Implications of a novel immune-related signature in COPD-associated non-small cell lung cancer

Lung cancer is the commonest fatal malignancy worldwide in both men and women, accounting for >1.3 million deaths each year. The mean time from diagnosis to death is 18 months, new paradigms are urgently needed for treatment and early diagnosis. In cigarette smokers, airways obstruction is a greater risk factor for lung cancer than age or smoking history, and the risk for lung cancer increased in proportion to the degree of airways obstruction.1 In a general population, impaired lung function and chronic mucus hypersecretion were significant predictors of death from lung cancer, even after adjusting for smoking.2 In patients with COPD, active inflammation evidenced by elevated levels of C reactive protein, fibrinogen and leucocytes is associated with a fourfold risk of lung cancer. Interestingly, all three major phenotypes of COPD—chronic bronchitis, airway obstruction and emphysema—have been associated with an increased incidence of lung cancer, while this requires further investigation, it suggests that there may be specific inflammatory phenotypes driving the induction of lung cancer.

The work by Wauters and colleagues starts to address this hypothesis, providing further evidence for the link between COPD and lung cancer and novel insights into how lung tumours of …