Lung cancer is the second most common kind of cancer.
It’s the number one cause of cancer deaths among both men and women, accounting for nearly one-quarter of all cancer deaths, according to the American Cancer Society. That’s more than colon, breast, and prostate cancers combined.
Researchers are always looking for ways to treat lung cancer. Their investigations have led to new lung cancer prevention and detection methods as well as treatments.
Here are some research highlights from the last few years.
We’ve known for a while that certain factors increase the risk of lung cancer.
Some of them aren’t possible to control, like your genes. Others are sometimes preventable, including:
- smoking tobacco
- exposure to radon and diesel exhaust
- HIV infection
Studies are trying to determine how genes interact with risks like these to increase the risk of lung cancer.
Researchers are also looking at the links between diet and nutritional supplements and cancer.
More research is needed to determine how these supplements affect lung cancer risk in these groups.
Finding lung cancer early is critical. According to the Lung Cancer Foundation of America, more than 80 percent of people receive their diagnosis at a late stage, when the cancer is harder to treat.
Many studies are focusing on ways to detect lung cancer sooner.
One way to find lung cancer early is with CT screening. The U.S. Preventive Services Task Force recommends low-dose CT scans for anyone ages 55 to 80 who has a history of heavy smoking. In this group, screening can reduce the risk of dying from lung cancer.
Now researchers are trying to figure out how to fine-tune CT screening to detect cancer more accurately and determine which other groups might benefit from screening.
Lung cancer treatment has become much more personalized in recent years. Researchers have discovered that DNA changes are unique to each person’s cancer.
Biomarkers are medical signs that can be measured in the body to predict the outcome of disease. Researchers have discovered more than 200 lung cancer biomarkers.
Biomarkers come in many forms, including genetic mutations and blood biomarkers. Some of the most common genetic mutations in lung cancer include:
- ALK (anaplastic lymphoma kinase)
- EGFR (epidermal growth factor receptor)
Doctors can now look for these and other lung cancer biomarkers with genetic testing by using a sample of your blood or lung tissue.
This can help them diagnose lung cancer earlier and recommend targeted treatments that work best against your particular genetic mutations.
Fluorescence and electromagnetic navigation bronchoscopy
Bronchoscopy is a test that uses a lighted scope to remove a sample of lung tissue for testing. There are two types:
- Fluorescence bronchoscopy. This adds a fluorescent light to help your doctor see the abnormal tissue more easily. The light makes cancer cells appear a different color than healthy tissue.
- Electromagnetic navigation bronchoscopy. This creates a virtual map that makes it easier to find cancer with the bronchoscope. A CT scan creates a 3-D image of your lung to help your doctor locate the suspicious area.
Four-dimensional computed tomography (4DCT)
This innovative new version of the CT scan takes pictures of your lungs from many angles to create a four-dimensional image.
It can help doctors more precisely identify where in the lungs the tumor is and whether the cancer has spread to other parts of the chest.
Computers can analyze CT scans and tissue samples much faster than doctors.
Researchers have already trained one computer program to read and analyze lung tissue samples. The program diagnosed two common types of lung cancer (adenocarcinomas and squamous cell cancers) with 97 percent accuracy.
Research has led to many new lung cancer treatments involving:
- targeted therapies
Surgery can cure some early stage cancers that haven’t spread outside the lungs. Surgeons now perform lung cancer procedures through smaller incisions. This may lead to fewer complications than open surgery.
One way to perform minimally invasive surgery more precisely is by using robotic arms. Whether robotic surgery has better outcomes than open surgery is still under investigation.
Video-assisted thoracic surgery (VATS) is another new technique that lets surgeons operate through smaller incisions. VATS may result in less pain and a shorter hospital stay compared with open surgery. It’s not yet clear whether it can treat larger tumors.
The typical chemotherapy regimen for lung cancer is four to six cycles of two or more drugs combined.
Today some people keep taking a chemotherapy or targeted drug after they finish all their cycles to keep their cancer under control. This is called maintenance therapy.
Radiation uses high-energy X-rays to kill cancer cells. It’s often used to shrink tumors before surgery or to get rid of any remaining cancer cells after surgery.
Because some types of lung cancer often spread to the brain, radiation is also used to prevent this.
The problem is that radiation can damage surrounding organs. Too much radiation can also damage the brain’s delicate structures.
Stereotactic ablative radiotherapy (SABR) is an alternative for people with early stage non-small cell lung carcinoma who can’t have surgery. SABR delivers a high-dose beam of radiation more precisely. This limits damage to surrounding tissue and the brain.
Studies are looking at whether SABR might be as effective as surgery for people with early stage lung cancer.
Targeted therapy is a more personalized approach to treating lung cancer than radiation or chemotherapy. Certain lung cancers have changes to certain genes that help them grow.
Targeted therapy blocks the activity of these genes to slow or stop the cancer.
A few drugs are already approved to treat people whose cancers have certain genetic mutations. These mutations include:
In 2020, the Food and Drug Administration (FDA) approved capmatinib (Tabrecta) for METex14 mutations. New treatments that target mutations including RET, HER2, and MEK are under investigation.
Immunotherapy boosts your body’s immune response to help it find and kill cancer cells. Immune checkpoint inhibitors for lung cancer have been around since 2015.
Checkpoints prevent your immune system from attacking your own healthy tissues. Cancer can hide behind these checkpoints to avoid detection.
Checkpoint inhibitors take the brakes off your immune system so that it can find and attack the cancer.
A few checkpoint inhibitors are already approved for lung cancer, including nivolumab (Opdivo) and pembrolizumab (Keytruda). These drugs block the protein PD-1 on the surface of some lung cancer cells that helps them hide from the immune system.
Studies are underway to find more new immunotherapies and figure out which people will respond best to them.
Researchers also want to learn whether giving checkpoint inhibitors plus radiation or chemotherapy might help people with lung cancer live longer.
Researchers use clinical trials to test new lung cancer treatments or combinations of existing treatments. The goal is to find therapies that work better than the current ones at improving survival.
More than 1,000 clinical trials for lung cancer are underway.
Ask your doctor about whether it might be a good idea for you to take part in one of these trials. Clinical trials may be an especially good option if you have a genetic mutation that existing targeted therapies can’t treat.
Lung cancer research is making many exciting advancements. The FDA approved twice as many new treatments in the last 2.5 years than it did in the whole decade before.
Many more new treatments are under investigation in clinical trials.
Immunotherapy and targeted treatments are safer and more effective than earlier lung cancer treatments. Thanks to these therapies, survival rates have improved.
As researchers introduce new tests and treatments, the outlook for people with lung cancer will likely improve even more.