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Interstitial lung disease associated with gemcitabine: A J apanese retrospective cohort study
Author(s) -
Hamada Tsuyoshi,
Yasunaga Hideo,
Nakai Yousuke,
Isayama Hiroyuki,
Matsui Hiroki,
Fushimi Kiyohide,
Koike Kazuhiko
Publication year - 2016
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.12665
Subject(s) - medicine , interstitial lung disease , retrospective cohort study , gemcitabine , oncology , lung cancer , lung disease , cohort , disease , cohort study , lung , chemotherapy
Background and objective Interstitial lung disease ( ILD ) is a widely recognized adverse consequence of gemcitabine administration, but data on gemcitabine‐associated ILD are limited. This study aimed to elucidate the incidence and risk factors for this adverse event. Methods Patients who underwent gemcitabine‐based chemotherapy between J uly 2010 and M arch 2013 were retrospectively identified using a Japanese nationwide administrative database. ILD was defined according to the I nternational C lassification of D iseases and R elated H ealth P roblems 10th R evision, codes: J70.2–70.4, J 84.1 and J 84.9. The cumulative incidence and risk factors for ILD were evaluated using a competing risk analysis. Results In total, 25 924 patients who underwent gemcitabine‐based chemotherapy were identified from 331 hospitals (primary cancer; pancreatic, urothelial, biliary tract, lung, ovarian and breast, in 9070, 5578, 4803, 4388, 1339 and746 patients, respectively). ILD was observed in 428 patients (1.7%), and the cumulative incidence was estimated at 1.1% (95% CI : 1.0–1.2%), 1.5% (95% CI : 1.4–1.7%) and 1.9% (95% CI : 1.7–2.1%) at 3, 6 and 12 months, respectively. In the multivariable regression model, age >80 years and lung cancer were the strongest predictors for ILD (subdistribution hazard ratio ( SHR ), 2.61; 95% CI : 1.69–4.02 and SHR , 2.81; 95% CI : 2.16–3.65, respectively). Other significant risk factors included heavy smoking, prior chemotherapy and advanced cancer stage. Conclusion This study successfully demonstrated the clinical course of gemcitabine‐associated ILD. Clinical oncologists should stratify individual patients for risk of ILD based on identified risk factors and fully consider the indication for gemcitabine‐based chemotherapy.