Medicine is constantly changing and improving protocols to offer the latest advances to patients and improve their quality of life. Research is always being made to obtain new strategies and drugs that contribute to curing the disease without causing so many side effects. The field of cancer is of particular interest, and every year there are new advances in detection and treatment.
In this article, we’re briefly going through the most significant advances and current research to improve lung cancer detection and treatment.
Advances In Lung Cancer Detection
Early detection of lung cancer is a topic of great concern because we know that treating cancer from an early stage is associated with higher levels of treatment success. New trials have found novel ways to detect lung cancer and possibly screen high-risk patients more appropriately using these strategies:
- CT screening: According to research, CT scans can be beneficial to screen lung cancer in patients who were previously heavy smokers or are still smoking heavily. According to the National Lung Screening Trial, using low-dose CT screening can detect cancer and reduce the proportion of patients who die from lung cancer. However, more work is still necessary to elucidate which CT screening methods are better to predict lung cancer in this high-risk population.
- Screening markers in the sputum and blood: Tumor markers are handy to detect cancer, but not many of them are available for lung cancer. More recently, scientists have been studying screening markers in the sputum and the blood to detect small tumors as they grow. In the sputum, abnormal cells with a peculiar morphology are useful to identify high-risk patients who need close follow-up. In the blood, molecular markers could help diagnose lung cancer earlier, but they are still under active research.
- Computerized prediction: In the field of computer programs, researchers are also developing algorithms to predict the outcomes of lung cancer and identify the disease in CT scans. They are artificial intelligence studies that contribute to radiologists detecting lung cancer more accurately. One of these trials had 97% accuracy and caught certain morphologic features specific to a given genetic mutation.
Advances In Lung Cancer Treatment
We all know the most common treatments for lung cancer, including surgical removal of the tumor, chemotherapy, and radiotherapy. Other treatment options include immunotherapy and targeted therapy, which are currently under study to develop better results for patients with advanced disease.
- Immunotherapy: In the field of immunotherapy, there is an auspicious type of drug being developed known as an immune checkpoint inhibitor. What they do is blocking proteins in the immune cell that silence the expression of cellular immunity. In other words, it takes out a command in the immune system to attack. Thus, it facilitates the immune response against cancer. Immune checkpoint inhibitors are currently approved to treat lung cancer and can be used in immunotherapy to strengthen therapy response in resistant cancers. The proteins inhibited by these drugs are known as PD-1 and PD-L1. So, any tumor that displays these proteins is potentially susceptible to immune checkpoint inhibitors.
- Targeted therapy: As the name implies, targeted therapy is an alternative to chemotherapy that runs in the veins and attacks cancer but does not harm our healthy tissues. Many targeted therapies are available for lung cancer. Still, not every patient will be responsive to them, and a previous evaluation should be made to determine if patients can receive this type of therapy. In recent years, four new targeted therapies have been made available:
- ALK inhibitors: Also known as Anaplastic Lymphoma Kinase inhibitors, they help patients with an alteration in a gene known as ALK. There are new treatments approved for patients with this type of alteration, and more recent ALK inhibitors are better than previous generations because they can cross the blood-brain barrier and attack lung cancer cells that migrated into the brain.
- EGFR inhibitors: Also known as Epidermal Growth Factor Receptor inhibitors, what they do is detecting cells with too many EGF receptors and blocking them. EGF receptors in cancer cells contribute to accelerated growth when activated, and more receptors mean more activation and more accelerated growth. What EGFR inhibitors do is blocking these receptors and slowing down tumor growth.
- ROS1 inhibitors: Similar to ALK inhibitors, this type detects a protein called ROS1, which is created by the gene of the same name. This protein stimulates cell growth in lung cancer. Thus, by blocking ROS1 in patients with an alteration in this gene, we can potentially slow down cancer growth.
- BRAF inhibitors: On a similar page, BRAF inhibitors detect the presence of the BRAF gene by inhibiting its protein, known as B-Raf. This protein usually contributes to cell growth in patients with non-small cell lung cancer. So, in a patient with a mutation in this gene, BRAF inhibitors can work by slowing down the accelerated growth in non-small cell lung cancer.
What Is Now Under Research?
Current research about lung cancer is varied because there are still many things we do not know about this disease. Some researchers focus their efforts on exploring the biological causes and triggers of lung cancer, including social factors that influence the incidence and severity of the disease.
Other studies have an immediate clinical application to improve the outcome of therapy. One of these studies is known as ALCHEMIST, and it is about non-small cell lung cancer and targeted therapy. The goal is to implement targeted therapy after surgery to see which patients respond with a better outcome and what type of tumor or genetic markers are seen in these patients.
Another initiative currently ongoing is the Small Cell Lung Cancer Consortium, a research group created to reunite lung cell cancer investigators in their preclinical and clinical studies, exchange information about the disease, and obtain feedback and innovations that contribute to joint efforts to improve lung cancer treatment outcomes.
Jones, G. S., & Baldwin, D. R. (2018). Recent advances in the management of lung cancer. Clinical Medicine, 18(Suppl 2), s41.
Sands, J., Mandrekar, S. J., Oxnard, G. R., Kozono, D. E., Hillman, S. L., Dahlberg, S. E., … & Stinchcombe, T. (2020). ALCHEMIST: Adjuvant targeted therapy or immunotherapy for high-risk resected NSCLC.
National Cancer Institute (2021) Advances in Lung Cancer Research. Available at: https://www.cancer.gov/types/lung/research