From COPD to Lung Cancer: Mechanisms Linking, Diagnosis, Treatment, and Prognosis

Int J Chron Obstruct Pulmon Dis. 2022 Oct 17:17:2603-2621. doi: 10.2147/COPD.S380732. eCollection 2022.

Abstract

Many studies have proved that the pathogenesis of the chronic obstructive pulmonary disease (COPD) and lung cancer is related, and may cause and affect each other to a certain extent. In fact, the change of chronic airway obstruction will continue to have an impact on the screening, treatment, and prognosis of lung cancer.In this comprehensive review, we outlined the links and heterogeneity between COPD and lung cancer and finds that factors such as gene expression and genetic susceptibility, epigenetics, smoking, epithelial mesenchymal transformation (EMT), chronic inflammation, and oxidative stress injury may all play a role in the process. Although the relationship between these two diseases have been largely determined, the methods to prevent lung cancer in COPD patients are still limited. Early diagnosis is still the key to a better prognosis. Thus, it is necessary to establish more intuitive screening evaluation criteria and find suitable biomarkers for lung cancer screening in high-risk populations with COPD. Some studies have indicated that COPD may change the efficacy of anti-tumor therapy by affecting the response of lung cancer patients to immune checkpoint inhibitors (ICIs). And for lung cancer patients with COPD, the standardized management of COPD can improve the prognosis. The treatment of lung cancer patients with COPD is an individualized, comprehensive, and precise process. The development of new targets and new strategies of molecular targeted therapy may be the breakthrough for disease treatment in the future.

Keywords: COPD; biomarkers; early diagnosis; endo-phenotyping of COPD; immunotherapy; lung cancer.

Publication types

  • Review

MeSH terms

  • Early Detection of Cancer
  • Humans
  • Immune Checkpoint Inhibitors
  • Lung Neoplasms* / diagnosis
  • Lung Neoplasms* / etiology
  • Lung Neoplasms* / therapy
  • Prognosis
  • Pulmonary Disease, Chronic Obstructive* / diagnosis
  • Pulmonary Disease, Chronic Obstructive* / drug therapy

Substances

  • Immune Checkpoint Inhibitors

Grants and funding

This article was funded by Jointown Caritas Fund of Hubei Red Cross Foundation.