Prognostic value of serial serum KL-6 measurements in patients with idiopathic pulmonary fibrosis

The serum KL‐6 levels in untreated idiopathic pulmonary fibrosis can naturally decline in association with disease progression

“…It is notable that the 66 subjects in their study population included 21 patients with a serial decrease in their KL‐6 levels and 16 patients whose KL‐6 levels were unchanged. In their study, the patients with decreased and unchanged KL‐6 levels were combined to form a non‐increased KL‐6 group because the initial FVC and KL‐6 levels of the two groups did not differ to a significant extent; there was no significant difference in the survival of the increased KL‐6 group and non‐increased KL‐6 group . This may indicate the existence of patients whose KL‐6 levels decline despite showing a clinical deterioration.…”

“…The results of the present study, which showed that the serum KL‐6 levels can increase and decrease in untreated patients with IPF, have proved this correct. Although some IPF patients, especially non‐survivors, showed a natural decline in their serum KL‐6 levels, a decline in the KL‐6 levels during the untreated period is not necessarily a predictor of a poor prognosis because it may also be true that IPF patients with a serial increase in their KL‐6 levels show a steeper decline in their FVC levels and have a tendency toward a poor prognosis . The prognosis of rapid FVC decliners is usually poor; however, there was a gap in the rate of change of KL‐6 between non‐survivors and rapid FVC decliners (Table ).…”

“…The results of the present study are consistent with those of previous reports that the baseline KL-6 levels of the nonsurvivors were significantly higher in comparison to the survivors. 6,12 A recent study by Wakamatsu et al 13 reported on the prognostic value of serial serum KL-6 measurements in IPF. They have found that patients with a baseline KL-6 level of ≥1000 U/ml and with increased KL-6 levels during the observation period had a significantly steeper decline in FVC than those who showed no serial increase in KL-6 levels.…”

Fibrotic lung toxicity induced by cytotoxic drugs, radiation and immunotherapy in patients treated for lung cancer

“…In the last few years some studies have reported the utility of KL 6 for the evaluation of DILD. KL 6 is typically elevated in patients with idiopathic interstitial pneumonia and in certain cases of cancer, and may therefore be useful for evaluating disease activity and clinical outcome in patients with ILD-IPF: it could predict the likelihood of radiation pneumonitis or lung toxicity induced by chemotherapy [15][16][17][18][19][20]. Recently, a similar predictive role of Surfactant Protein D (SP-D) for onset of ILD induced by anticancer agents was compared with KL 6 in an interesting case control study [18].…”

“…Another article described the frequency of EGFR mutation, ALK and ROS1 rearrangement and PDL 1 expression in patients with fibrosis and lung cancer [19][20][21]. Although conducted on limited cohorts, these studies suggest the need for more detailed molecular characterization of every type of lung fibrosis associated with cancer in order to define potential therapeutic targets.…”