The study, “Nintedanib prevented fibrosis progression and lung cancer growth in idiopathic pulmonary fibrosis” was published in the journal Respirology Case Reports.
It is estimated that IPF patients have a 14 times greater chance of developing lung cancer than the general population. This is a particularly difficult occurrence because treating lung cancer in these patients using radiation or chemotherapy can trigger acute exacerbations of the disease. That creates the a need for alternative therapeutic interventions.
Ofev (nintedanib, marketed by Boehringer Ingelheim), has effectively treated IPF in Phase 3 clinical trials (NCT01335464 and NCT01335477) by reducing the decline of lung function and disease progression.
Ofev targets molecules that act as receptors for certain growth factors in cells. It also can act as an inhibitor of the formation of new blood vessels, including those supplying tumors, which inhibits tumor growth.
In this case study, a 76-year-old man had been referred to the hospital with hypertension and hyperlipidemia (high blood levels of fat). The patient was an ex-smoker, had been diagnosed previously with IPF, and had a past history of acute exacerbations.
His respiratory condition improved with treatment of steroid pulse therapy followed by systemic corticosteroid and cyclosporine therapy. After controlling the acute exacerbation, the patient was prescribed Ofev at a dose of 300 mg/day to avoid a decline in lung function.
Before starting treatment with Ofev, a small nodular lesion (13.5 by 11.7 mm) was observed using chest computed tomography. Nine months later, Ofev was discontinued due to acute gangrenous appendicitis. At that time, the nodule had not changed significantly in size (10.7 by 12.5 mm).
However, four months later, the nodule had increased in size to 20.8 by 22.00 mm. The nodule was removed and was diagnosed as squamous cell carcinoma, a form of skin cancer.
“We administered nintedanib [Ofev] to suppress the decline of lung function and the progression of lung fibrosis by IPF; however, nintedanib appeared to also inhibit tumor progression for nine months due to its anti-tumor effects,” the researchers wrote.
These findings are consistent with results from previous trials, showing that Ofev has anti-tumor properties, including against lung cancer.
The team concluded: “We report a case of lung cancer associated with IPF in which nintedanib prevented the progression of IPF and the associated squamous cell carcinoma simultaneously because of its diverse mechanisms of action. Nintedanib may play an important role in the treatment of IPF‐associated lung cancer.”
Further studies are required, however, to further understand the positive effects of Ofev, the team noted.
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