Research progress and future perspectives of anticancer drug-induced interstitial lung disease/pneumonia in gastric cancer

Xiaoyu GUO; Xiujuan QU

doi:10.19401/j.cnki.1007-3639.2025.09.008

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Research progress and future perspectives of anticancer drug-induced interstitial lung disease/pneumonia in gastric cancer

Review | 更新时间：2025-12-31

- Research progress and future perspectives of anticancer drug-induced interstitial lung disease/pneumonia in gastric cancer
- China Oncology Vol. 35, Issue 9, Pages: 874-883(2025)
- 作者机构：
  
  中国医科大学附属第一医院肿瘤内科，辽宁沈阳 110001
- 作者简介：
- 基金信息：
  
  Noncommunicable Chronic Diseases-National Science and Technology Major Project(2023ZD0501500)
- DOI：10.19401/j.cnki.1007-3639.2025.09.008
  CLC： R735.2
- Received：18 April 2025，
  
  Revised：2025-07-10，
  
  Published：30 September 2025
- 稿件说明：
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Xiaoyu GUO, Xiujuan QU. Research progress and future perspectives of anticancer drug-induced interstitial lung disease/pneumonia in gastric cancer[J]. China Oncology, 2025, 35(9): 874-883.
DOI：

Xiaoyu GUO, Xiujuan QU. Research progress and future perspectives of anticancer drug-induced interstitial lung disease/pneumonia in gastric cancer[J]. China Oncology, 2025, 35(9): 874-883. DOI： 10.19401/j.cnki.1007-3639.2025.09.008.

摘要

胃癌发病率高，疾病负担沉重，且治疗困难。近年来，免疫检查点抑制剂（immune checkpoint inhibitor，ICI）、人表皮生长因子受体2（human epidermal growth factor receptor 2，HER2）和紧密连接蛋白18.2（Claudin 18.2，CLDN18.2）抑制剂等多种新型抗肿瘤药物为胃癌患者带来获益，单药治疗和不同联合治疗方案均在胃癌临床治疗中展现出巨大潜力。然而，由抗肿瘤药物诱发的间质性肺病/肺炎（interstitial lung disease/pneumonia，ILD/p），尤其是免疫抑制剂类药物和抗体药物偶联物（antibody-drug conjugate，ADC）药物相关ILD的发生风险，已然成为影响患者获益的关键安全性问题。由于不同抗肿瘤药物诱发ILD的风险和机制各不相同，且ILD多数起病隐匿，较难察觉。因此，深入理解不同抗肿瘤药物相关ILD的发生风险及其独特机制、合理且个体化的用药监测及患者管理至关重要。有鉴于此，本文系统性回顾分析近年来胃癌领域抗肿瘤药物相关临床研究中ILD/p的发生率、临床特征及ILD/p相关危险因素，旨在阐明不同抗肿瘤药物之间的风险分层、机制差异，以提升临床认知，从而使更多胃癌患者临床获益。

Abstract

Gastric cancer presents a high incidence rate and substantial disease burden

posing significant therapeutic challenges. Recent advances have yielded significant benefits for gastric cancer patients through novel anti-tumor agents

including immune checkpoint inhibitor (ICI)

human epidermal growth factor receptor 2 (HER2)-targeted therapies

and claudin 18.2 (CLDN18.2)-directed agents. Both monotherapy and various combination regimens demonstrate considerable promise in gastric cancer treatment. However

a critical safety concern potentially limiting patient benefit is drug-induced interstitial lung disease (ILD)/pneumonitis

particularly associated with ICI and antibody-drug conjugate (ADC). The risk and underlying mechanisms of ILD vary considerably across different anti-tumor drug classes

and its often insidious onset makes early detection difficult. Therefore

a deep understanding of the distinct ILD risks and mechanisms associated with different agents

coupled with rational

individualized drug monitoring and patient management

is paramount. This review systematically analyzes the incidence rates

clinical characteristics

and risk factors associated with ILD/pneumonitis reported in recent clinical trials of anti-tumor therapies for gastric cancer. It aimed to elucidate the risk stratification and mechanistic differences between drug classes

thereby enhancing clinical awareness and ultimately helping to maximize clinical outcomes for gastric cancer patients.

关键词

Keywords

references

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