Common Pathogenic Mechanisms Between Idiopathic Pulmonary Fibrosis and Lung Cancer

Τzouvelekis, Αrgyris; Gomatou, Georgia; Bouros, Evangelos; Trigidou, Rodoula; Tzilas, Vasilios

doi:10.1016/j.chest.2019.04.114

Cited by 109 publications

(84 citation statements)

References 67 publications

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“…Previous studies have revealed a high incidence of lung cancer in IPF [31,[79][80][81] and a likely increase in the annual risk of lung cancer that appears to rise over the years following diagnosis [31]. Cell senescence, genetic and epigenetic alterations, abnormal expression of microRNAs, delayed apoptosis, and activation of specific transduction pathways have been observed in both IPF and cancer pathogenesis [3,82]. An even higher incidence has been reported in CPFE [83,84].…”

Section: Lung Cancermentioning

confidence: 99%

Comorbidities in idiopathic pulmonary fibrosis: an underestimated issue

et al. 2019

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Idiopathic pulmonary fibrosis (IPF) is a progressive and fibrosing lung disease with a poor prognosis. Between 60% and 70% of IPF patients die of IPF; the remaining causes of death may be due to comorbidities occurring in this ageing population. Interest in the role played by comorbidities in IPF has increased in the past few years. The optimal clinical management of IPF is multifaceted and not only involves antifibrotic treatment, but also vaccinations, oxygen supplementation, evaluation of nutritional status as well as psychological support and patient education. Symptom management, pulmonary rehabilitation, palliative care and treatment of comorbidities represent further areas of clinical intervention. This review analyses the major comorbidities observed in IPF, focusing on those that have the greatest impact on mortality and quality of life (QoL). The identification and treatment of comorbidities may help to improve patients' health-related QoL (i.e. sleep apnoea and depression), while some comorbidities (i.e. lung cancer, cardiovascular diseases and pulmonary hypertension) influence survival. It has been outlined that gathering comorbidities data improves the prediction of survival beyond the clinical and physiological parameters of IPF.

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Section: Lung Cancermentioning

confidence: 99%

Comorbidities in idiopathic pulmonary fibrosis: an underestimated issue

et al. 2019

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“…Previous studies have suggested that the core of the ILD and lung cancer copathogenesis is the irreversible loss of the capacity of the cell to grow and divide. ILD may lead to genetic and epigenetic alterations as well as the abnormal activation of common transduction pathways, including Wnt/b‐catenin and phosphoinositide 3‐kinase/protein kinase B . There are other scholars using microsatellite DNA analysis, whereby they have observed a loss of heterozygosity in MYCL1, FHIT, SPARC, p16Ink4, and TP53 genomic loci among ILD patients .…”

Section: Discussionmentioning

confidence: 99%

Lung cancer in patients with and without rheumatoid arthritis: A propensity score‐matched survival analysis cohort study

et al. 2020

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Background Connective tissue disease increases the risk of lung cancer, but whether rheumatoid arthritis (RA) has an effect on the overall survival (OS) rate in this population has not been well studied. Methods Patients diagnosed with lung cancer between January 2015 and December 2017 were enrolled in this retrospective analysis. Propensity score matching was performed to balance the baseline of the two groups, whereas the differences between patients with and without RA were compared using survival analysis. Further, the effects of interstitial lung disease (ILD) and qi deficiency on survival in cases of RA with lung cancer were examined. Cox regression analysis was applied to predict the factors that influenced the survival of lung cancer to one year. Results Overall, 154 lung cancer patients, including 136 (88.3%) without RA and 18 (11.7%) with RA, were included. Two comparison cohorts were matched by 1:2 propensity score matching, which yielded 18 lung cancer patients with RA and 36 lung cancer patients without RA. Ultimately, the survival prognosis of lung cancer and RA was worse than that without RA, that of patients with ILD with RA and lung cancer was worse than that among those without RA, and that of patients with qi deficiency with RA and lung cancer was worse than that among those without RA. Conclusions The survival prognosis of lung cancer patients with RA is worse than that of those without RA. ILD and qi deficiency promote reduced survival when found in conjunction with RA in patients with lung cancer.

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“…2 Both diseases present with major similarities in terms of pathogenetic pathways, as well as potential causative factors, such as smoking and viral infections. 3 Lung cancer patients with comorbid IPF have few treatment options because surgery, radiotherapy, and chemotherapy elevate the risk of exacerbation of IPF. [4][5][6] An optimal therapeutic strategy for patients with both diseases is sorely needed.…”

Section: Introductionmentioning

confidence: 99%

Pirfenidone facilitates immune infiltration and enhances the antitumor efficacy of PD-L1 blockade in mice

et al. 2020

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Idiopathic pulmonary fibrosis (IPF) patients have a high risk of developing lung cancer, with few treatment options available. Pirfenidone, an antifibrotic agent approved for the treatment of IPF, has been demonstrated to suppress the TGFβ signaling and modulate the expression of immune-related genes. However, for lung cancer patients with comorbid IPF, whether pirfenidone has any synergetic effect with immune checkpoint inhibitors has not been investigated. In this study, we showed that pirfenidone monotherapy attenuated tumor growth with an increased T cell inflammatory signature in tumors. Co-administration of pirfenidone with PD-L1 blockades significantly delayed the tumor growth and increased survival, compared with the effect of either treatment alone. Combination therapy promoted gene expression with a unique signature associated with innate and adaptive immune response resulted in the infiltration of immune cells and optimal T cell positioning. Furthermore, we showed a great benefit of combination therapy in alleviating the pulmonary fibrosis and reducing the tumor growth in a tumor-fibrosis model. Our results collectively demonstrated that pirfenidone facilitated antitumor immunity and enhanced the efficacy of PD-L1 blockades. It may act as an adjuvant to immunotherapy in cancer treatment, particularly, in lung cancer patients with preexisting IPF.

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Common Pathogenic Mechanisms Between Idiopathic Pulmonary Fibrosis and Lung Cancer

Cited by 109 publications

References 67 publications

Comorbidities in idiopathic pulmonary fibrosis: an underestimated issue

Comorbidities in idiopathic pulmonary fibrosis: an underestimated issue

Lung cancer in patients with and without rheumatoid arthritis: A propensity score‐matched survival analysis cohort study

Pirfenidone facilitates immune infiltration and enhances the antitumor efficacy of PD-L1 blockade in mice

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