A LARGE-scale study suggests that pirfenidone use in patients with idiopathic pulmonary fibrosis (IPF) may be linked to a lower incidence of lung cancer, a frequent complication of the disease.
Researchers analysed data from 9,938 patients with IPF extracted from the Korean national claims database, using propensity score analysis with inverse probability of treatment weighting (IPTW) to adjust for confounding factors. Lung cancer incidence was compared between patients receiving pirfenidone and those who did not. Landmark analyses were conducted at 6 months post-diagnosis, and Cox regression models were employed to evaluate independent associations. A separate single-centre cohort of 941 patients served as validation.
During a median follow-up of 3 years, lung cancer developed in 7.7% of patients with IPF (21.9 cases per 1000 person-years). After IPTW adjustment, the pirfenidone group exhibited a significantly lower incidence of lung cancer (10.4 vs. 27.9 cases per 1,000 person-years) compared to the no pirfenidone group. Landmark analysis confirmed this trend, and Cox regression analysis revealed that pirfenidone use was independently associated with reduced lung cancer risk (weighted adjusted hazard ratio [HR]: 0.347, 95% CI: 0.258–0.466). Findings were consistent in the clinical validation cohort (weighted adjusted HR: 0.716, 95% CI: 0.517–0.991) and across age and sex subgroups.
These results suggest that pirfenidone may have a protective effect against lung cancer in patients with IPF, warranting further research to explore the underlying mechanisms and clinical implications.
Ada Enesco, EMJ
Reference
Yoon HY et al. Pirfenidone and risk of lung cancer development in idiopathic pulmonary fibrosis: a nationwide population-based study. Eur Respir J. 2025;65(2):2401484.
