COVID-19 as a Primer for Drug-Induced Pneumonitis in Patients With Cancer.

BACKGROUND: Drug-related pneumonitis is a hallmark adverse event of some systemic antican- cer therapies and is characterized by chronic lung inflammation that requires intervention and possible discontinuation of the causative agent. The etiology of pneumonitis is closely related to the mechanism of action of the oncologic drug involved, and alternative treatment options need to be explored more thoroughly. Since the beginning of the COVID-19 pandemic, interstitial lung dis- ease related to anticancer therapy has been more difficult to diagnose, because the clinical symptoms of COVID-19 pneumonia can mirror that of drug-related pneumonitis. There is very little information about the risk for pneumonitis with anticancer therapies in patients who received the COVID-19 vaccination series or who had COVID-19. OBJECTIVES: To highlight the incidence of drug-related pneumonitis in patients who received the COVID-19 vaccination series or who had COVID-19, and to provide information on the duration of onset, diagnosis, and management strategies of drug-related pneumonitis. METHODS: This single-center, retrospective chart review study included patients who were re- ceiving anticancer therapy and were diagnosed with COVID-19 or received COVID-19 vaccination between July 1, 2021, and May 31, 2022, at MD Anderson Cancer Center at Cooper University Hospital. The primary outcomes were the time from the COVID-19 primer to having symptoms of drug-related pneumonitis, and the time from receiving an anticancer therapy to having symptoms of drug-related pneumonitis. RESULTS: A total of 10 patients were included in the study. Of the 10 patients, 7 received a taxane drug and 5 patients had COVID-19 before drug-related pneumonitis. The time from COVID-19 to having drug-related pneumonitis ranged from 0.75 months to 14 months, and the time from COVID-19 vaccination to having a drug-related pneumonitis episode ranged from 0.5 months to 12 months. The average time from the start of an anticancer drug to the onset of pneumonitis was 75 days in the COVID-19 group and 28 days in the COVID-19 vaccination group. When separated by drug type, the median duration of onset of pneumonitis was longer in our study than in the patients in the historical data. CONCLUSION: In our study, we observed a possible increased sensitivity to drug-induced lung injury after having COVID-19 or after receiving COVID-19 vaccination. The results of our study also show a longer median duration of onset of pneumonitis than was previously reported in the histor- ical data. [ABSTRACT FROM AUTHOR]