When cancer treatment affects the lungs: a clinical overview on pulmonary toxicity induced by new cancer drugs

INTRODUCTION: Novel targeted therapies and immune checkpoint inhibitors have transformed the therapeutic landscape of lung cancer, significantly improving survival outcomes. However, these new therapeutic agents are accompanied by a broad spectrum of adverse events. Pulmonary adverse events, particularly pneumonitis, represent a clinically significant concern due to their potential severity and impact on treatment continuation. AREAS COVERED: This review summarizes current evidence on pulmonary toxicity associated with tyrosine kinase Inhibitors (TKIs) and immune checkpoint inhibitors (ICIs), with a primary focus on lung cancer. A comprehensive literature search of PubMed and recent clinical trial data was undertaken to investigate the overall incidence and management strategies for pneumonitis and related pulmonary events linked to these therapies. While TKIs and ICIs have revolutionized cancer therapy, pulmonary toxicities, though uncommon, can be life threatening. EXPERT OPINION: Improved understanding of underlying mechanisms, enhanced pharmacovigilance and thorough assessment of risk factors prior to drug- administration are essential to mitigate risks. Clinicians should maintain a high index of suspicion for pneumonitis in patients receiving ICIs or TKIs, and suspected cases should be promptly referred to specialized centers with expertise in therapy-related pulmonary complications.