TY - JOUR T1 - The DIAMORFOSIS (DIAgnosis and Management Of lung canceR and FibrOSIS) survey. International survey and call for consensus JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00529-2020 SP - 00529-2020 AU - Argyris Tzouvelekis AU - Katerina Antoniou AU - Michael Kreuter AU - Matthew Evison AU - Torsten G Blum AU - Venerino Poletti AU - Bogdan Grigoriu AU - Carlo Vancheri AU - Paolo Spagnolo AU - Theodoros Karampitsakos AU - Francesco Bonella AU - Athol Wells AU - Ganesh Raghu AU - Maria Molina-Molina AU - Daniel Culver AU - Elisabeth Bendstrup AU - Nesrin Mogulkoc AU - Stefano Elia AU - Jacques Cadranel AU - Demosthenes Bouros Y1 - 2020/01/01 UR - http://openres.ersjournals.com/content/early/2020/10/01/23120541.00529-2020.abstract N2 - Background Currently there is major lack of agreement on the diagnostic and therapeutic management of patients with Idiopathic Pulmonary Fibrosis (IPF) and lung cancer (LC). Our aim was to identify variations in diagnostic and management strategies across different institutions and provide rationale for a consensus statement on this issue.Methods This was a joint-survey by ERS Assemblies 8, 11 and 12. The survey consisted of 25 questions.Results Four hundred ninety four (n=494) physicians from 68 different countries and 5 continents responded to the survey. 94% of participants were pulmonologists and 1.8% thoracic surgeons and 1.9% oncologists. 97.7% involved MDT approaches on diagnosis and management. Regular low-dose HRCT scan was used by 49.5% of the respondents to screen for LC in IPF. PET scan and EBUS bronchoscopy is performed by 60% and 88%, to diagnose nodular lesions with mediastinal lymphadenopathy in patients with advanced and mild IPF, respectively. 83% of respondents continue anti-fibrotics following LC diagnosis; safety precautions during surgical interventions including low-tidal volume are applied by 67%. Stereotactic radiotherapy is used to treat patients with advanced IPF (DLCO<35%) and otherwise operable NSCLC by 54% of respondents and doublet platinum regimens and immunotherapy for metastatic disease by 25% and 31.9%, respectively. Almost all participants (93%) replied that a consensus statement for the management of these patients is highly warranted.Conclusion The diagnosis and management of IPF-LC is heterogeneous with most respondents calling for a consensus statement.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: AT has received travel grants and consultation fees from Boehringer Ingelheim and Hoffmann La Roche, outside the submitted work.Conflict of interest: KA has received travel grants and consultation fees from Boehringer Ingelheim and Hoffmann La Roche.Conflict of interest: None to declareConflict of interest: None to declareConflict of interest: None to declareConflict of interest: None to declareConflict of interest: CV has received unrestricted grants, speaker and advisory board fees from Boehringer Ingelheim and F. Hoffmann-La Roche, Ltd.Conflict of interest: PS reports grants, personal fees, and non-financial support from Roche, PPM Services, and Boehringer-Ingelheim and reports personal fees from Red X Pharma, Galapagos, and Chiesi, outside of the submitted work.Conflict of interest: None to declareConflict of interest: FB has received travel grants and consultation fees from Boehringer Ingelheim, Hoffmann La Roche, Galapalagos, Savara, BMS.Conflict of interest: AW has received travel grants and consultation fees from Boehringer Ingelheim and Hoffmann La Roche.Conflict of interest: none to declareConflict of interest: MMM reports grants and payment for scientific advice for Roche, Boehringer Ing, Esteve-Teijin, Chiesi, Pfizer, GSK, Galapagos.Conflict of interest: none to declare.Conflict of interest: none to declare.Conflict of interest: none to declare.Conflict of interest: none to declare.Conflict of interest: JC reports grants from BI and personal fees for consultancy and experts boards from Roche and BI, outside the submitted work.Conflict of interest: DB reports grants, personal fees, non-financial support and other from BI Hellas and other from Roche, outside the submitted work. ER -