Katerina M Antoniou1, Sara Tomassetti, Eliza Tsitoura, Carlo Vancheri. 1. aDepartment of Thoracic Medicine, University Hospital of Heraklion bLaboratory of Molecular and Cellular Pneumonology, Medical School, University of Crete, Crete, Greece cDepartment of Diseases of the Thorax, Pulmonary Unit, GB Morgagni Hospital, Forlì dRegional Centre for Interstitial and Rare Lung Diseases, Department of Clinical and Experimental Medicine, University Hospital Policlinico-Vittorio Emanuele, Catania, Italy.
Abstract
PURPOSE OF REVIEW: About one out of 10 patients with idiopathic pulmonary fibrosis (IPF) develop lung cancer. This review provides an epidemiology and clinical update of the association of these two lethal diseases. In addition, we focus on the emerging overlapping epigenetic mechanisms in both diseases. RECENT FINDINGS: In a vast majority of cases, lung cancer is diagnosed during the clinical and radiological follow-up for the fibrosis. The risk of development of lung cancer in IPF is higher for older male smokers and there is a significantly higher prevalence of lung cancer in the combined IPF and emphysema syndrome compared with fibrosis only. The association of two lethal diseases, such as IPF and lung cancer, carries a very poor outcome and the correct treatment strategy, particularly for advanced forms of lung cancer, is still unclear. SUMMARY: The two novel drugs approved for IPF, pirfenidone and nintedanib, open a new scenario in which treated patients with fibrosis will live longer, and possibly have a lower incidence of lung cancer. However, prospective studies are urgently needed to definitively clarify the role of lung cancer treatment in the management of IPF patients. Furthermore, common epigenetic alterations may represent a promising target for therapeutic approaches in the near future.
PURPOSE OF REVIEW: About one out of 10 patients with idiopathic pulmonary fibrosis (IPF) develop lung cancer. This review provides an epidemiology and clinical update of the association of these two lethal diseases. In addition, we focus on the emerging overlapping epigenetic mechanisms in both diseases. RECENT FINDINGS: In a vast majority of cases, lung cancer is diagnosed during the clinical and radiological follow-up for the fibrosis. The risk of development of lung cancer in IPF is higher for older male smokers and there is a significantly higher prevalence of lung cancer in the combined IPF and emphysema syndrome compared with fibrosis only. The association of two lethal diseases, such as IPF and lung cancer, carries a very poor outcome and the correct treatment strategy, particularly for advanced forms of lung cancer, is still unclear. SUMMARY: The two novel drugs approved for IPF, pirfenidone and nintedanib, open a new scenario in which treated patients with fibrosis will live longer, and possibly have a lower incidence of lung cancer. However, prospective studies are urgently needed to definitively clarify the role of lung cancer treatment in the management of IPFpatients. Furthermore, common epigenetic alterations may represent a promising target for therapeutic approaches in the near future.
Authors: Sasha Bernatsky; Rosalind Ramsey-Goldman; Michelle Petri; Murray B Urowitz; Dafna D Gladman; Paul R Fortin; Edward H Yelin; Ellen Ginzler; John G Hanly; Christine Peschken; Caroline Gordon; Ola Nived; Cynthia Aranow; Sang-Cheol Bae; David Isenberg; Anisur Rahman; James E Hansen; Yvan St Pierre; Ann E Clarke Journal: J Rheumatol Date: 2018-01-15 Impact factor: 4.666
Authors: Giulia Maria Stella; Vito D'Agnano; Davide Piloni; Laura Saracino; Sara Lettieri; Francesca Mariani; Andrea Lancia; Chandra Bortolotto; Pietro Rinaldi; Francesco Falanga; Cristiano Primiceri; Angelo Guido Corsico; Andrea Bianco Journal: Transl Lung Cancer Res Date: 2022-03