Biomarkers in IPF
Vincent Cottin and Luca Richeldi discuss biomarkers in IPF
LR: Of course, biomarkers are a specific tool which is absolutely needed if you want to identify a specific category of patients to address. So, I do know what is your take of biomarkers. I am a strong believer in biomarkers. I'm not a strong expert, maybe you are more expert than me, or probably you are more expert than me, so I would be curious to know, what do you think of biomarkers in IPF?
VC: Well, you're exactly right. I think it's the direct link between the precision medicine and the biomarkers because there will be no precision medicine without a good biomarker and biomarkers needs to be considered as the whole picture. That is, it's not necessarily something that you measure in the blood, it can be, of course, but it can be something broader. And a good biomarker will allow you to select patients for the right treatment. And of course, that has implications for clinical trials, because you also want the right patient into the right treatment trial, so you can demonstrate the efficacy of the trial. And currently, there is a very active research in biomarkers. Not all that is public, of course, but some has been published or presented, and there are some biomarkers that really are very promising.
First of them is metalloprotease 7, which predicts mortality in patients with IPF and consistently is increased in the blood of patients with any kinds of interstitial lung disease. And possibly you can combine several biomarkers such as MMP 7, KL-6, SPD-1 et cetera.
There is also a very active research on biomarkers that you can identify in peripheral blood monocyte cells. So, you take some blood, isolate the PBMC and then do some very sophisticated measures to combine, for example microarrays, and you get a signal that can identify patients who would maybe respond more to any given treatment.
And there are also biomarkers from the bronchoalveolar lavage, but personally I tend to feel they are less promising, because we perform less and less BALs.