Lung cancer treatment is changing, thanks to breakthroughs and early detection. There are surgical advances, improvements in radiation, and new drugs that target specific traits of the cancer and stimulate your immune system to fight the disease.
Low-Dose CT Scan
One of the things that makes lung cancer dangerous is the fact that symptoms don’t usually appear until the disease is at a late stage. Doctors can now check for lung cancer in people at high risk for it using what’s known as a low-dose computed tomography (LDCT) scan.
It takes about 15 minutes and gives you about the same amount of radiation as a mammogram.
Research shows that people who got LDCT had their risk of dying from the disease drop by 20% against those who got chest X-rays. The test is recommended for 50 to 80 years old who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years.
Video-Assisted Thoracic Surgery (VATS)
Doctors can treat some small lung tumors using this operation. Your surgeon removes parts of your lung through smaller incisions. This makes the procedure less painful. It also can make your recovery faster.
A newer approach to VATS is known as “robotic-assisted surgery.” Your surgeon sits at a control panel inside the operating room to maneuver long surgical instruments using robotic arms.
Image-Guided Radiation Therapy
Machines with built-in imaging scanners make it possible for your doctor to give radiation more precisely. They can take pictures of your lung and then adjust their aim right before giving you the radiation. It’s a way to zero in on your cancer. It may also bring fewer side effects.
Also known as immunotherapy, this can get your immune system to recognize and destroy cancer cells better. There are a couple of different types:
Checkpoint inhibitors: Part of your immune system’s job is to not attack normal cells in the body. To do this it uses so-called “checkpoints,” molecules that must be turned on or off to trigger an immune response. Cancer cells sometimes use these checkpoints to avoid being targeted by your immune system.
But four drugs -- atezolizumab (Tecentriq), durvalumab (Imfinzi), nivolumab (Opdivo) and pembrolizumab (Keytruda) -- target these checkpoints and basically take the brakes off your immune system so that it can mount a better attack.
Monoclonal antibodies: Made in a lab, these molecules target specific signs, called antigens, that are found on tumors. Examples used to treat lung cancer are bevacizumab (Avastin) and ramucirumab (Cyramza).
Scientists have learned that people with specific genetic combinations may benefit from targeted therapies like EGFR (epidermal growth factor receptor) blockers. afatinib (Gilotrif), amivantamab-vmiw (Rybrevant), erlotinib (Tarceva), gefitinib (Iressa), necitumumab (Portrazza) and osimertinib (Tagrisso) block a signal that tells cells to grow.
The drugs alectinib (Alecensa), brigatinib (Alunbrig), certinib (Zykadia), and crizotinib (Xalkori) have been found to help treat certain cancers with a change in the ALK gene. Some of these drugs are also used to treat tumors with an ROS1 gene change. Dabrafenib (Tafinlar) and trametinib (Mekinist) target certain proteins in tumors that have changes in the BRAF gene. Sotorasib (Lumakras) targets tumors with any KRAS mutation.
Although a lot of studies are focused on the pursuit of new ways to treat lung cancer, researchers are always looking for new chemotherapy drugs or improvements on existing ones.