Anticancer drug-induced interstitial lung disease: a critical appraisal of clinical practice guidelines and consensus statements.

Anticancer drug-induced interstitial lung disease (DIILD) has received increasing clinical attention, and the quality of relevant guidance documents has become critical. Our purpose was to assess the quality of documents for anticancer DIILD and summarize the recommendations. Clinical practice guidelines (CPGs) and consensus statements with recommendations for the evaluation, treatment, and monitoring of anticancer DIILD were searched in electronic databases, websites of guideline organizations, and professional societies. The quality of documents was assessed using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) methodology, and the specific recommendations were aggregated and compared to analyze the consistency among documents. A total of 11 documents were eligible, including 6 CPGs and 5 consensus statements. The quality of AGREE II assessments differed greatly, both between domains of documents and between documents across domains. The domains of scope and purpose and clarity of presentation received the highest median scores, while the stakeholder involvement domain received the lowest score. Recommendations were inconsistent between documents, particularly regarding the selection of steroid regimens. The methodological quality of the guidance documents needs to be enhanced, especially in the domain of stakeholder involvement. Inconsistencies exist in documents regarding specific recommendations for evaluation, treatment and, monitoring of anticancer DIILD, and further discussions among multidisciplinary experts are needed to reach an agreement. In particular, we have focused our concerns on the differences in steroid regimens, and future research is still needed on the risks of adverse events related to hormone therapy and discovery of precise biomarkers.