Bridging IPF and Lung Cancer Care: Laura Fabbri, MD

Exploring the tensions between patient management and care pathways for those with idiopathic pulmonary fibrosis (IPF) and lung cancer was the focus of “Management of Patients With Idiopathic Pulmonary Fibrosis and Lung Cancer," a session at the European Respiratory Society (ERS) 2026 International Congress in Barcelona, Spain.

In an interview with The American Journal of Managed Care^® (AJMC^®), Laura Fabbri, MD, from Imperial College London, and the session’s moderator discussed why the tension between early intervention and diagnostic certainty differs for interstitial lung abnormalities vs confirmed IPF and lung cancer.

Her role in translating research from 2 historically separate fields, IPF and oncology, into actionable guidelines allows her to explain the main obstacle to standardizing screening across centers and why she believes patient and caregiver experiences deserve a bigger seat at the table in clinical trial design.

This transcript was lightly edited for clarity.

AJMC: Your POSTPF [Perspectives on Screening and Treatment in Pulmonary Fibrosis] research explored how health care professionals think about interstitial lung abnormalities and whether early treatment is warranted before a clear PF diagnosis. Does that same tension—treating early vs waiting for certainty—show up in how clinicians approach patients with coexisting IPF and lung cancer?

Fabbri: This is a slightly different concept, because when we talk about interstitial lung abnormalities, this is not a disease; it's just radiological findings. Actually, it's a broad topic, but there is much more specific research on IPF and lung cancer. I would say, here, we still need to have a broader evaluation because these patients are more complicated, and sometimes the risk of a treatment may outweigh the benefit of it.

AJMC: As moderator for a session bridging 2 research communities—IPF and oncology—that don't always overlap, what do you see as your role in making sure this conversation translates into something actionable rather than just raising awareness?

Fabbri: We need to make sure that when we produce something such as guidelines, [we] ensure these things can be applied in clinical practice. That's why, in the guidelines process, there are many steps where you are also evaluating the acceptability or the feasibility.

Our role is to translate all the data that we elaborate and find into practical guidelines that can be applied in every clinical setting, not only specifically to tertiary centers, for example. This is the part we want to really emphasize. We’re not just producing documents for the sake of producing documents. We create documents, and potentially we give indications and suggestions, or we do mandate treatment, with the idea that this can be applied in almost every clinical setting.

AJMC: The session mentioned standardizing preventive strategies that could affect survival and quality of life. From your experience researching screening acceptability, what tends to be the biggest obstacle to standardizing an approach across centers? Lack of evidence, lack of consensus, or resistance from clinicians and patients themselves?

Fabbri: The lack of data; meaning that a screening program is considered acceptable only if you also have an action plan. If you find something, because screening a population just for the sake of finding something when there is no action plan, the risk is to cause more harm than benefit. Because that is when you need to consider all the consequences that may happen. Perhaps it’s something psychological, even from an insurance perspective or from a work perspective. You really risk opening a can of worms, if I may say, that you don't want to.

The aim of a screening program should be this idea that you can act early on something. When the trajectory of those diseases can still be acted on, then it can potentially be modified into a better outcome.

AJMC: You've spent your career so far focused on the patient- and clinician-experience side of interstitial lung disease care rather than pharmacological treatment. Do you think this session accomplished what a purely clinical or trial-data-focused session may not have?

Fabbri: It’s the fact that we need to consider the patient’s wishes more. I would say patients, but all stakeholders, because in this concept we also believe in the caretakers, the relatives of those people. Sometimes we focus on the disease, and we treat that person. We call them patients and actually don't even consider that person. But we should bring them into the discussion, because even if you want to be selfish and think about the money that you spent on this treatment, the resources that we spent on that, we should use those resources only if we are giving a benefit rather than taking those resources from the person.
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For example, with this treatment, if the person doesn't really benefit or is still experiencing the adverse effects or consequences, like psychological stress, I think that we should reconsider another treatment. It's really important to bring patients in from the beginning of the discussion when you're still studying the disease, or you're still designing the clinical trial. Patients must be part of the design, either as part of the steering committee or the executive committee, when you set up the outcomes or set up what the targets are and what the aims are, because what we think they may want doesn't always match what the stakeholders actually want from us.