proposed a multifactorial model of CIP that integrates three primary domains of risk: patient-related factors (including pre-existing ILD like IPF, as well as chronic obstructive pulmonary disease and emphysema), tumor-specific features (notably lung cancer with high PD-L1 expression), and treatment-related exposures (such as ICI combined with small molecule targeted therapy or chemotherapy, and prior thoracic radiation) (2). This evidence concerns the gene CD274 and interstitial lung disease.