Interstitial lung disease in advanced pancreatic ductal adenocarcinoma patients treated with gemcitabine and nab-paclitaxel combination therapy: a retrospective analysis
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Gemcitabine and nab-paclitaxel (GnP) combination therapy is a standard regimen for advanced pancreatic ductal adenocarcinoma (PDAC) worldwide; however, concerns regarding the unexpectedly high incidence of interstitial lung disease (ILD) have emerged. We investigated the incidence and predictive factors of ILD in PDAC patients who were treated with GnP combination therapy.
Thirty-seven patients treated with GnP therapy as either 1st or 2nd line treatment were included, among whom seven developed ILD (18.9%). The clinical characteristics (age, etc.) were compared between patients with and without ILD. The diagnostic yield of the markers to predict the presence of ILD was calculated. The clinical course of the seven patients with ILD was summarized. Survival analysis was performed using the Kaplan–Meier method and log-rank test.
The median age was higher in patients with ILD (73.0 vs. 65.0 years old, p = 0.03), while no differences were observed in the other clinical characteristics. Among the three investigated markers, SP-D showed the best diagnostic yield (AUC = 0.94) for diagnosing ILD. Though one patient required steroid therapy and the discontinuation of GnP therapy, all patients could undergo subsequent treatment. In the survival analysis, the median survival time of PDAC patients with ILD was comparable to that of patients without ILD (25.1 vs. 24.5 months, p = 0.98).
ILD was observed in 18.9% of PDAC patients treated with GnP therapy. With appropriate management, no prognostic influence was observed.
KeywordsPancreatic ductal adenocarcinoma Chemotherapy Interstitial lung disease Gemcitabine Nab-paclitaxel
Pancreatic ductal adenocarcinoma
Interstitial lung disease
Krebs von den Lungen-6 antigen
Surfactant protein A
Surfactant protein D
Forced expiratory volume
The authors would like to acknowledge and are grateful to Dr. Shyuko Suzuki (Kamimachi Naika-Hifuka Clinic) for the intellectual discussion.
HI and RS designed the study, wrote the manuscript, and analysed the data. All authors contributed to patient care and read and approved the final manuscript.
No funding relevant to this study was received.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no competing interests.
The study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki and was approved by the institutional review committee of Fukushima Medical University (Fukushima, Japan; IRB number#19254).
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