Though lung cancer may not be the most common type worldwide, it nonetheless kills more men and women in the United States each year than any other type of cancer. Thankfully, the number of people dying from non-small cell lung cancer—the most common type of lung cancer—has sharply declined in recent years, according to a study published in the New England Journal of Medicine by Howlader et al. This is a result of both the decline in tobacco use (particularly among men) as well as the increased effectiveness of new lung cancer treatments.
At Zangmeister Cancer Center, we offer all the cutting-edge, Food & Drug Administration (FDA) approved treatments available, as well as investigational treatments being studied through the National Cancer Institute Community Oncology Research Program (NCORP).
The Benefits of Precision Medicine
Precision medicine is an approach for disease treatment and prevention that takes into account individual variability in the genes, environment and lifestyle for each person. It has significantly impacted how cancer care providers help patients with lung cancer. Currently, physicians select the best treatment based on an in-depth analysis of the patient’s tumor. This analysis allows for the search for genetic alterations that could be treated with therapies that target that specific alteration (targeted therapies) and helps sort out patients more likely to benefit from other treatments such as immunotherapy. These targeted therapies and immunotherapies have helped drive down lung cancer mortality rates at an accelerated rate over the last seven years.
Targeted therapies have a high success in controlling disease growth, with shrinkage of tumors that can be seen in roughly 80% of patients using this treatment. This is significant in comparison to a 30%-40% rate of response with chemotherapy treatments — and can add 10-12 months and in some case more than 20 months to a patient’s survival compared to chemotherapy.
Currently, immunotherapy, through drugs called immune checkpoint inhibitors, have firmly established a role in the treatment of advanced non-small cell lung cancer. In this type of treatment, medicines are used to help a person’s own immune system identify and attack cancer cells. One out of every four patients with advanced non-small cell lung cancer receiving these treatments are alive at five years. Since not every patient receiving these treatments obtains the same benefit, the scientific community is actively looking for different strategies to identify those that would benefit the most, as well as how to increase the number of patients that have good outcomes.
Newer Treatment Strategies Are on the Way
Both immunotherapy and targeted therapies are making inroads in the treatment of patients with locally advanced and early stages of lung cancer, which had previously been treated only with surgery or radiation and/or chemotherapy. The use of these therapies in early-stage lung cancer seems imminent in the near future.
While lung cancer CT screens have a significant impact in the reduction of lung cancer mortality rates, the strategy is underutilized due to a variety of reasons such as logistics and cost. Consequently, liquid biopsies are currently being tested as a potential strategy to overcome the limitations of low-dose lung CT screening.
Liquid biopsies could help doctors screen for cancer long before a patient has any symptoms and could also be administered after surgery to check for the presence of any residual cancer. Other screening strategies, such as the analysis of exhaled volatile organic compounds and quantification of lipids in the blood of patients, are currently being tested as well.
Brighter Future for Lung Cancer Patients
Prior to the development of targeted therapies and immunotherapy, a patient with advanced lung cancer had a less than 5% chance of being alive after two years. Currently, approximately one in four patients with advanced lung cancer can be alive at five years. Newer technologies such as liquid biopsies, artificial intelligence and “omics” approaches are exciting opportunities that could have the potential of further improving the outcomes in patients with lung cancer at all stages.