Idiopathic Pulmonary Fibrosis Time to get personal

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive and debilitating disease of unknown etiology. Median survival after diagnosis ranges from 3 to 5 years. The clinical course of the disease is highly heterogeneous and unpredictable. Despite this heterogeneity, the two novel compounds, pirfenidone and nintedanib, are administered uniformly to patients with IPF with little correlation to inter-individual differences. Personalized medicine refers to a medical model aiming to determine disease susceptibility, tailor the ideal treatment, predict and improve outcome according to individuals' molecular and environmental profile. The conceptualization of precision medicine dates back to the era of Hippocrates, the father of western medicine, who first coined out the term "idiosyncrasy" to describe the individuality in the clinical course of the disease. Compared to oncology, precision medicine approaches in IPF have significantly lagged behind. Disease management and prognostication is still based on functional and physiological parameters, which present with several caveats and provide no mechanistic insights. This short review article summarizes the current state of knowledge in the prognostic and therapeutic field of IPF, highlights the most recent findings and addresses the pressing need to integrate molecular biomarkers in the everyday clinical practice.