The Incidence of Abemaciclib-induced Interstitial Lung Disease: A Single-center Retrospective Study in Japan

Abemaciclib, a CDK4/6 inhibitor, is used for estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer. Interstitial lung disease (ILD) is a frequent adverse event of abemaciclib, particularly in Asian patients, though limited information is available on its incidence and risk factors. This study aimed to identify the incidence and risk factors of abemaciclib-induced ILD through a single-center retrospective analysis.

We analyzed ER-positive, HER2-negative inoperable or metastatic breast cancer patients treated with abemaciclib at Kakogawa Central City Hospital between November 1, 2018, and March 31, 2022. At least two respiratory medicine specialists evaluated computed tomography and examined the development of ILD after the initiation of abemaciclib. We conducted univariate analysis to examine factors associated with the development of ILD.

Forty-nine patients were analyzed. The median (range) observation period was 27.0 (10-49) months, and the median (range) duration of abemaciclib was 11.0 (1-43) months. Fourteen patients (28.6%) received abemaciclib as a 3rd-line treatment or later. Ten patients (20.4%) were diagnosed with abemaciclib-induced ILD; 7 were diagnosed within 6 months of the initiation of abemaciclib and 3 developed severe ILD during the same period. We identified lung metastasis as a risk factor for the development of ILD (odds ratio = 5.00, 95% confidence interval: 1.15-21.70; p = 0.032).

The incidence of abemaciclib-induced ILD was 20.4%, which was higher than previously reported values. Today, as abemaciclib is one of the standard treatments for ER-positive, HER2-negative breast cancer, we should be more careful about ILD.