Lung cancer ups all-cause mortality risk in patients with IPF

A diagnosis of lung cancer can significantly worsen survival in patients with idiopathic pulmonary fibrosis (IPF), reports a study.

This multicentre, retrospective study was carried out across seven countries in Europe between 1 January 2010 and 18 May 2021. The investigators included a total of 3,178 patients with IPF, of which 324 (10.2 percent) had lung cancer.

Among IPF patients who remained alive by the end of the 10-year period following IPF diagnosis, 26.6 percent had been diagnosed with lung cancer. IPF patients with lung cancer had a higher risk of all-cause mortality than those without lung cancer (hazard ratio [HR], 1.51, 95 percent confidence interval [CI], 1.22‒1.86; p<0.0001).

However, all-cause mortality was significantly lower among IPF patients with lung cancer who had a monocyte count of either <0.60 or 0.60‒<0.95 K/μl relative to those with monocyte count ≥0.95 K/μl (<0.60 vs ≥0.95 K/μl: HR, 0.35, 95 percent CI, 0.17–0.72; 0.60–<0.95 vs ≥0.95 K/μl: HR, 0.42, 95 percent CI, 0.21–0.82; p=0.003).

Additionally, patients with IPF and lung cancer who were treated with antifibrotics had reduced all-cause mortality relative to those who were not treated with antifibrotic therapy (HR, 0.61, 95 percent CI, 0.42‒0.87; p=0.006).

In the adjusted model, all-cause mortality was significantly reduced in surgically treated patients with IPF and otherwise technically operable lung cancer compared to nonsurgically treated counterparts (HR, 0.30, 95 percent CI, 0.11‒0.86; p=0.02).

“A consensus statement for the management of patients with IPF and lung cancer is sorely needed,” the investigators said.