2023 World Conference on Lung Cancer (Posters)-P2.02. PROphylactic Pirfenidonefor Prevention of Radiation Induced Pneumonitis in Patients with Lung Cancer(PROPeR study)

P2.02. PROphylactic Pirfenidonefor Prevention of Radiation Induced Pneumonitis in Patients with Lung Cancer(PROPeR study) - PDF(Slides)

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The PROPER study, conducted at Tata Memorial Hospital in India, aims to investigate the use of pirfenidone as a prophylactic treatment to prevent radiation-induced pneumonitis in patients with lung cancer. Radiation pneumonitis is a common complication of radical radiation therapy for lung cancer and can negatively impact patient outcomes. The incidence of radiation pneumonitis ranges from 15% to 40% depending on the study. <br /><br />Pirfenidone is a medication that has anti-inflammatory, antioxidant, and antifibrotic effects. It has been shown to reduce fibroblast proliferation and the production of fibrogenic and inflammatory mediators. Currently, pirfenidone is indicated for the treatment of idiopathic pulmonary fibrosis, bleomycin-induced pulmonary fibrosis, non-idiopathic pulmonary fibrosis, and progressive fibrosing interstitial lung disease. <br /><br />The primary objective of the PROPER study is to assess the role of pirfenidone in reducing the decline in pulmonary function tests, specifically FEV1/DLco, following radiation therapy. The secondary objectives include studying the evolution of radiological features of pneumonitis, quality of life as measured by QOL questionnaires, progression-free survival, and overall survival. <br /><br />The study includes patients aged 18-70 years with a diagnosis of lung cancer (NSCLC or LS-SCLC) who are candidates for radical radiation therapy with or without chemotherapy. Patients must have adequate heart, liver, and kidney function and an expected survival of at least 6 months. <br /><br />Results from the study so far indicate that 32 patients have completed the study, and no acute side effects related to pirfenidone have been observed. The absolute change in pulmonary function tests at 3 months from baseline was minimal. Longer follow-up is needed to determine the efficacy of pirfenidone in preventing worsening of pulmonary function tests and radiological evidence of pneumonitis. <br /><br />Overall, pirfenidone appears to be a well-tolerated drug with the potential to reduce radiation-induced pneumonitis. The study's findings are particularly important given that adjuvant immunotherapy, which can increase pneumonitis, is being increasingly used in clinical practice.

Asset Subtitle

Naveen Mummudi

Meta Tag

Speaker Naveen Mummudi

Topic Local-Regional NSCLC: Toxicities of Multimodality Therapy

Keywords

PROPER study

pirfenidone

radiation-induced pneumonitis

lung cancer

pulmonary function tests

radiological features

QOL questionnaires

progression-free survival

overall survival

adjuvant immunotherapy