Five Areas of Exciting New Lung Cancer Research
October 14, 2020
October is Healthy Lung Month, and it is a time for awareness and reflection on the many ways we can protect our lung health and how science is working to prevent and treat lung disease.
Almost 10 million people are diagnosed with chronic bronchitis each year, and about 25 million people live with asthma.
Some occupations face significant lung disease risks, such as mesothelioma, asbestosis and lung cancer caused by exposure to asbestos and other carcinogens.
Lung cancer is the deadliest cancer and makes up approximately 25% of all cancer deaths. Every year, there are more lung cancer deaths than breast, colon and prostate cancers combined.
However, thanks to ongoing research efforts, new lung cancer cases are declining, and the number of deaths has decreased thanks to early detection and advanced treatment options.
Discoveries in lung cancer research are leading scientists closer to a cure, and every step forward also aids efforts towards treatments for other lung diseases.
These five areas of study may hold the key to a future where lung cancer is easily treatable and claims far fewer lives.
Immunotherapies for mesothelioma and lung cancer share many of the same characteristics.
Immunotherapy medications stimulate the immune system to respond against cancerous tumors, similar to how the body fights infection.
Using the body’s immune response, this lung cancer and mesothelioma treatment attacks cancer without damaging healthy cells. In recent years, researchers have developed new immunotherapy medications that prevent cancer cells from hiding or disabling the immune system.
The FDA approved two new immunotherapy medications in 2015 to treat non-small cell lung cancer. These drugs are nivolumab (Opdivo) and pembrolizumab (Keytruda), and doctors have been prescribing them as a second-line treatment for patients who have progressed on standard chemotherapy.
In October 2020, Opdivo and Yervoy became available as a first-line treatment for patients with malignant mesothelioma who do not qualify for surgery. This drug combination is the second systemic therapy ever approved for mesothelioma by the FDA and the first new drug regimen in 16 years.
Immunotherapy is an incredibly exciting research area because patients are experiencing fewer side effects than chemotherapy, and the treatment is a crucial part of many multimodal therapy plans.
Researchers are continuing to work on new combinations and approaches to immunotherapy that will work with radiation therapy, surgery and other methods. Eventually, immunotherapy regimens could help cure more people with early-stage disease.
Unfortunately, more than 60% of lung cancer patients do not receive a diagnosis until their disease has reached an advanced stage, and a cure is less likely. Historically, early lung cancer detection has been challenging, and survival advantages were not always clear.
Biomarkers are molecular changes in tumor DNA that can help physicians diagnose lung cancer earlier or inform treatment decisions. Many clinicians now report that an earlier diagnosis of lung cancer leads to improved survival rates.
In 2018, researchers discovered that high levels of a biomarker called cytoskeleton-associated protein 4 (CKAP4) were present in the blood of patients with lung cancer. Doctors can look for these biomarkers in healthy individuals to catch lung cancer earlier, when tumors may not yet show on X-ray or MRI imaging.
Lung cancer research and biomarkers have guided medicine towards a precision-driven approach that customizes treatment to each individual. Comprehensive biomarker testing uses diagnostic exams that analyze a patient’s tumor cells from a biopsy sample and identify specific markers on the cancer cells’ surface.
Knowing a patient’s specific biomarker status allows their physician to develop an effective treatment plan catered to the patient’s exact lung cancer type. For example, patients with an ALK mutation in their tumor cells would receive medication specifically targeting that type of cancer.
More than 25% of patients with an adenocarcinoma type of non-small cell lung cancer have a biomarker that corresponds to an FDA-approved targeted therapy drug. As researchers continue to identify new biomarker targets, early detection and targeted treatment could significantly advance lung cancer prevention and therapy.
Many advanced robotic surgery methods have emerged as safer and more effective alternatives to traditional surgical procedures within the last decade. Robotic technology has become smaller and more efficient, allowing surgeons to perform more complex operations with fewer and smaller incisions.
Lung cancer and mesothelioma surgery benefit from these advances in significant ways. Patients have experienced shorter hospital stays, fewer complications and lower costs. Many physicians also report their patients have had faster healing times and return to their everyday routines much quicker than after conventional surgery.
Currently, the FDA has only approved the da Vinci Robotic System for thoracic surgery. This system utilizes three surgical arms, a central guiding arm, two three-dimensional cameras and a master console where the surgeon operates the machine.
Many surgeons have transitioned to robotic systems as a more advanced form of video-assisted thoracoscopic surgery (VATS). However, robotic surgical procedures are still relatively new and have substantial untapped potential.
Robotic technology can potentially help the 50% to 70% of thoracic surgeons who do not perform VATS lobectomies. With further research, there is an opportunity for this technology to give the majority of lung cancer patients the option of a less invasive operation.
Mesothelioma radiation therapy has become a widely accepted standard, thanks in part to decades of lung cancer research. Identifying advances in radiation technology for current lung cancer patients can help predict the direction of possible future treatments for mesothelioma patients and others with thoracic diseases.
Radiation therapy has evolved into a safer and more effective treatment as research has identified new ways of delivering smaller doses more accurately. A crucial part of this development is the adaption of volumetric imaging.
Three-dimensional conformal radiation therapy (3DCRT) and volumetric-modulated arc therapy (VMAT) allow physicians substantial control over target doses and which parts of the body receive radiation.
Newer methods include stereotactic body radiation therapy (SBRT) and pencil-beam scanning (PBS). SBRT has expanded treatment options for early-stage patients who are not candidates for surgery. PBS is a proton therapy that uses different particles than conventional radiation, preventing exposure to healthy tissue.
Technology continues to advance the radiation options available for lung cancer patients, and the future of research within this field is promising. Thanks to these emerging technologies, radiation treatment is becoming an integral part of multimodal therapy for lung cancer and mesothelioma patients.
Artificial intelligence (AI) has impacted almost all technology fields, and machine learning might be the future of medical diagnosis standards. Cancer imaging AI is now advanced enough to detect early-stage lung, breast, pancreatic and colorectal cancer.
Advanced computer programs can recognize tumors automatically from imaging scans and alert radiologists to possible disease areas.
Some types of cancer, such as mesothelioma, can be challenging to identify in their early stages. AI technology differentiates between healthy and cancerous tissue with incredible speed and accuracy.
Machine learning trains AI programs to complete repetitive and often time-consuming tasks, allowing physicians more time to develop personalized treatment plans. AI has exceptional attention to detail and can notice differences in textures that are virtually invisible to the human eye.
Research in machine learning helps scientists create programs that perform rigorous searches through medical records, finding details that others may have missed.
Machine learning algorithms can scan every patient’s imaging records for cancer, catching an early-stage disease in patients who otherwise wouldn’t have undergone a cancer screening.
Machine learning and artificial intelligence represent much of what lung cancer and mesothelioma patients can expect from future research advances. Improved technology streamlines workflows and improves patient outcomes.
Early detection, safer treatments and computer science advances are all benefits of continuing research efforts that will one day hopefully lead to a cure for lung cancer, mesothelioma and many other thoracic malignancies.