Recent advances in diagnostics and therapy are raising survival rates of those diagnosed with lung cancer, with more exciting developments on the horizon.
One such recent advance involves giving chemotherapy after the surgical removal of a tumor.
"Two years ago, we didn't recommend the therapy because we had just preliminary data that it might be helpful, but not enough information to make it a generally accepted recommendation," says James Rigas, MD, director of the Comprehensive Thoracic Oncology Program at the Norris Cotton Cancer Center in Lebanon, N.H.
But in 2004 two studies showed big improvements in survival for patients who got chemotherapy over those who didn't. Here were the conclusive data that doctors had been hoping for.
How good was the news? One study by the National Cancer Institute of Canada showed that, of those who received a two-drug chemo combination, 15% more lived five years or more after their surgery, while a U.S. study showed a 12% increase in survival rates.
The chemotherapy drugs used in these studies are not new, yet with these study results doctors now have better knowledge of how to work with what's available, meaning many people may live longer without a relapse or spread of their cancer.
"I think we're going to be seeing a lot more trials to try to improve upon the fact that we know treatment helps," Rigas tells WebMD.
Targeted Treatment for Lung Cancer
Nearly 60% of all people with lung cancer die within a year of their diagnosis and an estimated 164,000 Americans -- most of them smokers or ex-smokers -- are diagnosed each year.
Fortunately, an important development in treating advanced lung cancer was announced last year.
In a large study, people taking a drug called Avastin, together with chemotherapy, lived an average of two months longer than those taking chemo alone -- a big improvement for people with a disease that can kill so quickly.
Avastin is a "targeted" treatment, meaning it more specifically targets cancer cells over normal cells. It works by disrupting the cancer cells' ability to form new blood vessels, which a tumor needs to grow.
And, in addition to hopefully improving treatment, targeted drugs often decrease side effects.
Now researchers hope Avastin plus chemotherapy might cure people with early-stage lung cancer. "If this gives us the same kind of benefit in advanced disease, which I think it probably will, this will be probably one of the biggest life-savers for lung cancer," Rigas says.
Another targeted treatment -- approved for lung cancer in 2004 -- is Tarceva, which targets a protein found on cancer cells that helps them multiply.
This drug was tested as a sole treatment on people with late-stage lung cancer who had not done well with chemotherapy. On average, those taking Tarceva lived two months longer than those taking a placebo, and also found an easing of symptoms.
Antibody Therapy for Lung Cancer
Your immune system does not see cancer cells as a threat, destroying them like it does viruses, bacteria, and foreign tissue. But the immune system can be trained to attack tumors, and researchers have taken the first steps toward creating lung cancer drugs that work this way.
One approach is called "targeted antibody therapy," where the immune system recognizes a molecule called an antigen on the surface of an invader, creates an antibody which latches onto the antigen, then destroys the invader.
This works because some cancer cells have antigens that don't show up on the vast majority of normal, healthy cells. And because the body doesn't naturally make antibodies against these cancer antigens, scientists have.
Andrew Scott, MD, head of the Melbourne, Australia branch of the Ludwig Institute for Cancer Research, has tested an antibody that targets the tissue which supports a tumor. In a phase I clinical trial -- a study that tests a drug's safety -- people with advanced lung cancer or colon cancer were injected with the antibody. Then, using special dyes, researchers tracked where the antibody went.
What they found were "very high concentrations in the cancer but very low concentrations in any other normal tissue," says Scott, meaning the antibody targets tumors specifically and that treatment will likely cause little damage to healthy cells.
Scott says he expects to begin a phase II study by late 2007, which will test how well the antibody treatment works. Besides prompting the immune system to attack, antibodies might also be used to deliver a "payload" drug directly to cancer cells, or to interfere with cellular communications, he says.
With many antigens unique to lung cancer cells, some researchers believe it's vital to develop as many antibodies as possible. This way, says Sacha Gnjatic, PhD, a researcher at the Ludwig Institute's New York City branch, "if one antigen somehow escapes immune system, you can target another one."
Gradually, experts hope, lung cancer survival rates will rise.
Published March 13, 2006.