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- Title
Pan-cancer assessment of antineoplastic therapy-induced interstitial lung disease in patients receiving subsequent therapy immediately following immune checkpoint blockade therapy.
- 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
- Abstract
Background: 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. Methods: 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. Results: 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). Conclusions: 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.
- Subjects
IMMUNE checkpoint proteins; INTERSTITIAL lung diseases; NON-small-cell lung carcinoma; IMMUNE checkpoint inhibitors; LUNG cancer; CANCER patients
- Publication
Respiratory Research, 2024, Vol 25, Issue 1, p1
- ISSN
1465-9921
- Publication type
Article
- DOI
10.1186/s12931-024-02683-8