Perioperative nintedanib for lung resection in patients with idiopathic pulmonary fibrosis

Although nintedanib, an anti-fibrotic drug, relieves the chronological worsening of pulmonary function and prevents acute exacerbations of interstitial pneumonia, the perioperative safety and efficacy of nintedanib remains to be elucidated. The present study aimed to examine the safety and efficacy of nintedanib in patients with interstitial pneumonia. This study included 12 patients who underwent lung resection, including bilobectomy (n=2), lobectomy (n=7), segmentectomy (n=2) and wedge resection (n=1) between January 2020 and August 2023 at Juntendo University Nerima Hospital (Tokyo, Japan). Nintedanib was administered preoperatively to 10 male and two female patients with idiopathic pulmonary fibrosis and stage I to III lung cancer. The nintedanib dosing period ranged from 14 to 43 days. None of the patients canceled or postponed surgery because of side effects of nintedanib. Although prolonged air leak (n=3), surgical site infection (n=2), pyothorax (n=1), heart failure (n=1) and pleurisy (n=1) were observed postoperatively, the 30-day mortality rate was 0, with no acute exacerbation of interstitial pneumonia. These results encourage further investigation into the potential of nintedanib treatment in a larger patient cohort through prospective verification.