Pan-cancer assessment of antineoplastic therapy-induced interstitial lung disease in patients receiving subsequent therapy immediately following immune checkpoint blockade therapy

• Published in: Respiratory research 2024-01, Vol.25 (1), p.25-25, Article 25
• Main Authors: Kitahara, Yoshihiro, Inoue, Yusuke, Yasui, Hideki, Karayama, Masato, Suzuki, Yuzo, Hozumi, Hironao, Furuhashi, Kazuki, Enomoto, Noriyuki, Fujisawa, Tomoyuki, Funai, Kazuhito, Honda, Tetsuya, Misawa, Kiyoshi, Miyake, Hideaki, Takeuchi, Hiroya, Inui, Naoki, Suda, Takafumi
• Format: Article
• Language: English
• Subjects: Adverse and side effects; Analysis; Antimitotic agents; Antineoplastic agents; Antineoplastic Agents - adverse effects; Cancer; Cancer patients; Cancer therapies; Carcinoma, Non-Small-Cell Lung - drug therapy; Care and treatment; Chemotherapy; Complications and side effects; Development and progression; Docetaxel; Docetaxel - adverse effects; Dosage and administration; Drug dosages; Drug-induced pneumonitis; Drugs; Gastrointestinal system; Gastrointestinal tract; Humans; Immune checkpoint inhibitor; Immune checkpoint inhibitors; Immune Checkpoint Inhibitors - adverse effects; Immunotherapy; Interstitial lung disease; Ipilimumab; Lung cancer; Lung cancer, Non-small cell; Lung diseases; Lung diseases, Interstitial; Lung Diseases, Interstitial - chemically induced; Lung Diseases, Interstitial - diagnosis; Lung Diseases, Interstitial - epidemiology; Lung Neoplasms - drug therapy; Medical prognosis; Non-small cell lung carcinoma; Oncology; Oncology, Experimental; Patients; Pneumonia; Pneumonitis; Prevention; Radiation therapy; Retrospective Studies; Risk; Risk factors; Small cell lung carcinoma; Therapy; Urinary tract; Urogenital system; Vascular endothelial growth factor
• ISSN: 1465-993X; 1465-9921; 1465-993X; 1465-9921
• DOI: 10.1186/s12931-024-02683-8

Drug-induced interstitial lung disease (DIILD) is a serious adverse event potentially induced by any antineoplastic agent. Whether cancer patients are predisposed to a higher risk of DIILD after receiving immune checkpoint inhibitors (ICIs) is unknown. This study retrospectively assessed the cumulative incidence of DIILD in consecutive cancer patients who received post-ICI antineoplastic treatment within 6 months from the final dose of ICIs. There was also a separate control cohort of 55 ICI-naïve patients with non-small cell lung cancer (NSCLC) who received docetaxel. Of 552 patients who received ICIs, 186 met the inclusion criteria. The cohort predominantly comprised patients with cancer of the lung, kidney/urinary tract, or gastrointestinal tract. The cumulative incidence of DIILD in the entire cohort at 3 and 6 months was 4.9% (95% confidence interval [CI] 2.4%-8.7%) and 7.2% (95% CI 4.0%-11.5%), respectively. There were significant differences according to cancer type (Gray's test, P = .04), with the highest cumulative incidence of DIILD in patients with lung cancer being 9.8% (95% CI 4.3%-18.0%) at 3 months and 14.2% (95% CI 7.3%-23.3%) at 6 months. DIILD was caused by docetaxel in six of these 11 lung cancer patients (54.5%). After matching, the cumulative incidence of docetaxel-induced ILD in patients with NSCLC in the post-ICI setting was higher than that in the ICI-naïve setting: 13.0% (95% CI 3.3%-29.7%) vs 4.3% (95% CI 0.3%-18.2%) at 3 months; and 21.7% (95% CI 7.9%-39.9%) vs 4.3% (95% CI 0.3%-18.2%) at 6 months. However, these were not significant differences (hazard ratio, 5.37; 95% CI 0.64-45.33; Fine-Gray P = .12). Patients with lung cancer were at high risk of developing DIILD in subsequent regimens after ICI treatment. Whether NSCLC patients are predisposed to additional risk of docetaxel-induced ILD by prior ICIs warrants further study.