5 advances in lung cancer treatment

As efforts to increase awareness around the importance of lung cancer screening have gained traction and more people at higher risk of developing the disease are getting screened, more lung cancers are now being diagnosed at an earlier stage.

This represents real progress in the fight against lung cancer, as early diagnosis typically leads to more successful treatment and better long-term outcomes for patients, explained Endeavor Health thoracic surgeon Seth Krantz, MD, a longtime advocate for this vital screening.

Advances in lung cancer treatment are also offering better outcomes for patients. Dr. Kranz highlights these advances:

1. Minimally invasive, lung-sparing procedure

   Traditional treatment for stage I lung cancer (which is a small cancer confined entirely to the lung) used to be surgical removal of the whole lobe, but studies in the last two years have shown that for very small cancers on the edges of the lung, lesser lung removal known as “sublobar resection” provides equal or even slightly better long-term survival.

   “We’ve learned there’s no benefit to the whole lobe removal for these patients and most people are able to go home the next day after a minimally invasive, lung-sparing procedure,” said Dr. Krantz. “They have a much easier, quicker recovery as well.”

2. Newer immunotherapy

   There are also major advances for patients with more advanced stage II or stage III cancers (these are patients whose tumors are bigger than 4 cm or that have spread to the lymph nodes), said Dr. Krantz.

   While traditional treatment for these patients was chemotherapy and radiation or chemotherapy and surgery, newer immunotherapy drugs are now providing much better outcomes. Chemotherapy combined with immunotherapy drugs designed to harness the body’s own immune system to fight cancer is delivering remarkable improvement and much higher cure rates, explained Dr. Krantz.

3. Combination therapy

   Research is ongoing to determine the best methods of treatment for combination therapies involving immunotherapy, chemotherapy and surgery. Currently, chemotherapy and immunotherapy are given before surgery for stage II and stage III patients, and studies are underway to see if these patients would benefit from receiving immunotherapy again after surgery.

   “As we continue to pursue more combination therapy and figure out the best order, we are achieving better outcomes for patients,” said Dr. Krantz.

4. Genomic mutations and targeted therapy

   Progress is also underway with targeted therapies for cancers with specific genomic mutations. Tumor biopsies are examined with next-generation sequencing to discover biomarkers — specific mutations — that respond to tailored therapeutic medications. The EGFR (epidermal growth factor receptor) and the ALK (anaplastic lymphoma kinase) mutations are the two main mutations now responding to new drugs.

   The new medications have led to major improvements in survival, and are now given after surgery for patients with those mutations. Trials are also underway to further refine the treatment and to evaluate giving treatment before surgery as well.

   “These drugs are getting better and better, and we’re seeing huge decreases in the numbers for overall lung cancer mortality,” said Dr. Krantz. Even patients with late-stage cancer are seeing major improvements with many having very good long-term survival.

5. Clinical trials

   Endeavor Health is part of a clinical trial looking at novel therapies for stage I patients at higher risk of recurrence. We’re also running trials to understand genetic risk for developing cancer and for recurrence, said Dr. Krantz.

“There are even more treatment advances on the horizon and screening is finally taking off. It’s a very exciting time in the field,” said Dr. Krantz.