. We examined the prevalence of and risk factors for gefitinib-induced ILD associated with practical use of the drug in Japanese with non-small-cell lung cancer (NSCLC). Patients and Methods: Clinical information was retrospectively assembled for NSCLC patients who started gefitinib treatment at affiliated institutions of the West Japan Thoracic Oncology Group between August 31 and December 31, 2002. Medical records of patients who developed pulmonary infiltrates were reviewed by a central committee of extramural experts for identification of patients with gefitinib-induced ILD. Multivariate logistic or Cox regression analysis was performed to identify independent predictive factors for ILD, antitumor response, and survival. Results: Seventy cases of and 31 deaths from gefitinib-induced ILD were identified among 1,976 consecutively treated patients at 84 institutions, corresponding to a prevalence of 3.5{\%} and mortality of 1.6{\%}. Gefitinib-induced ILD was significantly associated with male sex, a history of smoking, and coincidence of interstitial pneumonia (odds ratios = 3.10, 4.79, and 2.89, respectively). Predictive factors for response were female sex, no history of smoking, adenocarcinoma histology, metastatic disease, and good performance status (PS), whereas predictive factors for survival were female sex, no history of smoking, adenocarcinoma histology, nonmetastatic disease, good PS, and previous chest surgery. Conclusion: ILD is a serious adverse effect of gefitinib in the clinical setting that cannot be ignored. However, patient selection based on sex and smoking history can minimize ILD risk and maximize the clinical benefit of gefitinib.",
author = "Masahiko Ando and Isamu Okamoto and Nobuyuki Yamamoto and Koji Takeda and Kenji Tamura and Takashi Seto and Yutaka Ariyoshi and Masahiro Fukuoka",
year = "2006",
month = "6",
day = "1",
doi = "10.1200/JCO.2005.04.9866",
language = "English",
volume = "24",
pages = "2549--2556",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "16",

}

TY - JOUR

T1 - Predictive factors for interstitial lung disease, antitumor response, and survival in non-small-cell lung cancer patients treated with gefitinib

AU - Ando, Masahiko

AU - Okamoto, Isamu

AU - Yamamoto, Nobuyuki

AU - Takeda, Koji

AU - Tamura, Kenji

AU - Seto, Takashi

AU - Ariyoshi, Yutaka

AU - Fukuoka, Masahiro

PY - 2006/6/1

Y1 - 2006/6/1

N2 - Purpose: Interstitial lung disease (ILD) is a serious adverse effect of gefitinib, but its prevalence and risk factors remain largely unknown. We examined the prevalence of and risk factors for gefitinib-induced ILD associated with practical use of the drug in Japanese with non-small-cell lung cancer (NSCLC). Patients and Methods: Clinical information was retrospectively assembled for NSCLC patients who started gefitinib treatment at affiliated institutions of the West Japan Thoracic Oncology Group between August 31 and December 31, 2002. Medical records of patients who developed pulmonary infiltrates were reviewed by a central committee of extramural experts for identification of patients with gefitinib-induced ILD. Multivariate logistic or Cox regression analysis was performed to identify independent predictive factors for ILD, antitumor response, and survival. Results: Seventy cases of and 31 deaths from gefitinib-induced ILD were identified among 1,976 consecutively treated patients at 84 institutions, corresponding to a prevalence of 3.5% and mortality of 1.6%. Gefitinib-induced ILD was significantly associated with male sex, a history of smoking, and coincidence of interstitial pneumonia (odds ratios = 3.10, 4.79, and 2.89, respectively). Predictive factors for response were female sex, no history of smoking, adenocarcinoma histology, metastatic disease, and good performance status (PS), whereas predictive factors for survival were female sex, no history of smoking, adenocarcinoma histology, nonmetastatic disease, good PS, and previous chest surgery. Conclusion: ILD is a serious adverse effect of gefitinib in the clinical setting that cannot be ignored. However, patient selection based on sex and smoking history can minimize ILD risk and maximize the clinical benefit of gefitinib.

AB - Purpose: Interstitial lung disease (ILD) is a serious adverse effect of gefitinib, but its prevalence and risk factors remain largely unknown. We examined the prevalence of and risk factors for gefitinib-induced ILD associated with practical use of the drug in Japanese with non-small-cell lung cancer (NSCLC). Patients and Methods: Clinical information was retrospectively assembled for NSCLC patients who started gefitinib treatment at affiliated institutions of the West Japan Thoracic Oncology Group between August 31 and December 31, 2002. Medical records of patients who developed pulmonary infiltrates were reviewed by a central committee of extramural experts for identification of patients with gefitinib-induced ILD. Multivariate logistic or Cox regression analysis was performed to identify independent predictive factors for ILD, antitumor response, and survival. Results: Seventy cases of and 31 deaths from gefitinib-induced ILD were identified among 1,976 consecutively treated patients at 84 institutions, corresponding to a prevalence of 3.5% and mortality of 1.6%. Gefitinib-induced ILD was significantly associated with male sex, a history of smoking, and coincidence of interstitial pneumonia (odds ratios = 3.10, 4.79, and 2.89, respectively). Predictive factors for response were female sex, no history of smoking, adenocarcinoma histology, metastatic disease, and good performance status (PS), whereas predictive factors for survival were female sex, no history of smoking, adenocarcinoma histology, nonmetastatic disease, good PS, and previous chest surgery. Conclusion: ILD is a serious adverse effect of gefitinib in the clinical setting that cannot be ignored. However, patient selection based on sex and smoking history can minimize ILD risk and maximize the clinical benefit of gefitinib.

UR - http://www.scopus.com/inward/record.url?scp=33745006872&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33745006872&partnerID=8YFLogxK

U2 - 10.1200/JCO.2005.04.9866

DO - 10.1200/JCO.2005.04.9866

M3 - Article

C2 - 16735708

AN - SCOPUS:33745006872

VL - 24

SP - 2549

EP - 2556

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 16

ER -