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D’Agnano V, Mariniello DF, Ruotolo M, Quarcio G, Moriello A, Conte S, Sorrentino A, Sanduzzi Zamparelli S, Bianco A, Perrotta F. Targeting Progression in Pulmonary Fibrosis: An Overview of Underlying Mechanisms, Molecular Biomarkers, and Therapeutic Intervention. Life (Basel) 2024; 14:229. [PMID: 38398739 PMCID: PMC10890660 DOI: 10.3390/life14020229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 01/22/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024] Open
Abstract
Interstitial lung diseases comprise a heterogenous range of diffuse lung disorders, potentially resulting in pulmonary fibrosis. While idiopathic pulmonary fibrosis has been recognized as the paradigm of a progressive fibrosing interstitial lung disease, other conditions with a progressive fibrosing phenotype characterized by a significant deterioration of the lung function may lead to a burden of significant symptoms, a reduced quality of life, and increased mortality, despite treatment. There is now evidence indicating that some common underlying biological mechanisms can be shared among different chronic fibrosing disorders; therefore, different biomarkers for disease-activity monitoring and prognostic assessment are under evaluation. Thus, understanding the common pathways that induce the progression of pulmonary fibrosis, comprehending the diversity of these diseases, and identifying new molecular markers and potential therapeutic targets remain highly crucial assignments. The purpose of this review is to examine the main pathological mechanisms regulating the progression of fibrosis in interstitial lung diseases and to provide an overview of potential biomarker and therapeutic options for patients with progressive pulmonary fibrosis.
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Affiliation(s)
- Vito D’Agnano
- Department of Translational Medical Sciences, University of Campania L. Vanvitelli, 80131 Naples, Italy; (V.D.); (D.F.M.); (M.R.); (G.Q.); (A.M.); (S.C.); (A.S.); (A.B.)
| | - Domenica Francesca Mariniello
- Department of Translational Medical Sciences, University of Campania L. Vanvitelli, 80131 Naples, Italy; (V.D.); (D.F.M.); (M.R.); (G.Q.); (A.M.); (S.C.); (A.S.); (A.B.)
| | - Michela Ruotolo
- Department of Translational Medical Sciences, University of Campania L. Vanvitelli, 80131 Naples, Italy; (V.D.); (D.F.M.); (M.R.); (G.Q.); (A.M.); (S.C.); (A.S.); (A.B.)
| | - Gianluca Quarcio
- Department of Translational Medical Sciences, University of Campania L. Vanvitelli, 80131 Naples, Italy; (V.D.); (D.F.M.); (M.R.); (G.Q.); (A.M.); (S.C.); (A.S.); (A.B.)
| | - Alessandro Moriello
- Department of Translational Medical Sciences, University of Campania L. Vanvitelli, 80131 Naples, Italy; (V.D.); (D.F.M.); (M.R.); (G.Q.); (A.M.); (S.C.); (A.S.); (A.B.)
| | - Stefano Conte
- Department of Translational Medical Sciences, University of Campania L. Vanvitelli, 80131 Naples, Italy; (V.D.); (D.F.M.); (M.R.); (G.Q.); (A.M.); (S.C.); (A.S.); (A.B.)
| | - Antonio Sorrentino
- Department of Translational Medical Sciences, University of Campania L. Vanvitelli, 80131 Naples, Italy; (V.D.); (D.F.M.); (M.R.); (G.Q.); (A.M.); (S.C.); (A.S.); (A.B.)
| | | | - Andrea Bianco
- Department of Translational Medical Sciences, University of Campania L. Vanvitelli, 80131 Naples, Italy; (V.D.); (D.F.M.); (M.R.); (G.Q.); (A.M.); (S.C.); (A.S.); (A.B.)
| | - Fabio Perrotta
- Department of Translational Medical Sciences, University of Campania L. Vanvitelli, 80131 Naples, Italy; (V.D.); (D.F.M.); (M.R.); (G.Q.); (A.M.); (S.C.); (A.S.); (A.B.)
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Medusa PM, Gilli M, Notizia L, Pagliaro R, Carro N, Moriello A, D'Agnano V, Bianco A, Perrotta F, Vitiello F. Complete response to pembrolizumab as a single agent in a patient with stage III NSCLC with high PD-L1 expression: a case report. Monaldi Arch Chest Dis 2022; 93. [PMID: 36426899 DOI: 10.4081/monaldi.2022.2440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022] Open
Abstract
Non-small cell lung cancer (NSCLC) accounts for 75-80% of all lung cancer cases. Stage III NSCLC represents a highly heterogenous stage characterized by different disease presentations and a wide range of treatment options. For patients with good performance status and unresectable-stage III NSCLC with programmed death-ligands 1 (PD-L1) tumor proportion score (TPS) ≥1%, durvalumab consolidation immunotherapy after a platinum-based chemo-radiotherapy is strongly recommended. However, age, poor performance status, underlying comorbidities may represent contraindications for chemotherapy to be used in a subgroup of patients. Herein, we report a case of an 80-year-old male affected by a stage IIIB lung adenocarcinoma with overexpression of PD-L1 (TPS 90%) treated with pembrolizumab, an immune checkpoint inhibitor targeting PD-1/PD-L1 pathways, which shows a complete resolution of lung lesion after four cycles of treatment. Although randomized controlled trials are required, this case report may suggest the potential role of pembrolizumab for chemotherapy unsuitable patients with overexpressing PD-L1 unresectable-stage III NSCLC.
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Affiliation(s)
- Paola Maria Medusa
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"; U.O.C. Clinica Pneumologica "L. Vanvitelli", Monaldi Hospital, A.O. Dei Colli, Naples.
| | - Marina Gilli
- Unit of Pulmonary Oncology, University of Campania "L. Vanvitelli", Monaldi Hospital, A.O. Dei Colli, Naples.
| | - Luca Notizia
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"; U.O.C. Clinica Pneumologica "L. Vanvitelli", Monaldi Hospital, A.O. Dei Colli, Naples.
| | - Raffaella Pagliaro
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"; U.O.C. Clinica Pneumologica "L. Vanvitelli", Monaldi Hospital, A.O. Dei Colli, Naples.
| | - Nicola Carro
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"; U.O.C. Clinica Pneumologica "L. Vanvitelli", Monaldi Hospital, A.O. Dei Colli, Naples.
| | - Alessandro Moriello
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"; U.O.C. Clinica Pneumologica "L. Vanvitelli", Monaldi Hospital, A.O. Dei Colli, Naples.
| | - Vito D'Agnano
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"; U.O.C. Clinica Pneumologica "L. Vanvitelli", Monaldi Hospital, A.O. Dei Colli, Naples.
| | - Andrea Bianco
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"; U.O.C. Clinica Pneumologica "L. Vanvitelli", Monaldi Hospital, A.O. Dei Colli, Naples.
| | - Fabio Perrotta
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli"; U.O.C. Clinica Pneumologica "L. Vanvitelli", Monaldi Hospital, A.O. Dei Colli, Naples.
| | - Fabiana Vitiello
- Unit of Pulmonary Oncology, University of Campania "L. Vanvitelli", Monaldi Hospital, A.O. Dei Colli, Naples.
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