Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Jul 30;17(15):2522.
doi: 10.3390/cancers17152522.

Balancing Innovation and Safety: Prediction, Prevention, and Management of Pneumonitis in Lung Cancer Patients Receiving Novel Anti-Cancer Agents

Affiliations
Review

Balancing Innovation and Safety: Prediction, Prevention, and Management of Pneumonitis in Lung Cancer Patients Receiving Novel Anti-Cancer Agents

Sarah Liu et al. Cancers (Basel). .

Abstract

Pneumonitis is characterized as inflammation of the lung parenchyma, and a potential adverse effect of several anti-cancer therapies. Diagnosing pneumonitis can be particularly challenging in lung cancer patients due to inherent similarities in symptoms and radiological presentation associated with pneumonitis, as well as other common conditions such as infection or disease progression. Furthermore, many lung cancer patients have underlying pulmonary conditions that might render them more susceptible to severe or fatal outcomes from pneumonitis. Novel anti-cancer agents, such as antibody-drug conjugates (ADCs) and bispecific antibodies (BsAbs), are being incorporated into the treatment of lung cancer; therefore, understanding the risk and mechanisms underlying the potential development of pneumonitis with these new therapies is important to ensure continuous improvements in patient care. This narrative review provides an overview of the incidence of pneumonitis observed with novel anti-cancer agents, characterizes potential pathophysiological mechanisms underlying pneumonitis risk and emerging predictive biomarkers, highlights management strategies, and explores future directions for minimizing the risk of pneumonitis for lung cancer patients.

Keywords: antibody–drug conjugate; bispecific antibody; immunotherapy toxicity; lung cancer; pneumonitis.

PubMed Disclaimer

Conflict of interest statement

S.G.: Honoraria: Amgen; Consulting/Advisory Role: GSK; Research Funding (institution): AstraZeneca, Merck. A.R.: Consulting/Advisory: Astra Zeneca, Bristol Myers Squibb, Amgen, MSD; Y.L.: Honoraria: AstraZeneca, Pfizer, Amgen Consulting/Advisory: AstraZeneca, Pfizer Research Funding: AstraZeneca.

Figures

Figure 1
Figure 1
General antibody–drug conjugate (ADC) structure and specific components of main ADCs currently approved and in development for the treatment of lung cancer patients.
Figure 2
Figure 2
Mechanisms contributing to pneumonitis in cancer patients treated with antibody-drug conjugates and bispecific antibodies.
Figure 3
Figure 3
Bispecific antibodies with distinct antigen binding sites targeting tumor-associated antigens and/or immune cell targets.

Similar articles

References

    1. Li C., Lei S., Ding L., Xu Y., Wu X., Wang H., Zhang Z., Gao T., Zhang Y., Li L. Global burden and trends of lung cancer incidence and mortality. Chin. Med. J. (Engl.) 2023;136:1583–1590. doi: 10.1097/CM9.0000000000002529. - DOI - PMC - PubMed
    1. Brenner D.R., Gillis J., Demers A.A., Ellison L.F., Billette J.-M., Zhang S.X., Liu J.L., Woods R.R., Finley C., Fitzgerald N., et al. Projected estimates of cancer in Canada in 2024. Can. Med. Assoc. J. 2024;196:E615–E623. doi: 10.1503/cmaj.240095. - DOI - PMC - PubMed
    1. Molina J.R., Yang P., Cassivi S.D., Schild S.E., Adjei A.A. Non-Small Cell Lung Cancer: Epidemiology, Risk Factors, Treatment, and Survivorship. Mayo Clin. Proc. 2008;83:584–594. doi: 10.1016/S0025-6196(11)60735-0. - DOI - PMC - PubMed
    1. Nooreldeen R., Bach H. Current and Future Development in Lung Cancer Diagnosis. Int. J. Mol. Sci. 2021;22:8661. doi: 10.3390/ijms22168661. - DOI - PMC - PubMed
    1. Lin M.-X., Zang D., Liu C.-G., Han X., Chen J. Immune checkpoint inhibitor-related pneumonitis: Research advances in prediction and management. Front. Immunol. 2024;15:1266850. doi: 10.3389/fimmu.2024.1266850. - DOI - PMC - PubMed

LinkOut - more resources