" /> 【特集】今日の薬剤性肺障害の実際■抗腫瘍薬:抗癌薬,分子標的治療薬,PDL-1など■柏田 建ほか |
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【特集】今日の薬剤性肺障害の実際

企画:寺崎泰弘


 他誌などでも本特集テーマは時々ございますが,日進月歩の新しい治療薬に関連する,常に呼吸器領域の重要なテーマであります。新規薬剤に関する情報や鑑別に役立つ新知見などあればご紹介していただければと思います。

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抗腫瘍薬:抗癌薬,分子標的治療薬,PDL-1など

柏田 建*, 齋藤好信*

**日本医科大学大学院医学研究科呼吸器内科学分野(〒113-8603 東京都文京区千駄木1-1-5)


Drug-induced lung injury associated with anticancer agents

Takeru Kashiwada*, Yoshinobu Saito*

*Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo


Keywords:薬剤性肺炎,抗腫瘍薬/drug-induced lung injury, anticancer agents


呼吸臨床 2019年4巻4号 論文No.e00086
Jpn Open J Respir Med 2020 Vol.4 No.4 Article No.e00086

DOI: 10.24557/kokyurinsho.4.e00086


掲載日:2020年4月14日


©️Takeru Kashiwada, et al. 本論文の複製権,翻訳権,上映権,譲渡権,貸与権,公衆送信権(送信可能化権を含む)は弊社に帰属し,それらの利用ならびに許諾等の管理は弊社が行います。


要旨

 近年,癌治療の抗腫瘍薬として,従来の殺細胞性抗癌薬に加え,分子標的薬,免疫チェックポイント阻害薬が臨床に導入されている。それに伴い,抗腫瘍薬による薬剤性肺障害の頻度は増加し,病型も多彩になっている。本稿では,肺癌治療の主要抗腫瘍薬における肺障害について,それぞれの頻度や病型,また近年のトピックスを概説する。また,薬剤性肺障害の最大のリスクである背景肺の間質性肺炎を合併した患者における,薬剤性肺障害への予防や対策についても記載する。

