{
  "abstract": "Introduction Tyrosine kinase inhibitors (TKI) are approved for the management of various malignancies. In clinical practice, some patients experience serious respiratory complications from these drugs. However, real world analysis of the adverse respiratory effects of TKIs is lacking. We set out to study clinical features predictive of respiratory complications from TKIs.Method All patients aged 16 and over treated with a TKI for solid tumours between 01/01/2024 and 01/07/2024 at a large tertiary hospital were identified. Electronic patient records were screened for respiratory events that occurred within a year of commencing TKI therapy.Results 120 patients (mean patient age was 65±15 years) treated with one of 11 TKIs were identified. 57% of patients (n=68) had lung metastases. The most frequently prescribed TKIs were cabozantinib (n=31), dabrafenib (n=25), and lenvatinib (n=17). 48% of patients (n=58) reported at least one respiratory complication during the follow-up period. The median time from the initiation of therapy to the development of the first complication was 79 days. The most common complications were new or worsening pleural effusion (n=21) and lower respiratory tract infection (n=19). The risk of pleural effusion was significantly higher in patients who took cabozantinib compared to other TKIs (RR=3.83, 95% CI 1.79–8.20). Less common complications included pulmonary embolism (PE, n=8) and pneumothorax (n=4). Five patients who developed a PE and all patients who developed a pneumothorax had been treated with cabozantinib. For pneumothorax, 3 patients were treated for osteosarcoma. This represents a notable proportion of the 4 patients with osteosarcoma who were included in this study. Overall, the risk of respiratory complications with cabozantinib was high compared to other TKIs ( figure 1; RR=1.75, 95% CI 1.25–2.46). The presence of pulmonary metastasis also increased the risk of respiratory complications (RR=1.70, 95% CI 1.11–2.60).Abstract P83 Figure 1Kaplan-Meier curve of the probability of no respiratory event occurring within 1 year of follow-upConclusion Our study identified cabozantinib as conferring the greatest risk of developing TKI-associated respiratory complications including pneumothorax. A follow-on national study is planned.",
  "authors": [
    {
      "affiliations": [
        "University of Cambridge, Cambridge, UK",
        "Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"
      ],
      "name": "J Treves"
    },
    {
      "affiliations": [
        "Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"
      ],
      "name": "A Warrier"
    },
    {
      "affiliations": [
        "Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"
      ],
      "name": "J Harrington"
    },
    {
      "affiliations": [
        "University of Cambridge, Cambridge, UK",
        "Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"
      ],
      "name": "S Marciniak"
    }
  ],
  "title": "P83 Respiratory complications including pneumothorax in patients receiving tyrosine kinase inhibitors",
  "uid": "227c14b7-20a5-51c2-8bfd-9947e389dbee"
}