Drug induced lung disease in patients with nonsmall cell lung cancer: a review of imaging patterns and clinical observations

Drug-induced lung disease (DILD) is a significant clinical problem in the treatment of cancer patients, especially with widespread introduction of novel anticancer agents—immune checkpoint inhibitors and targeted therapies. The incidence of DILD in clinical practice and diversity of radiological manifestations are increasing. It is crucial to determine whether new clinical and imaging findings in these patients are due to disease progression, infection, pulmonary edema, or drug exposure, as this changes patient management. Although the diagnosis of DILD is usually established by excluding other possible causes, radiologists, oncologists, thoracic surgeons, and radiotherapists should be familiar with appropriate imaging patterns. This article provides an overview of the key radiological manifestations of DILD in patients with non-small cell lung cancer (NSCLC) with emphasis on novel therapeutic agents, and presents three clinical observations demonstrating different variants of drug-induced pneumonitis.