Patients with progressive fibrosing interstitial lung diseases (fILD) have increased morbidity and mortality. Lung fibrosis can be associated with lung cancer (LC). The pathogenesis of both diseases shows similarities although not all mechanisms are understood. The combination of the diseases is challenging, due to its amplified risk of mortality and also because lung cancer treatment carries additional risks in patients with underlying lung fibrosis. Acute exacerbations in fILD patients are linked to increased mortality and the risk of acute exacerbations is increased after LC treatment with surgery, chemotherapy, or radiotherapy. Careful selection of treatment modalities is crucial to improve survival whilst maintaining acceptable quality of life in patients with combined LC and fILD. This overview of epidemiology, pathogenesis, treatment, and a possible role for antifibrotic drugs in patients with LC and fILD is the summary of a session presented during the virtual ERS conference 2021. The review summarises current knowledge and identifies areas of uncertainty. Most current data relate to patients with combined idiopathic pulmonary fibrosis and LC. There is a pressing need for additional prospective studies, required for the formulation of a consensus statement or guideline on the optimal care of patients with LC and fILD.
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