Interstitial lung disease recurrence on chemotherapy rechallenge in breast cancer: a nationwide Japanese database

Abstract

Aim: The present study assessed the incidence of drug-induced interstitial lung disease (ILD) recurrence among breast cancer patients who underwent rechallenge with cancer-directed therapy. Materials & methods: Japanese insurance claims data and the Diagnosis Procedure Combination database (2009–2022) involving 81,601 patients were analyzed to evaluate 1,042 breast cancer patients who developed ILD. Of these, 566 patients underwent cancer-directed therapy rechallenge, and 42.1% of them were re-challenged with the same therapeutic regimen that caused the initial ILD. Results: ILD recurrence was observed in 18.9% of the patients, with a median recurrence time of 40 days. The drugs most commonly causing ILD were cytotoxic agents, and those most frequently used for rechallenge were cytotoxic agents.   Conclusion: A notable ILD recurrence rate was observed in breast cancer patients after a cancer-directed therapy rechallenge, highlighting the need for cautious treatment planning and personalised strategies to balance cancer control while mitigating ILD risk.