Lung cancer complicated with interstitial lung diseases

Abstract

Chronic interstitial lung diseases (ILDs) are one of the most common complications in patients with lung cancer. In the context of lung cancer patients with ILDs in Japan, the most serious toxicity is acute exacerbation of ILDs caused by anticancer treatment. Nevertheless, there is, so far, no consensus regarding optimal chemotherapy for advanced lung cancer patients with ILDs. On the other hand, introduction of molecular-targeted agents, in particular specific inhibitors targeting driver oncogene mutations, has dramatically changed the treatment of advanced non-small cell lung cancer (NSCLC). However, the application of molecular-targeted agents for lung cancer patients with preexisting ILDs should be carefully considered. In the case of patients treated with epithelial growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI), some reports suggest that preexisting ILDs are significant risk factor for severe acute lung injury following treatment. In respect of molecular-targeted agents other than EGFR-TKIs, severe drug-induced ILDs have been reported. Further investigations will be needed to access the benefit and safety of molecular-targeted agents in lung cancer patients with chronic ILDs.