What’s new in small cell lung cancer research?
Research on small cell lung cancer (SCLC) is going on now in many medical centers throughout the world.
Prevention offers the greatest promise at this time for fighting lung cancer.
Smoking still accounts for at least 8 out of 10 lung cancer deaths. This percentage is likely even higher for small cell lung cancers. Studies are going on to look at how best to help people quit smoking through counseling, nicotine replacement, and other medicines. Other studies are looking at ways to convince young people not to start smoking. Researchers are also looking at differences in genes that may make some people much more likely to get lung cancer if they smoke or are exposed to someone else’s smoke.
Researchers also continue to look into some of the other causes of lung cancer, such as exposure to radon and diesel exhaust. Finding new ways to limit these exposures could potentially save many more lives.
Diet, nutrition, and medicines
Researchers are looking for ways to use vitamins or medicines to prevent lung cancer in people at high risk, but so far these have not proved to help. Many researchers think that simply following the American Cancer Society nutrition recommendations (such as staying at a healthy weight and eating a diet rich in fruits and vegetables each day) may be the best approach.
Finding lung cancer
As mentioned in the section, “Can small cell lung cancer be found early?” a large study called the National Lung Screening Trial (NLST) recently found that low-dose CT scanning in people at high risk of lung cancer (due to smoking history) lowered the risk of death from lung cancer. This finding has led to the development of screening guidelines for lung cancer.
Another approach uses new ways to try to find cancer cells in sputum (spit) samples. Researchers have found some changes that often affect the DNA of lung cancer cells. New tests might be able to spot these changes and find lung cancer at an earlier stage.
Fluorescence bronchoscopy (also known as autofluorescence bronchoscopy) is a method that may help doctors find some lung cancers earlier, when they could be easier to treat. For this test, the doctor puts a bronchoscope through the mouth or nose and into the lungs. The end of the bronchoscope has a special light on it. The light causes abnormal areas in the airways to show up in a different color than healthy parts of the airway. Some cancer centers now use this to look for early lung cancers, especially when no tumors are seen with normal bronchoscopy.
An imaging test called virtual bronchoscopy uses CT scans to create detailed 3-D pictures of the airways in the lung. The images can be looked at as if the doctor were actually using a bronchoscope. There are benefits and drawbacks to this approach. But it may be a useful tool in some cases, such as in people who might be too sick to get a standard bronchoscopy. This test will likely be used more often as the technology improves.
Real-time tumor imaging
Researchers are looking to use new imaging techniques, such as four-dimensional computed tomography (4DCT), to help improve treatment. In this technique, the CT machine scans the chest constantly for about 30 seconds. It shows how the tumor moves as a person breathes, as opposed to just giving a ‘snapshot’ of a point in time, like a standard CT does.
4DCT can be used to show exactly where the tumor is during each part of the breathing cycle, which can help doctors aim radiation at the tumor more precisely. This technique might also be used to help show if a tumor is attached to or invading important structures in the chest, which could help doctors figure out if it can be removed with surgery.
Many clinical trials are being done to see if newer combinations of chemo drugs are safer and more effective. This is especially important in patients who are older and have other health problems. Doctors are also searching for better ways to combine chemo with radiation and other treatments.
Some new chemo drugs have shown promise in early studies and are now being tested in larger clinical trials.
Researchers are learning more about the inner workings of lung cancer cells that control their growth and spread. This is being used to develop new targeted drugs. These drugs work in a different way from standard chemo drugs. They might work in some cases when standard chemo drugs don’t, and they often have different (and less severe) side effects. Many of these are being tested in clinical trials to see if they can help people with lung cancer live longer or relieve their symptoms.
Drugs to keep new blood vessels from growing (anti-angiogenesis drugs): For cancers to grow, new blood vessels must develop to nourish the cancer cells within tumors. This process is called angiogenesis. New drugs that slow or stop angiogenesis are being studied as lung cancer treatments. Some are already used for other cancer types. For instance, a drug called bevacizumab (Avastin) has been shown to help patients with some types of non-small cell lung cancer. In early studies, it has helped stop some small cell lung cancers from growing for a time, but so far it hasn’t been shown to help patients live longer. Other drugs that affect blood vessel growth are also being tested for use against SCLC.
Researchers are hoping to develop drugs that can help the body’s immune system fight the cancer.
Ipilimumab (Yervoy): This drug targets a protein in the body that normally suppresses the immune response. Blocking this protein might help the immune system attack cancer cells. The drug is already used to treat melanoma, and it is now being studied in other cancers, including SCLC.
Vaccines: Vaccines that boost the body’s immune system to better kill lung cancer cells are being tested in clinical trials. Unlike vaccines against infections like measles or mumps, these vaccines are designed to help treat, not prevent, lung cancer. These types of treatments seem to have fewer side effects, so they might be useful in people who can’t have other treatments. At this time, vaccines are only being used in clinical trials.
Last Medical Review: 09/09/2013
Last Revised: 02/11/2014