“Idiopathic pulmonary fibrosis and lung cancer: data mining and predictor factors analysis. A single institution experience”

Epidemiological and biological connection between Idiopathic pulmonary fibrosis (IPF) and lung cancer (LC) represents a modern matter of interest around the scientific community for a further definition of both diseases underlying mechanisms and drugs development. Nowadays is well known that IPF is characterized by an abnormal process of tissue repair and impairment of the alveolar structure which is driven by pathogenic events similarly to those happening in cancer development . Moreover, it has also been noticed that an IPF diagnosis is associated to a significantly higher risk of lung cancer development and that the coexistence of both diseases is characterized by an unfavourable prognosis due to experiences of severe disease exacerbations during antineoplastic therapy . Reports indicated a cumulative incidence of cancer in IPF patients varying from 3.3 %, 15.4% and 54.7% respectively after 1, 5 and 10 years of follow-up . These increasing percentages are a demonstration of the similar events, including genetic and epigenetic changes, altered response to regulatory signals, abnormal expression of microRNAs and activation of specific signalling pathways that unites these pathologies which are going to be discussed further. As a matter of facts this disease association is burdened by an overall shortage of life expectancy due to the severity of both conditions and the clinical and pharmacological difficulties to establish a properly working therapy for IPF. This Institution did evaluate a cohort of patients with Idiopathic Pulmonary Fibrosis that subsequently developed lung cancer, analysing impacting habits, environmental factors and exposures, pre-existing comorbidities, cancer biology and gender differences to better assess the weight of each prognostic factor and to lead to a more focused clinical and therapeutical approach.