Reply: Ventilation and tumour spread: Still a pending matter.

We thank Liu Zhang and co-workers for their interest in our manuscript on the role of mechanical ventilation as an activator of lung tumour cells and promoter of distant metastases [1]. Our study spans from cell cultures to animal models and clinical data to illustrate the impact of mechanical stimulation on cancer cells, trying to put it in a clinical context and pointing to novel therapeutic strategies. Mechanical ventilation in presence of a lung neoplasm highlights the relevance of mechanotransduction in cancer cells and opens novel therapeutic approaches