RT Journal Article SR Electronic T1 Acute exacerbation of idiopathic interstitial pneumonias related to chemotherapy for lung cancer: nationwide surveillance in Japan JF ERJ Open Research JO erjor FD European Respiratory Society SP 00184-2019 DO 10.1183/23120541.00184-2019 VO 6 IS 2 A1 Yuji Minegishi A1 Akihiko Gemma A1 Sakae Homma A1 Kazuma Kishi A1 Arata Azuma A1 Takashi Ogura A1 Naoki Hamada A1 Hiroyuki Taniguchi A1 Noboru Hattori A1 Yasuhiko Nishioka A1 Kiminobu Tanizawa A1 Takeshi Johkoh A1 Takuma Yokoyama A1 Kazutaka Mori A1 Yoshio Taguchi A1 Masahito Ebina A1 Naohiko Inase A1 Koichi Hagiwara A1 Hiroshi Ohnishi A1 Hiroshi Mukae A1 Yoshikazu Inoue A1 Kazuyoshi Kuwano A1 Hirofumi Chiba A1 Ken Ohta A1 Yoshinori Tanino A1 Fumikazu Sakai A1 Yukihiko Sugiyama A1 , YR 2020 UL http://openres.ersjournals.com/content/6/2/00184-2019.abstract AB Background Chemotherapy-induced acute exacerbation (AEx) of idiopathic interstitial pneumonias (IIPs) seriously compromises the success of treatment of Japanese lung cancer patients. Here, we conducted a nationwide surveillance to clarify the risk of AEx and compare it with the survival benefit of chemotherapy for this population.Methods Advanced nonsmall cell lung cancer (NSCLC) or small cell lung cancer (SCLC) patients with IIPs were retrospectively analysed. For the surveillance of first-line chemotherapy in 2009, we gathered clinical data from 396 patients who received chemotherapy at 19 institutions between January 1990 and July 2009. In a consecutive retrospective study in 2012, we analysed data from 278 patients from 17 institutions who received second-line chemotherapy between April 2002 and March 2012.Results Of the 396 patients analysed, 13.1% developed chemotherapy-related AEx. Combination chemotherapies of carboplatin plus paclitaxel (CP) or carboplatin plus etoposide (CE) were frequently used as first-line treatments. The lowest incidence of AEx was 3.7% in CE, followed by 8.6% in CP. In the retrospective study, 16.2% of the 278 patients developed a second-line chemotherapy-related AEx. The overall response rate by second-line chemotherapy was 7.4% in NSCLC and 25.7% in SCLC. The median overall survival from second-line and first-line chemotherapy was 8.0 and 14.3 months in NSCLC, and 8.7 and 16.0 months in SCLC, respectively.Conclusion Combination chemotherapies consisting of CP or CE are candidates for standard first-line treatments for patients with advanced lung cancer accompanied by IIP. Second-line chemotherapy should be considered for patients remaining fit enough to receive it.The Japanese are at high risk of acute exacerbation of IPF. Therefore, chemotherapy for Japanese lung cancer patients with IIPs is challenging. However, appropriate chemotherapy may give a survival benefit, despite the risk of acute deterioration of IIPs. http://bit.ly/3cROaCy