文献

  1. 弦間昭彦. 特発性間質性肺炎合併肺癌に対する化学療法の現況と治療関連急性増悪に関する実態調査. びまん性肺疾患に関する調査研究班平成21年度研究報告書. 2010: 38-40.
  2. 峯岸裕司. 特発性間質性肺炎合併進行/術後再発肺癌の二次治療以降の化学療法に関する実態調査.びまん性肺疾患に関する調査研究班 平成24年度研究報告書. 2013: 87-92.
  3. Minegishi Y, et al. The safety and efficacy of weekly paclitaxel in combination with carboplatin for advanced non-small cell lung cancer with idiopathic interstitial pneumonias. Lung Cancer. 2011; 71: 70-4.
  4. Minegishi Y, et al. The feasibility study of Carboplatin plus Etoposide for advanced small cell lung cancer with idiopathic interstitial pneumonias. J Thorac Oncol. 2011; 6: 801-7.
  5. Sekine A, et al. Safety and efficacy of S-1 in combination with carboplatin in non-small cell lung cancer patients with interstitial lung disease: a pilot study. Cancer Chemother Pharmacol. 2016; 77: 1245-52.
  6. 日本呼吸器学会. 間質性肺炎合併肺癌に関するステートメント. 東京: 南江堂. 2017: 69-74.
  7. Niwa H, et al. Nab-paclitaxel plus carboplatin as an effective and safe chemotherapy regimen for pulmonary carcinosarcoma with interstitial lung disease: A case report. Respir Med Case Rep. 2018; 23: 131-5.
  8. Yasuda Y, et al. The safety and efficacy of carboplatin plus nanoparticle albumin-bound paclitaxel in the treatment of non-small cell lung cancer patients with interstitial lung disease. Jpn J Clin Oncol. 2018; 48: 89-93.
  9. Yasuda Y, et al. Retrospective analysis of acute exacerbation of interstitial lung diseases with nanoparticle albumin-bound paclitaxel in patients with advanced lung cancer with preexisting interstitial lung disease. Mol Clin Oncol. 2017; 7: 677-80.
  10. Kashiwada T, et al. Interstitial lung disease associated with nanoparticle albumin-bound paclitaxel treatment in patients with lung cancer. Jpn J Clin Oncol. 2019; 49: 165-73.
  11. Inoue A, et al. Severe acute interstitial pneumonia and gefitinib. Lancet. 2003; 361: 137-9.
  12. 吉田 茂. 癌分子標的治療の現状と今後の展望: ゲフィチニブプロスペクティブ調査(特別調査)で何が変わるか. ゲフィチニブプロスペクティブ調査(特別調査)結果報告. 医薬ジャーナル. 2005; 41: 772-89.
  13. Kudoh S, et al. Interstitial lung disease in Japanese patients with lung cancer: a cohort and nested case-control study. Am J Respir Crit Care Med. 2008; 177: 1348-57.
  14. Gemma A, et al. Final safety and efficacy of erlotinib in the phase 4 POLARSTAR surveillance study of 10 708 Japanese patients with non-small-cell lung cancer. Cancer Sci. 2014; 105: 1584-90.
  15. Tamura K, et al. Real-world treatment of over 1600 Japanese patients with EGFR mutation-positive non-small cell lung cancer with daily afatinib. Int J Clin Oncol. 2019; 24: 917-26.
  16. Schoenfeld AJ, et al. Severe immune-related adverse events are common with sequential PD-(L)1 blockade and osimertinib. Ann Oncol. 2019; 30: 839-44.
  17. Uchida T, et al. Different incidence of interstitial lung disease according to different kinds of EGFR-tyrosine kinase inhibitors administered immediately before and/or after anti-PD-1 antibodies in lung cancer. Thorac Cancer. 2019 ; 10: 975-9.
  18. Soria JC, et al. Osimertinib in untreated EGFR-mutated advanced non-small-cell lung cancer. N Engl J Med. 2018; 378: 113-25.
  19. Khunger M, et al. Incidence of pneumonitis with use of programmed death 1 and programmed death-ligand 1 inhibitors in non-small cell lung cancer: A systematic review and meta-analysis of trials. Chest. 2017; 152: 271-81.
  20. Nishino M, et al. PD-1 inhibitor-related pneumonitis in advanced cancer patients: Radiographic patterns and clinical course. Clin Cancer Res. 2016; 22: 6051-60.
  21. Baba T, et al. Radiologic features of pneumonitis associated with nivolumab in non-small-cell lung cancer and malignant melanoma. Future Oncol. 2019; 15: 1911-20.
  22. Haratani K, et al. Association of immune-related adverse events with nivolumab efficacy in non-small-cell lung cancer. JAMA Oncol. 2018; 4: 374-8.
  23. Ricciuti B, et al. Impact of immune-related adverse events on survival in patients with advanced non-small cell lung cancer treated with nivolumab: long-term outcomes from a multi-institutional analysis. J Cancer Res Clin Oncol. 2019; 145: 479-85.
  24. Suresh K, et al. Impact of checkpoint inhibitor pneumonitis on survival in NSCLC patients receiving immune checkpoint immunotherapy. J Thorac Oncol. 2019; 14: 494-502.
  25. Fukihara J, et al. Prognostic impact and risk factors of immune-related pneumonitis in patients with non-small-cell lung cancer who received programmed death 1 inhibitors. Clin Lung Cancer. 2019; pii: S1525-7304(19)30210-4.
  26. Fujimoto D, et al. A pilot trial of nivolumab treatment for advanced non-small cell lung cancer patients with mild idiopathic interstitial pneumonia. Lung Cancer. 2017; 111: 1-5.
  27. Kanai O, et al. Efficacy and safety of nivolumab in non-small cell lung cancer with preexisting interstitial lung disease. Thorac Cancer. 2018; 9: 847-55.