Treatment Strategies for Non-Small-Cell Lung Cancer with Comorbid Respiratory Disease; Interstitial Pneumonia, Chronic Obstructive Pulmonary Disease, and Tuberculosis

• Published in: Cancers Vol. 16; no. 9; p. 1734
• Main Authors: Otoshi, Ryota, Ikeda, Satoshi, Kaneko, Taichi, Sagawa, Shinobu, Yamada, Chieri, Kumagai, Kosumi, Moriuchi, Asami, Sekine, Akimasa, Baba, Tomohisa, Ogura, Takashi
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.05.2024
• Subjects: acute exacerbation; Bacterial pneumonia; Blood vessels; Carboplatin; Chemotherapy; Chronic obstructive pulmonary disease; Clinical trials; Comorbidity; cytotoxic anti-cancer drug; Cytotoxicity; Development and progression; Drug therapy; immune checkpoint inhibitor; Immune checkpoint inhibitors; Immunosuppressive agents; interstitial pneumonia; Kinases; Lung cancer; Lung cancer, Non-small cell; Lung diseases; Medical prognosis; Mutation; Nanoparticles; Non-small cell lung carcinoma; Observational studies; Paclitaxel; Pemetrexed; Pneumonia; Pulmonary fibrosis; Respiratory diseases; Risk factors; Signal transduction; Small cell lung carcinoma; Tuberculosis; Japan; lung cancer; immune checkpoint inhibitor; cytotoxic anti-cancer drug; interstitial pneumonia; tuberculosis; acute exacerbation; non-small cell lung carcinoma; chronic obstructive pulmonary disease
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers16091734

Non-small cell lung cancer (NSCLC) patients are often complicated by other respiratory diseases, including interstitial pneumonia (IP), chronic obstructive pulmonary disease (COPD), and pulmonary tuberculosis (TB), and the management of which can be problematic. NSCLC patients with IP sometimes develop fatal acute exacerbation induced by pharmacotherapy, and the establishment of a safe treatment strategy is desirable. For advanced NSCLC with IP, carboplatin plus nanoparticle albumin-bound paclitaxel is a relatively safe and effective first-line treatment option. Although the safety of immune checkpoint inhibitors (ICIs) for these populations remains controversial, ICIs have the potential to provide long-term survival. The severity of COPD is an important prognostic factor in NSCLC patients. Although COPD complications do not necessarily limit treatment options, it is important to select drugs with fewer side effects on the heart and blood vessels as well as the lungs. Active TB is complicated by 2-5% of NSCLC cases during their disease course. Since pharmacotherapy, especially ICIs, reportedly induces the development of TB, the possibility of developing TB should always be kept in mind during NSCLC treatment. To date, there is no coherent review article on NSCLC with these pulmonary complications. This review article summarizes the current evidence and discusses future prospects for treatment strategies for NSCLC patients complicated with IP, severe COPD, and TB.