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

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. 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. 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.   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. This article discusses a study that researched a lung condition known as interstitial lung disease (ILD) in individuals with breast cancer who were treated again with cancer-directed therapy after recovering from ILD. ILD involves inflammation and damage to the lungs and can be a serious side effect of cancer treatment. We analyzed data from Japanese health insurance claims and hospital records from 2009 to 2022, of 81,601 patients with breast cancer, 1,042 developed ILD that required treatment with steroids. Of the 1,042 patients, 566 underwent cancer-directed therapy again after their initial ILD episode. The findings showed that approximately 19% of these patients experienced ILD recurrence, typically approximately 40 days after they had started cancer-directed therapy again. The most common rechallenge therapy for these patients was cytotoxic drugs, which are powerful and used to kill cancer cells. The results of this study highlight the risk of ILD recurrence in patients with breast cancer who undergo cancer-directed therapy again. This insight is crucial for doctors and patients when deciding on cancer treatments, especially after a patient has already had ILD. This demonstrates the importance of careful planning and personalized treatment strategies to manage the risk of ILD while attempting to effectively control cancer. This study helps in understanding the trade-off between treating cancer to protect patients while not causing serious side effects such as ILD.

本研究评估了接受抗肿瘤治疗（cancer-directed therapy）再挑战的乳腺癌患者中，药物诱发性间质性肺疾病（interstitial lung disease, ILD）的复发发生率。本研究分析了2009至2022年的日本保险理赔数据与诊断程序组合数据库（Diagnosis Procedure Combination database），涉及81601名患者，其中1042名乳腺癌患者罹患ILD。其中566名患者接受了抗肿瘤治疗再挑战，42.1%的患者再次使用了引发初始ILD的同一治疗方案。18.9%的患者出现了ILD复发，中位复发时间为40天。引发ILD最常见的药物为细胞毒性制剂（cytotoxic agents），而再挑战中最常使用的同样为细胞毒性制剂。乳腺癌患者接受抗肿瘤治疗再挑战后，可观察到较为显著的ILD复发率，这凸显了需谨慎制定治疗方案、采用个体化策略，以在平衡癌症控制的同时降低ILD风险。
本文探讨了一项针对乳腺癌患者的研究：这类患者在ILD康复后再次接受抗肿瘤治疗，本研究针对此类人群的间质性肺疾病（ILD）展开研究。ILD以肺部炎症与损伤为特征，可作为癌症治疗的严重不良反应。我们分析了2009至2022年日本健康保险理赔数据与医院记录，涉及81601名乳腺癌患者，其中1042名罹患需接受糖皮质激素治疗的ILD。在这1042名患者中，566名在初始ILD发作后再次接受了抗肿瘤治疗。研究结果显示，此类患者中约19%出现了ILD复发，通常在再次开始抗肿瘤治疗后约40天。此类患者最常见的再挑战治疗方案为细胞毒性药物——一类用于杀灭癌细胞的强效制剂。本研究结果凸显了乳腺癌患者再次接受抗肿瘤治疗后出现ILD复发的风险。这一发现对于医生与患者制定癌症治疗方案至关重要，尤其是在患者既往罹患ILD的情况下。这表明，需谨慎规划治疗方案、采用个体化治疗策略，在有效控制癌症的同时管控ILD风险。本研究有助于理解在治疗癌症以保护患者与避免ILD等严重不良反应之间的权衡关系。