Antifibrotic therapy may be associated with a reduced risk of lung cancer in patients with idiopathic pulmonary fibrosis (IPF), a new study published in Thorax found. This “may be partly associated with its survival benefit,” the authors wrote.

Patients with IPF are at a high risk of developing lung cancer. Because antifibrotic treatment slows the progression of IPF, it also prolongs patient survival. However, the effect of the treatment on the risk of lung cancer in these patients has not been clear.

In the present study, a team of researchers led by Takafumi Suda, MD, PhD, from the Department of Internal Medicine, Hamamatsu University School of Medicine in Japan conducted a multicentre retrospective study to evaluate the effect of antifibrotic therapy on the risk of lung cancer development in 345 patients with IPF.


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The researchers found that the incidence and prevalence of lung cancer were significantly lower in patients with IPF who were receiving antifibrotic therapy compared to those who were not receiving the treatment. Lung-cancer-related mortality was, therefore, also significantly lower in patients with IPF treated with antifibrotics compared to the others.

“These results suggest that antifibrotic therapy was possibly associated with a reduced risk of [lung cancer] development in patients with IPF, which may be partly associated with its survival benefit,” the researchers wrote.

IPF is a chronic, progressive lung disease of unknown etiology characterized by the buildup of fibrotic tissue in the pulmonary parenchyma leading to dyspnea, chronic, unproductive cough, and clubbed fingers. Several environmental and genetic factors may contribute to the development of the disease including cigarette smoke, agricultural compounds, dust, and microbial agents.

Antifibrotics such as pirfenidone work by inhibiting fibroblast proliferation and differentiation and collagen synthesis, thereby reducing the build-up of fibrotic tissue in the lungs.

Reference

Naoi H, Suzuki Y, Mori K, et al. Impact of antifibrotic therapy on lung cancer development in idiopathic pulmonary fibrosis. Thorax. Published online March 30, 2022. doi:10.1136/thoraxjnl-2021-218281