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. 2025 Jun:204:108590.
doi: 10.1016/j.lungcan.2025.108590. Epub 2025 May 21.

Risk of lung injury with immune checkpoint inhibitors after talc pleurodesis: A retrospective study

Susumu Tanaka  1 , Koichiro Nozaki  1 , Satoshi Watanabe  2 , Naohiro Yanagimura  1 , Masashi Arita  1 , Miyuki Sato  1 , Tomohiro Tanaka  1 , Yu Saida  1 , Yuka Goto  3 , Kohei Kushiro  4 , Toshiya Fujisaki  5 , Ko Sato  6 , Daisuke Ishikawa  7 , Takao Miyabayashi  8 , Kosuke Ichikawa  9 , Takeshi Ota  10 , Yoshiki Hayashi  11 , Kenichi Koyama  12 , Akira Ishida  13 , Toshiaki Kikuchi  1
Affiliations

Risk of lung injury with immune checkpoint inhibitors after talc pleurodesis: A retrospective study

Susumu Tanaka et al. Lung Cancer. 2025 Jun.

Abstract

Introduction: The safety of administering immune checkpoint inhibitors (ICIs) after talc pleurodesis, particularly the impact of talc on the development of immune-related interstitial lung disease (ILD), remains unclear.

Methods: We retrospectively analysed patients with primary lung cancer or malignant pleural mesothelioma who received ICIs within 90 days of talc pleurodesis at facilities participating in the Niigata Lung Cancer Treatment Study Group between November 2016 and June 2023.

Results: A total of 52 cases were included, with 17 patients (32.7 %) developing ILD following ICI administration. The median time to ILD onset after ICI administration was 62 days. The median overall survival was 6 months in patients who developed ILD and 16.4 months in those who did not (P = 0.081). Among the five patients with pre-existing interstitial changes, four (80.0 %) developed ILD after ICI administration, identifying a high-risk subgroup.

Conclusion: A high incidence of ILD was observed in patients who received ICI therapy after talc pleurodesis. Additionally, overall survival tended to be shorter in patients who developed ILD.

Keywords: Acute respiratory distress syndrome; Immune checkpoint inhibitors; Interstitial lung disease; Lung cancer; Malignant pleural mesothelioma; Talc pleurodesis.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Koichiro Nozaki has received lecture fees from AstraZeneca, Bristol-Myers, Ono Pharmaceutical, Chugai Pharmaceutical Co., Taiho Pharmaceutical, and MSD. Dr. Satoshi Watanabe has received grants from Boehringer Ingelheim and Nippon Kayaku and lecture fees from Eli Lilly, Pfizer, Novartis Pharma, AstraZeneca, Chugai Pharma, Bristol-Myers, Boehringer Ingelheim, MSD, Ono Pharmaceutical, Daiichi Sankyo, Kyowa Kirin, Takeda Pharmaceutical, Nippon Kayaku, Merck, Celltrion, and Taiho Pharmaceutical. Dr. Naohiro Yanagimura has received lecture fees from MSD, Taiho Pharmaceutical, and Merck. Dr. Tomohiro Tanaka has received lecture fees from Chugai Pharma. Dr. Yu Saida has received lecture fees from Chugai Pharma, MSD, AstraZeneca, and Eli Lilly. Dr. Kohei Kushiro has received lecture fees from Chugai Pharma, Merck, Takeda Pharmaceutical, Taiho Pharmaceutical, Eli Lilly, Kyowa Kirin, and Teijin Healthcare. Dr. Toshiya Fujisaki has received lecture fees from AstraZeneca and Kyowa Kirin. Dr. Daisuke Ishikawa has received lecture fees from AstraZeneca, Bristol-Myers, Chugai Pharma and Kyowa Kirin. Dr. Kosuke Ichikawa has received lecture fees from AstraZeneca, Bristol-Myers, Taiho Pharmaceutical, MSD, Takeda Pharmaceutical, Kyowa Kirin, Chugai Pharma, Ono Pharmaceutical, Daiichi Sankyo, Hisamitsu Pharmaceutical, and Nippon Kayaku. Dr. Takeshi Ota has received lecture fees from AstraZeneca, Bristol-Myers, Chugai Pharma, Nippon Kayaku and Eli Lilly. Dr. Toshiaki Kikuchi has received grants and personal fees from Nobelpharma, Boehringer Ingelheim, Taiho Pharmaceutical, KYORIN Pharmaceutical, Shionogi, Chugai Pharma, Asahi Kasei, Daiichi Sankyo, Nippon Kayaku, TEIJIN PHARMA, AN2 Therapeutics and received honoraria for speakers bureaus from Viatris, Astellas Pharma, Insmed, Boehringer Ingelheim, Terumo, AstraZeneca, Daiichi Sankyo, KYORIN Pharmaceutical, Bristol-Myers, Eisai, Ono Pharmaceutical, Chugai Pharma, GSK, Sumitomo Pharma, Kyowa Kirin, MSD, Tsumura, Gilead Sciences, Kracle, Pfizer Japan, Merck, Asahi Kasei Pharma, Japan Blood Products Organization, Nippon Kayaku, Nippon Shinyaku, and Takeda Pharmaceutical, and participate Advisory Board for Janssen Pharmaceutical, and received drugs from Nobelpharma. The other authors have no conflicts of interest to declare.

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