Pulmonary fibrosis tied to unique NSCLC presentation, poorer prognosis

  • Whittaker Brown SA & al.
  • Ann Am Thorac Soc
  • 16 Apr 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Patients with NSCLC and idiopathic pulmonary fibrosis (IPF) often have a different disease presentation at diagnosis, are less likely to receive therapy with advanced disease, and have poorer outcomes compared with patients without IPF.

Why this matters

  • Patients with IPF have a 10%-30% chance of developing lung cancer compared with a risk of 6% in the general population.

Study design

  • 54,453 patients with stage I-IV NSCLC from the Surveillance, Epidemiology, and End Results database.
  • Funding: Stony Wold Herbert Fund Inc.

Key results

  • 855 patients (2%) had IPF.
  • Patients with IPF were more often diagnosed with stage I disease (31% vs 25%; P<.01 and with smaller tumors size vs mm p>
  • Patients with IPF had a greater proportion of squamous carcinoma (46% vs 35%; P<.01 and lower-lobe tumors vs p>
  • Patients with IPF with stage III-IV lung cancer were less likely to undergo treatment than advanced stage patients without IPF (OR, 0.82; 95% CI, 0.68-0.99).
  • Patients with IPF had significantly poorer OS (aHR, 1.35; 95% CI, 1.26-1.45) and cancer-specific survival (CSS; aHR, 1.32; 95% CI, 1.21-1.44).
    • Survival was poorer with receipt and nonreceipt of stage-appropriate therapy in stratified analysis.

Limitations

  • No patient-specific data.

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