Table 3.
Clinical features and outcomes of gefitinib-induced interstitial lung disease (ILD)
| Variable | Total (n=15) | Non-fatal (n=6) | Fatal (n=9) | p-value |
|---|---|---|---|---|
| Clinical findings | ||||
| Mean age (yr) | 60.69±12.01 | 66.93±10.60 | 56.53±11.55 | 0.101 |
| Sex (male:female) | 4 (26.7):11 (73.3) | 0 (0):6 (100) | 4 (44.4):5 (55.6) | 0.103 |
| Current or ex-smoker | 4 (26.7) | 0 | 4 (44.4) | 0.103 |
| ECOG PS (≥ 2) | 5 (33.3) | 3 (50.0) | 2 (22.2) | 0.329 |
| Emphysematous lung | 3 (20.0) | 0 | 3 (33.3) | 0.229 |
| Previous treatment | ||||
| Chest surgery | 4 (26.7) | 2 (33.3) | 2 (22.2) | > 0.999 |
| Thoracic radiotherapy | 2 (13.3) | 1 (16.7) | 1 (11.1) | > 0.999 |
| Chemotherapy | 15 (100) | 6 (100) | 9 (100) | > 0.999 |
| Combined lung cancer progression | 3 (20.0) | 1 (16.7) | 2 (22.2) | > 0.999 |
| Responder to gefitinib | 1 (6.7) | 1 (16.7) | 0 | 0.400 |
| Onset of symptoms after gefitinib therapy, median (range, day) | 29.0 (3-1,953) | 54.0 (14-1,953) | 10.0 (3-56) | 0.024 |
| ≤ 8 wk | 12 (80.0) | 3 (50.0) | 9 (100) | 0.044 |
| > 8 wk | 3 (20.0) | 3 (50.0) | 0 | |
| Symptoms | ||||
| Dyspnea | 15 (100) | 6 (100) | 9 (100) | > 0.999 |
| Cough | 9 (60.0) | 4 (66.7) | 5 (55.6) | > 0.999 |
| Chest discomfort | 2 (13.3) | 0 | 2 (22.2) | 0.486 |
| Fever ≥ 38.0°C | 2 (13.3) | 0 | 2 (22.2) | 0.486 |
| SpO2 (%) (n=13) | 80.47±20.32 | 96.75±2.06 | 73.23±20.65 | 0.009 |
| Laboratory findings at the time of ILD onset | ||||
| Leukocytes (×103/μL) | 13.90±8.47 | 9.08±2.35 | 17.12±9.68 | 0.070 |
| Eosinophil percentage | 2.52±2.60 | 3.05±2.53 | 2.17±2.74 | 0.539 |
| Hemoglobin (g/dL) | 10.86±1.97 | 11.17±2.61 | 10.66±1.56 | 0.641 |
| CRP (mg/dL) (n=13) | 12.01±8.78 | 7.72±10.31 | 13.92±7.91 | 0.257 |
| Albumin (g/dL) | 3.03±0.56 | 3.55±0.45 | 2.69±0.31 | 0.001 |
| Treatment | ||||
| Cessation of gefitinib treatment | 15 (100) | 6 (100) | 9 (100) | > 0.999 |
| Interval from onset of symptoms to cessation of gefitinib (day) | 8.21±8.12 | 10.80±7.66 | 6.78±8.44 | 0.396 |
| Administration of corticosteroids | 12 (80.0) | 4 (66.7) | 8 (88.9) | 0.525 |
| Methylprednisolone dose (mg/kg/day) at first | 0.87±0.61 | 0.52±0.42 | 1.06±0.63 | 0.110 |
| Duration of corticosteroids treatment (day) | 34.08±34.24 | 61.50±45.86 | 20.38±17.22 | 0.170 |
| Interval from symptom onset to start of corticosteroids (day) | 5.64±4.38 | 8.20±6.02 | 4.22±2.59 | 0.087 |
| Coadministration of antibiotics | 12 (80.0) | 4 (66.7) | 8 (88.9) | 0.220 |
| Clinical course | ||||
| ILD-related death | 6 (40.0) | 0 | 6 (66.7) | 0.028 |
| Median survival time after ILD onset (wk) | 7.10±2.93 | 16.00±2.12 | 4.10±3.58 | < 0.001 |
| Subsequent chemotherapy after ILD | 0.177 | |||
| Cytotoxic chemotherapy | 1 (6.7) | 1 (16.7) | 0 | |
| Erlotinib | 1 (6.7) | 1 (16.7) | 0 |
Values are presented as mean±standard deviation or number (%) unless otherwise stated. ECOG PS, Eastern Cooperative Oncology Group performance status.