Re-challenge chemotherapy in patients with sensitive relapse small-cell lung cancer and interstitial lung disease

Shingo Nasu, Hidekazu Suzuki, Kazunori Moriizumi, Yuki Hara, Satoshi Tanaka, Hiromune Takada, Satomu Morita, Ayako Tanaka, Takayuki Shiroyama, Naoko Morishita, Norio Okamoto, Tomonori Hirashima


Background: Treatment modalities for small-cell lung cancer (SCLC) with pre-existing interstitial lung disease (ILD) are limited. Although re-challenge with first-line chemotherapy can be effective for sensitive relapse SCLC, its safety and efficacy are uncertain in cases with ILD. This study aimed to investigate both the efficacy and safety of re-challenge chemotherapy in patients with sensitive relapse SCLC with ILD.
Methods: Patients with sensitive relapse SCLC with ILD who received re-challenge chemotherapy were studied retrospectively. Sensitive relapse was defined as a treatment-free interval (TFI) of more than 60 days after first-line platinum-based treatment. The endpoints were progression-free survival (PFS), overall survival (OS), and safety.
Results: Re-challenge platinum and etoposide were administered in 11 patients, with the median re-challenge cycle of 3. The overall response rate was 55%. The median PFS and OS from the time of re-challenge treatment were 4 months (95% CI, 2.9–NA) and 9.2 months (95% CI, 8.0–NA), respectively. One patient developed acute exacerbation of ILD 173 days after the last course of re-challenge treatment.
Conclusions: Re-challenge chemotherapy can be effective and considered in SCLC patients with pre-existing ILD.