Henrik Landgren

• Moving beyond broad disease labels to a molecular understanding of ILD, exploring how multi-omic and biomarker-driven approaches are beginning to define patient subtypes based on underlying biology rather than clinical classification alone
• Advancing strategies to identify patients at risk of progression, including how circulating biomarkers, imaging, and molecular signatures can be integrated to predict disease trajectory and enable earlier, more confident intervention
• Interrogating the “lumping vs splitting” debate in ILD and PPF, and what a precision medicine framework means for patient stratification, clinical trial design, and the future development of targeted therapies

Drug development in interstitial lung diseases has traditionally focused on individual conditions such as IPF or connective tissue disease–associated ILD. However, increasing evidence suggests that many ILDs converge on shared fibrotic pathways. As PPF has emerged as a cross-disease construct to enable trial design, this raises a critical question: are we building therapies for diseases, or for fibrosis itself?

Key Discussion Points:

• What is best disease vs phenotype-driven development? Should therapies be developed for individual ILDs, or for fibrotic progression across diseases through constructs like PPF?
• How indication strategy influence trial design from patient stratification, endpoint selection, and the likelihood of detecting meaningful treatment effects
• Navigating the regulatory and commercial realities of broader indications vs disease-specific labels for approval, positioning, and reimbursement
• As shared fibrotic biology becomes clearer, should drug development move toward mechanism-based approaches rather than traditional disease categories?