由于药物诱导和放射性肺炎的风险增加,治疗肺纤维化患者的晚期肺癌可能具有挑战性。我们介绍了一名78岁的女性,患有IIIB期肺腺癌和特发性肺纤维化(IPF)。在对铂类化疗有部分反应后,她开始接受培美曲塞的维持治疗,但这是由于骨髓抑制和肾损伤而停止的。她没有接受进一步的化疗。随后开始Nintedanib治疗IPF。值得注意的是,2年的进展成像显示她的肺腺癌进一步消退,IPF的稳定性。Nintedanib是一种多靶点酪氨酸激酶抑制剂,由于抑制血管生成而具有抗癌作用。Nintedanib联合化疗已显示改善非小细胞肺癌(NSCLC)的生存率。本病例报告并文献复习讨论尼达尼布治疗IPF和NSCLC并发患者的有效性。特别是对于常规化疗耐受性差的患者。
Treating advanced lung cancer in patients with pulmonary fibrosis can be challenging due to increased risks of drug-induced and radiation-induced pneumonitis. We present the
case of a 78-year-old female with stage IIIB lung adenocarcinoma and idiopathic pulmonary fibrosis (IPF). Following partial response to platinum-based chemotherapy, she was started on maintenance pemetrexed, but this was stopped due to bone marrow suppression and kidney injury. She received no further chemotherapy. Nintedanib was subsequently commenced for treatment of IPF. Remarkably, progress imaging at 2 years showed further regression of her lung adenocarcinoma, with stability of IPF. Nintedanib is a multi-target tyrosine kinase inhibitor with anti-cancer effects due to inhibition of angiogenesis. Nintedanib with chemotherapy has shown improvements in survival in non-small cell lung cancer (NSCLC). This
case report and literature review discuss the effectiveness of nintedanib in treating patients with concurrent IPF and NSCLC, in particular for patients poorly tolerant of conventional chemotherapy.