2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.08F.02 Pifenidone Prophylactic Therapy for Radiation Lung Injury in Patients Who Have Previously Received Immune Checkpoint Inhibitors

EP.08F.02 Pifenidone Prophylactic Therapy for Radiation Lung Injury in Patients Who Have Previously Received Immune Checkpoint Inhibitors

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This document summarizes a phase II clinical study focused on the prophylactic use of Pirfenidone to prevent radiation pneumonitis (RP) in lung cancer patients who have previously been treated with immune checkpoint inhibitors (ICIs) and are undergoing thoracic radiotherapy (TR). Pirfenidone, a Transforming Growth Factor-beta (TGF-β) inhibitor, has shown promise in managing pneumonia, and this trial seeks to evaluate its effectiveness and safety in reducing the incidence of RP, which is notably high in patients receiving both ICIs and TR.<br /><br />The study is open-label, single-arm, and divided into two stages. The initial phase enrolled 14 lung cancer patients, both non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), with the first phase's goal to advance if less than 6 patients developed grade 2 RP. Follow-up on this cohort showed 64.3% experienced some grade of RP, but only 21.4% exhibited grade 2 RP, indicating promising preliminary results. Adverse events related to Pirfenidone were mild, primarily gastrointestinal or dermatological in nature.<br /><br />Key eligibility criteria included having received a minimum of two previous ICI cycles and preparing for a specific dosage of TR. The trial uses precise statistical methodologies to aim for a reduction in RP incidence. The first phase's outcomes suggest that Pirfenidone can indeed reduce the risk of RP in this patient population, warranting progression to the second phase of the study.<br /><br />The study, supported by grants from Wuhan City and the National Cancer Center, proposes that Pirfenidone may serve as an effective prophylactic treatment against RP in patients undergoing thoracic radiotherapy following ICI treatment, with the potential to significantly improve patient outcomes.

Asset Subtitle

Guang Han

Meta Tag

Speaker Guang Han

Topic Local-Regional Non-small Cell Lung Cancer

Keywords

Pirfenidone

radiation pneumonitis

lung cancer

immune checkpoint inhibitors

thoracic radiotherapy

Transforming Growth Factor-beta

clinical study

NSCLC

SCLC

adverse events