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Drugs. 2018 Nov;78(16):1717-1740. doi: 10.1007/s40265-018-1001-8.

Chronic Obstructive Pulmonary Disease and Lung Cancer: Underlying Pathophysiology and New Therapeutic Modalities.

Author information

1
Respiratory Translational Research Group, Department of Laboratory Medicine, School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag-1322, Newnham Drive, Launceston, TAS, 7248, Australia.
2
School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia.
3
Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, Newcastle and Centenary Institute and University of Technology Sydney, Lot 1 Kookaburra Circuit, New Lambton Heights, Sydney, NSW, Australia.
4
Lung Biology, Department of Experimental Medical Science, Lund University, Lund, Sweden.
5
Center for Theoretical Biological Physics, Rice University, Houston, TX, USA.
6
Centre for BioSystems Science and Engineering, Indian Institute of Science, Bangalore, 560012, India.
7
Discipline of Medical Sciences, School of Life Sciences, University of Technology Sydney, Sydney, NSW, Australia.
8
Woolcock Emphysema Centre, Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia.
9
Department of Respiratory Medicine, Launceston General Hospital, Launceston, TAS, Australia.
10
Department of Cardiothoracic Surgery, Royal Hobart Hospital, Hobart, TAS, Australia.
11
Department of Respiratory Medicine, Tasmanian Health Services (THS), North West Hospital, Burnie, TAS, Australia.
12
School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
13
Institute for Respiratory Health, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
14
Department of Allergy, Immunology and Respiratory Medicine, Alfred Health, Melbourne, VIC, Australia.
15
Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, VIC, Australia.
16
Institute for Breathing and Sleep, Heidelberg, VIC, Australia.
17
School of Medicine, University of Melbourne, Melbourne, VIC, Australia.
18
Respiratory Translational Research Group, Department of Laboratory Medicine, School of Health Sciences, College of Health and Medicine, University of Tasmania, Locked Bag-1322, Newnham Drive, Launceston, TAS, 7248, Australia. sssohal@utas.edu.au.

Abstract

Chronic obstructive pulmonary disease (COPD) and lung cancer are major lung diseases affecting millions worldwide. Both diseases have links to cigarette smoking and exert a considerable societal burden. People suffering from COPD are at higher risk of developing lung cancer than those without, and are more susceptible to poor outcomes after diagnosis and treatment. Lung cancer and COPD are closely associated, possibly sharing common traits such as an underlying genetic predisposition, epithelial and endothelial cell plasticity, dysfunctional inflammatory mechanisms including the deposition of excessive extracellular matrix, angiogenesis, susceptibility to DNA damage and cellular mutagenesis. In fact, COPD could be the driving factor for lung cancer, providing a conducive environment that propagates its evolution. In the early stages of smoking, body defences provide a combative immune/oxidative response and DNA repair mechanisms are likely to subdue these changes to a certain extent; however, in patients with COPD with lung cancer the consequences could be devastating, potentially contributing to slower postoperative recovery after lung resection and increased resistance to radiotherapy and chemotherapy. Vital to the development of new-targeted therapies is an in-depth understanding of various molecular mechanisms that are associated with both pathologies. In this comprehensive review, we provide a detailed overview of possible underlying factors that link COPD and lung cancer, and current therapeutic advances from both human and preclinical animal models that can effectively mitigate this unholy relationship.

PMID:
30392114
DOI:
10.1007/s40265-018-1001-8
[Indexed for MEDLINE]

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