Diagnosis and Management of Drug-Induced Interstitial Lung Disease in the context of Anti-Cancer Therapy: a Multidisciplinary Viewpoint by Portuguese Experts.

IF 2.9 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Mário Fontes E Sousa, Sérgio Campainha, Inês Dias Marques, Rui Dinis, João Rodrigues Inácio, João João Mendes, Rita Luís, Ana Magalhães Ferreira, Ricardo Racha-Pacheco, Rui Rolo, Gabriela Sousa, Paulo Cortes
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Abstract

Drug-induced interstitial lung disease (DI-ILD) is a significant complication in patients undergoing treatment with certain anti-cancer therapies, with incidence rates rising, particularly with newer drugs such as trastuzumab-deruxtecan, which may impact their safe and effective use. Although the exact pathophysiological mechanisms remain unknown, and different drugs may induce lung damage through different pathways, the most recognized mechanisms are cytotoxic- and immune-mediated effects. Multidisciplinary teams play a crucial role in the diagnosis, management, and prevention of DI-ILD. Given the wide variability in the onset of DI-ILD, which may occur within the first few days of treatment or months after, patient education and clinician training are essential for early detection and improved outcomes. Moreover, the diagnostic confirmation requires the exclusion of alternative causes through clinical, imaging and bronchoscopy evaluation. Treatment strategies largely depend on the grade of severity of the clinical manifestations of DI-ILD, ranging from interruption or discontinuation of the offending drug to corticosteroid therapy and hospitalization for appropriate monitoring. Nonetheless, further research is needed to better understand the impact of emerging anti-cancer drugs on DI-ILD and to establish standardized management protocols.

抗癌治疗中药物诱发间质性肺病的诊断和管理:葡萄牙专家的多学科观点。
药物诱发间质性肺病(DI-ILD)是接受某些抗癌疗法治疗的患者的一个重要并发症,其发病率不断上升,尤其是曲妥珠单抗-德鲁司坦等新药,这可能会影响其安全有效的使用。尽管确切的病理生理学机制尚不清楚,而且不同的药物可能通过不同的途径诱发肺损伤,但最公认的机制是细胞毒性和免疫介导效应。多学科团队在 DI-ILD 的诊断、管理和预防中发挥着至关重要的作用。鉴于 DI-ILD 的发病差异很大,可能发生在治疗的头几天或几个月后,因此患者教育和临床医生培训对于早期发现和改善预后至关重要。此外,确诊需要通过临床、影像学和支气管镜评估排除其他病因。治疗策略主要取决于 DI-ILD 临床表现的严重程度,包括中断或停用违规药物、皮质类固醇治疗和住院进行适当监测。然而,要更好地了解新出现的抗癌药物对DI-ILD的影响并制定标准化的治疗方案,还需要进一步的研究。
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来源期刊
CiteScore
5.90
自引率
3.10%
发文量
108
审稿时长
6-12 weeks
期刊介绍: Clinical Drug Investigation provides rapid publication of original research covering all phases of clinical drug development and therapeutic use of drugs. The Journal includes: -Clinical trials, outcomes research, clinical pharmacoeconomic studies and pharmacoepidemiology studies with a strong link to optimum prescribing practice for a drug or group of drugs. -Clinical pharmacodynamic and clinical pharmacokinetic studies with a strong link to clinical practice. -Pharmacodynamic and pharmacokinetic studies in healthy volunteers in which significant implications for clinical prescribing are discussed. -Studies focusing on the application of drug delivery technology in healthcare. -Short communications and case study reports that meet the above criteria will also be considered. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Clinical Drug Investigation may be accompanied by plain language summaries to assist readers who have some knowledge, but non in-depth expertise in, the area to understand important medical advances.
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