Interstitial lung disease epidemiology and etiology in patients with solid malignant tumors: a systematic literature...

Interstitial lung disease (ILD) can occur in patients with cancer. ILD can be caused by anti-cancer treatments (drug-induced [DI] ILD), but also by opportunistic infection, and non-drug-related etiologies. This systematic literature review (SLR) investigated the epidemiology and etiology of non-DI ILD and DI ILD management and outcomes in patients with solid cancers.

Databases were searched to August 2023 using terms for ILD and solid cancers. Relevant congresses held 2021-2023 and SLR bibliographies were hand-searched. Records were screened by two independent reviewers. Inclusion criteria comprised ILD epidemiology outcomes, ILD clinical management, and survival outcomes.

Of 4,519 unique records screened, 55 full texts were included (six from supplementary sources) and 37 were prioritized for extraction. Studies were frequently retrospective cohort studies in Japan (n = 21). Patients mostly had lung cancers (n = 32) and received immune checkpoint inhibitors (n = 24). Reporting of non-DI ILD was limited and associated with radiation therapy (n = 4) or surgery (n = 1). Most studies reported DI ILD outcomes only (n = 31).

The limited evidence of non-DI ILD indicates that prompt intervention to manage ILD until other ILD etiologies have been ruled out remains key to preventing progression of both cancer and ILD.Protocol registration http://www.crd.york.ac.uk/prospero identifier: CRD42023463573.