A modified ILD-GAP index for patients with non-small cell lung cancer and interstitial lung disease

Background and objective: Patients with non-small cell lung cancer (NSCLC) and interstitial lung disease (ILD) are usually excluded from most clinical trials because of acute exacerbation (AE) of ILD. Data on the efficacy and feasibility of chemotherapy are limited. Recently, the ILD-GAP index (total point score obtained from ILD subtype, sex, age, FVC, DLCO; range 0–8) was reported as a prognostic factor in patients with ILD. Therefore, we evaluated the incidence of ILD-AE during the clinical course of the disease and the overall survival (OS) in patients with NSCLC and ILD using a modified ILD-GAP index (total point score obtained from ILD subtype, sex, age, FVC; range 0–5). Materials and methods: Between September 2002 and December 2014, we performed a retrospective analysis of 78 patients with NSCLC and ILD treated platinum-based chemotherapy as first-line treatment. Among these patients, we compared the incidence of ILD-AE and OS between the modified ILD-GAP index. Results: Among these patients, 21 (27%; 95%CI 18–38) had ILD-AE during the clinical course of the disease. The median OS was 11.3 months. The incidence of ILD-AE increased gradually and the median OS decreased gradually with increasing the modified ILD-GAP index as shown figure A and B, respectively. Conclusion: The modified ILD-GAP index may be a useful tool to predict of the incidence of ILD-AE and its prognosis for patients with NSCLC and ILD.