SPEAKER 1: There are two major types of lung cancers, which can affect smokers and non-smokers alike, small-cell lung cancer and non-small-cell lung cancer.

JAMIE CHAFT: I would say, interestingly, despite all of us using "non-small-cell lung cancer" in our everyday lingo, it actually isn't a thing. So, "non-small-cell lung cancer" is a historic term, and it really meant just that, not small-cell lung cancer.

SPEAKER 1: Doctors now recognize it's a group of cancer diagnoses, including adenocarcinoma, squamous cell carcinoma, and a host of rare subtypes. As researchers have moved beyond the historic lingo and narrowed in on these more specific conditions, they've started making advances on this biological chessboard. But doctors still haven't found their checkmate.

JAMIE CHAFT: It's very exciting. As a field, it is constantly changing. And it certainly keeps us on our toes.

SPEAKER 1: While people may still be diagnosed with non-small-cell lung cancer, how they're treated depends on what their cancer actually looks like under a microscope.

Old-school chemotherapy can help some people live longer, healthier lives. But scientists have made big advances in targeted therapies, including immunotherapies, which help the body's own immune system attack cancer cells, and a class of drugs called "small molecule inhibitors." Researchers have found that some people's tumors can have just one genetic change that can lead to cancerous cells. These powerful mutations are called "drivers."

JAMIE CHAFT: And we have found that, in the lab, drugs have been developed that are highly specific at blocking these abnormal proteins. And it's like stepping on the gas and letting the car go, where we now have medicines that, not permanently, but at least with some degree of durability, can step on the brake.

SPEAKER 1: The first of these inhibitors targeted a protein called the "epidermal growth factor receptor," or EGFR. Researchers found that many lung cancers had surfaces littered with the excess product of EGFR proteins, so they developed an EGFR inhibitor to suppress these growth factors. It worked, slowing the growth of cancer cells.

JAMIE CHAFT: And that was pretty revolutionary. And since then, we've found many different genes for which targeted therapies can be designed and prescribed in the clinic.

SPEAKER 1: These include inhibitors for genes like ELK, MET, RET, KRAS, and more. But there's still plenty of room for improvement.

JAMIE CHAFT: I envision that, in the future, lung cancer care is going to be exceptionally different.

SPEAKER 1: Right now, targeted therapies are slow to start, because doctors need lots of data, including tumor biopsies, to make sure they're choosing the right treatment. The wait can be hard on patients.

JAMIE CHAFT: And, as a provider, we do our best to reassure people that the best therapy is usually far better than a quick therapy, and it's something that's often really hard to wrap your head around. In 20 years, we will likely be making our diagnoses based on a blood test, not on a biopsy, and we'll probably be monitoring therapy based on serial blood tests, where we can track the tumor and its evolution through the blood, and hopefully target and tailor therapy to be maximally effective in that setting. SPEAKER 1: Researchers will also continue to improve on immunotherapies through research on the patients who respond well to the treatment and those who don't.

JAMIE CHAFT: My personal wish list is to improve cure rates, and really to take all of these interventions that we've shown to be beneficial in stage-four disease and move them into the earlier stage.

SPEAKER 1: But here's one move patients and providers can make today.

JAMIE CHAFT: We still need the primary care physicians and the pulmonologists across the country to believe in lung cancer screening, and to believe that we can change outcomes if we screen and identify these cancers earlier.