Drug-Related Pneumonitis in Cancer Treatment during the COVID-19 Era

SIMPLE SUMMARY: Interstitial lung disease is a group of diseases characterized by chronic lung inflammation that can be related to oncological treatments, such as traditional chemotherapy drugs and the newest targeted therapies and immunotherapies. Awareness about this potentially fatal adverse event is paramount in patient management and to make a conscious therapeutic choice. It represents a differential diagnostic challenge, especially in the context of the COVID-19 pandemic. Our aim is to describe the incidence and characteristics of this adverse event across oncological treatment groups and to promote greater knowledge about this important toxicity. ABSTRACT: Interstitial lung disease is recognized as a group of diseases with a different etiopathogenesis characterized by chronic lung inflammation with the accumulation of inflammatory cells, lymphocytes and macrophages, and the consequent release of proinflammatory cytokines. Various degrees of pulmonary fibrosis can be associated with this inflammatory condition. Interstitial lung disease related to oncological drugs is a relevant problem in clinical practice. The etiopathogenetic mechanisms underlying this adverse event are not completely known but can be partly explained by the mechanism of action of the drug involved. Therefore, knowledge of the relevance of this potentially fatal adverse event supported by the reported safety data of pivotal studies becomes fundamental in the management of patients. The prompt diagnosis of drug-related pneumonia and the consequent differential diagnosis with other forms of pneumonia allow a rapid suspension of treatment and the establishment of an immunosuppressive treatment if necessary. In the context of the health emergency related to SARS CoV2 infection and COVID-19-related interstitial lung disease, such knowledge holds decisive relevance in the conscious choice of cancer treatments. Our intent was to describe the oncological drugs most correlated with this adverse event by reporting, where possible, the percentages of insurgency in pivotal studies to provide an overview and therefore promote greater awareness of this important toxicity related to oncological treatment.