Is there a role for nintedanib in the management of patients with radiation-induced pulmonary fibrosis?

There is no phase III evidence I am aware of on the benefits of nintedanib in the prevention of radiation-induced pulmonary fibrosis so it is not a drug I use. There are a few case reports and some pre-clinical studies suggesting an effect. There is a small (34 patients) randomized phase II study that looked at the addition of the drug to steroids in the management of grade 2+ radiation pneumonitis [Rimner et al., PMID 36889516]. The study closed due to poor accrual. The primary endpoint was fre...