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

Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusion: 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.