Idiopathic pulmonary fibrosis and lung cancer: targeting the complexity of the pharmacological interconnection

Expert Rev Respir Med. 2022 Oct;16(10):1043-1055. doi: 10.1080/17476348.2022.2145948. Epub 2022 Nov 16.

Abstract

Introduction: Many data already suggested that cancer and IPF are underlined by a number of common pathogenic biologic pathways. However, fewer data regards the interconnections, in terms of synergy or increased toxicities, of drugs used in cancer and IPF. Particularly, how the specific therapy influences the concurrent condition and prognostic factors of response in patients with both lung cancer and IPF are far to be clarified. Similarly, identification of features of IPF patients with higher risk of developing pulmonary adverse events when treated with chemotherapy, immune checkpoint inhibitors, TKIs, or radiotherapy is of primary importance in clinical practice.

Areas covered: We will discuss the scientific rationale, based on the extensive analysis of literature data, by consulting several databases for combining anticancer and antifibrotic treatments and for the design of novel therapeutic strategies. The role of immunotherapy in cancer aroused in IPF context will be discussed with specific interested, based on the continuously increasing role of immune checkpoint inhibition against lung tumors.

Expert opinion: This work will help to improve knowledge, based on a multidisciplinary perspective, on IPF and cancer patients, which identify an unmet clinical need. A better management during each phase of disease progression will require the design innovative trials and the development of new drugs and molecules both in the oncologic and respiratory medicine pipeline.

Keywords: Antifibrotic drugs; idiopathic pulmonary fibrosis; immune checkpoint inhibitors; lung cancer.

MeSH terms

  • Disease Progression
  • Humans
  • Idiopathic Pulmonary Fibrosis* / therapy
  • Immunotherapy / adverse effects
  • Lung Neoplasms* / drug therapy
  • Pulmonary Medicine*