Idiopathic pulmonary fibrosis: Current knowledge, future perspectives and its importance in radiation oncology

Türkkan, Görkem; Y, Willems; Hendriks, Lizza; Mostard, Rémy L M; Conemans, Lennart; Gietema, Hester A.; Mitea, Cristina; Peeters, Stéphanie; Ruysscher, Dirk De

doi:10.1016/j.radonc.2020.11.020

Cited by 23 publications

(25 citation statements)

References 88 publications

(115 reference statements)

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“…The factors contributing to the incidence of radiation-induced fibrosis can be dichotomized into treatment-related and patient-specific factors. Treatment-related factors include parameters such as the extent of the radiation field, dose and fractionation as well as the combination of multiple cancer treatment modalities such as surgery and chemotherapy with radiation, whereas patient-specific factors involve pre-existing comorbidities such as IPF and connective tissue diseases [78,79].…”

Section: Radiation-induced Fibrosismentioning

confidence: 99%

Inflammation, Fibrosis and Cancer: Mechanisms, Therapeutic Options and Challenges

Sodji

Oyelere

2022

Cancers

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Uncontrolled inflammation is a salient factor in multiple chronic inflammatory diseases and cancers. In this review, we provided an in-depth analysis of the relationships and distinctions between uncontrolled inflammation, fibrosis and cancers, while emphasizing the challenges and opportunities of developing novel therapies for the treatment and/or management of these diseases. We described how drug delivery systems, combination therapy and the integration of tissue-targeted and/or pathways selective strategies could overcome the challenges of current agents for managing and/or treating chronic inflammatory diseases and cancers. We also recognized the value of the re-evaluation of the disease-specific roles of multiple pathways implicated in the pathophysiology of chronic inflammatory diseases and cancers—as well as the application of data from single-cell RNA sequencing in the success of future drug discovery endeavors.

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Section: Radiation-induced Fibrosismentioning

confidence: 99%

Inflammation, Fibrosis and Cancer: Mechanisms, Therapeutic Options and Challenges

Sodji

Oyelere

2022

Cancers

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“…Radiation-induced lung toxicities are caused by a complex mechanism involving damage to the alveolar epithelia, cell senescence, oxidative stress and local inflammation (pneumonitis) [3][4][5]. With the attraction of fibroblasts and collagen deposition, subacute pneumonitis is superseded by chronic lung fibrosis.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Toxicity after Total Body Irradiation—An Underrated Complication? Estimation of Risk via Normal Tissue Complication Probability Calculations and Correlation with Clinical Data

Oertel

Kittel

Martel

et al. 2021

Cancers

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Total body irradiation (TBI) is an essential part of various conditioning regimens prior to allogeneic stem cell transplantation, but is accompanied by relevant (long-term) toxicities. In the lungs, a complex mechanism induces initial inflammation (pneumonitis) followed by chronic fibrosis. The hereby presented analysis investigates the occurrence of pulmonary toxicity in a large patient collective and correlates it with data derived from normal tissue complication probability (NTCP) calculations. The clinical data of 335 hemato-oncological patients undergoing TBI were analyzed with a follow-up of 85 months. Overall, 24.8% of all patients displayed lung toxicities, predominantly pneumonia and pulmonary obstructions (13.4% and 6.0%, respectively). NTCP calculations estimated median risks to be 20.3%, 0.6% and 20.4% for overall pneumonitis (both radiological and clinical), symptomatic pneumonitis and lung fibrosis, respectively. These numbers are consistent with real-world data from the literature and further specify radiological and clinical apparent toxicity rates. Overall, the estimated risk for clinical apparent pneumonitis is very low, corresponding to the probability of non-infectious acute respiratory distress syndrome, although the underlying pathophysiology is not identical. Radiological pneumonitis and lung fibrosis are expected to be more common but require a more precise documentation by the transplantation team, radiologists and radiation oncologists.

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“…Thoracic radiotherapy plays a role in enhancing the occurrence of AEs in IPF, even when baseline symptoms are trivial. Pre-existing IPF is a well-known risk factor for pulmonary toxicity after ionising irradiation (240); previous reports have shown that it can raise the risk of severe and even life-threatening pneumonitis, whose rates in such patients range between 6.3% and 18.2%, in relation to different radiotherapy techniques (241). Nevertheless, IPF does not constitute an absolute contraindication for thoracic radiotherapy, even if European Organisation for Research and Treatment of Cancer (EORTC) guidelines suggest avoiding irradiating lung cancer patients with IPF (242).…”

Section: Radiotherapy In Lung Cancer With Ipfmentioning

confidence: 99%

The oncogenic landscape of the idiopathic pulmonary fibrosis: a narrative review

Stella¹,

D’Agnano²,

Piloni³

et al. 2022

Transl Lung Cancer Res

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Background and Objective: Translational research is a source of continuous innovation in medicine, more particularly for clinical research on new treatment modalities in idiopathic pulmonary fibrosis (IPF) patients.However, the heterogeneity of the disease is well recognized, and different pathological and molecular settings have been identified. The molecular mechanisms by which IPF proceeds in time and space remains poorly understood. Although some IPF features are reminiscent of cancer, the dynamics of malignant divergent clonal selective pressure and heterogeneity clearly differ from those occurring in IPF. This is reflected in the absence of patient proper selection and stratification to biological agents (pirfenidone, nintedanib) which limit therapeutic efficacy. Consequently, increased costs are related to the clinical management of advanced IPF patients. Steady collaboration and fluid communication between pneumo-oncologists, radiologists and molecular biologists is a clear priority for the correct interpretation of tests and the definition of effective personalized strategies against this orphan disease. The present work aims at providing the most relevant hints shared by cancer and IPF.Methods: A systematic literature review was performed to identify all relevant data. The examined databases were Scopus, Web of Science, Cochrane, Google Scholar, and PubMed. The last search was run on January 5, 2022. We have primarily conducted separated research for lung cancer, IPF, genetics, epigenetics, surgery in IPF and cancer.

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Idiopathic pulmonary fibrosis: Current knowledge, future perspectives and its importance in radiation oncology

Cited by 23 publications

References 88 publications

Inflammation, Fibrosis and Cancer: Mechanisms, Therapeutic Options and Challenges

Inflammation, Fibrosis and Cancer: Mechanisms, Therapeutic Options and Challenges

Pulmonary Toxicity after Total Body Irradiation—An Underrated Complication? Estimation of Risk via Normal Tissue Complication Probability Calculations and Correlation with Clinical Data

The oncogenic landscape of the idiopathic pulmonary fibrosis: a narrative review

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