Researchers Focus on Lung Cancer Treatment

female researcher using dropper in lab

Finding better ways to treat lung cancer is a priority for researchers in medical centers around the world. New therapies are badly needed because lung cancer causes more deaths among Americans than any other cancer. Lung cancer is often difficult to treat, and most patients don’t have any symptoms until the cancer has spread too far to be cured.

Lung-MAP study

A new kind of large research study is currently testing 5 different experimental drugs at the same time, all for advanced squamous cell lung cancer.

Most research trials of new treatments test only 1 drug and try to figure out which patients might be helped by it. In the Lung-MAP trial, researchers are looking at the DNA from each volunteer patient’s lung tumor to find out what changes are causing it to grow. They are using the results of the DNA screening to assign the patient to the arm of the study that’s testing a drug designed to target those specific genetic changes.

Squamous cell lung cancer represents about 25% - 30% of lung cancer cases. Chemotherapy is the main treatment for advanced disease, but its effects are often limited. A goal of the Lung-MAP trial is to improve patients’ access to promising new drugs, as well as making it easier for researchers to find patients to help them test the drugs.

The trial is being conducted at more than 200 medical centers around the country. To learn more about the study or find a participating medical center, visit the Lung-MAP website or clinicaltrials.gov.

Radiation therapy

Recent studies have found promise using radiation therapy to help some people with hard-to-treat types of lung cancer.

In a study by Dutch and British researchers, adding chest radiation to standard treatment with chemotherapy helped people with advanced small cell lung cancer (SCLC) live longer and reduced the chances of the cancer coming back in the chest.

The trial involved 498 people in the Netherlands, the United Kingdom, Norway, and Belgium with advanced SCLC who had improved with chemotherapy. They were randomly assigned to receive either radiation to the brain only, or radiation to the brain and chest.

After 2 years of follow-up, 13% of those treated with chest radiation were still alive compared with only 3% of those treated with standard care but no chest radiation. Also, 24% of those who had chest radiation survived for 6 months without their lung cancer getting worse compared with only 7% who did not have chest radiation. In addition, cancer came back in the chests of only 20% of those who had chest radiation compared with 46% of those who did not.

The study was published online September 14, 2014 in The Lancet and presented at the annual meeting of the American Society for Radiation Oncology (ASTRO) in San Francisco.

Another study presented at the ASTRO meeting found that a specialized form of radiation therapy might be a reasonable treatment option for some patients with early-stage non-small cell lung cancer (NSCLC) who aren’t healthy enough for surgery.

Researchers from the University of Texas Southwestern Medical Center in Dallas and colleagues studied 55 people with early-stage NSCLC. Surgery is sometimes part of the main treatment for these cancers, but these people couldn’t have surgery because they had other serious medical conditions. Instead, they received stereotactic body radiation therapy (SBRT), a type of external beam therapy that delivers high doses of radiation to the tumor in a short amount of time while limiting exposure to surrounding healthy organs.

Five years after treatment, 40% of the patients were still alive, and 26% still had no signs of any remaining cancer.

A larger study is going to look at whether SBRT might be a reasonable option even in patients who would be eligible for surgery.

Targeted therapies, immunotherapies

The US Food and Drug Administration (FDA) this year approved Zykadia (ceritinib) for a type of late-stage NSCLC. Zykadia is a kind of targeted drug that works by blocking a protein that helps cancer cells grow. It specifically targets cells with mutations (changes) in the ALK gene.

Only a small percentage of NSCLC patients test positive for the ALK gene mutation. Zykadia is intended for these people when the cancer has spread (metastasized), after they were treated with Xalkori (crizotinib), the only other FDA-approved drug that targets cells with a mutated ALK gene.

The FDA based its decision on a clinical trial of 163 people with metastatic ALK-positive NSCLC. All of them were treated with Zykadia. Tumors shrank in about half the patients, and the improvement lasted on average for about 7 months.

Perhaps the most exciting new approach to lung cancer treatment is the development of drugs that use the body’s immune system to fight the cancer. For example, cancer cells often have a protein called PD-L1 on their surface that helps them evade the immune system. New drugs that block the PD-L1 protein, or the corresponding PD-1 protein on immune cells called T cells, can help the immune system recognize the cancer cells and attack them.

In early studies, an anti-PD-1 drug known as nivolumab shrank tumors in about 1 out of 5 people with NSCLC, while a drug targeting PD-L1 (known as BMS-936559) shrank tumors in about 1 out of 10 people. Many of the tumor responses have been long-lasting so far. Larger studies of these and other, similar new drugs are now being done, but they are still only available in clinical trials.

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Use of thoracic radiotherapy for extensive stage small-cell lung cancer: a phase 3 randomised controlled trial. Published online September 14, 2014 in The Lancet. First author Ben J. Slotman MD, VU University Medical Center, Amsterdam, Netherlands.


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