Radiation pneumonitis is a dreaded potential complication of thoracic radiation. Nintedanib is a drug used to treated idiopathic pulmonary fibrosis by inhibiting fibroblast proliferation and extracellular matrix formation. So, could it help with radiation pneumonitis? This randomized, phase 2 trial took 30 patients with grade 2+ radiation pneumonitis and randomized them to a standard 8 week prednisone taper with or without nintedanib. At 1 year, the addition of nintedanib significantly improved freedom from pulmonary exacerbation (72% v 40%). However, there was a higher rate of grade 2+ toxicity (89% v 42%). | Rimner, Int J Radiat Oncol Biol Phys 2023
