Drug-induced Interstitial Lung Disease After Chemotherapy in Pancreatic Cancer
Alessio Morandi, Jun Yoshino, Chiara Scandavini, Ira Sotirova, Oskar Franklin, Roberto Valente, Ioannis Gkekas, Daniel Öhlund, Ala Muala, Karl A. Franklin, Gian Luca Grazi, Asif HalimiObjective:
This systematic review and meta-analysis evaluated the incidence and mortality of drug-induced interstitial lung disease (DI-ILD) in pancreatic cancer patients treated with f
Background:
Pancreatic cancer is an aggressive malignancy with limited curative options. FOLFIRINOX and Gem-Nab are widely used in neoadjuvant, adjuvant, and palliative settings. DI-ILD is a potentially life-threatening complication that can delay or preclude further chemotherapy or surgery.
Methods:
A systematic search identified studies reporting DI-ILD incidence and/or mortality in patients receiving FOLFIRINOX or Gem-Nab. Meta-analyses estimated incidence rates, compared regimens, and assessed neoadjuvant use. Random or common-effects models were applied depending on heterogeneity, and publication bias was assessed by Egger’s test.
Results:
Thirty studies involving 9575 patients were included: 961 received FOLFIRINOX and 8614 received Gem-Nab. In 11 studies on FOLFIRINOX, DI-ILD incidence ranged from 0% to 3.22%; in 22 studies on Gem-Nab, it ranged from 0% to 26.66%. The estimated DI-ILD incidence was 1.06% [95% confidence interval (CI) = 0.35%–1.77%] for FOLFIRINOX and 2.74% (95% CI = 1.93%–3.55%) for Gem-Nab. Although the comparative analysis indicated a higher risk of DI-ILD with Gem-Nab (odds ratio: 2.136; 95% CI = 0.837–5.45;
Conclusions:
DI-ILD is a rare but potentially serious complication of chemotherapy in pancreatic cancer, with no significant difference observed between patients receiving Gem-Nab and FOLFIRINOX. Awareness of this condition and careful monitoring during chemotherapy are crucial for early detection and effective management.