NATIONAL CANCER INSTITUTE

Advances in Lung Cancer Research

NCI-funded researchers are working to advance our

understanding of how to prevent, detect, and treat lung
cancer. There has been a great deal of progress made, for
scientists are identifying many different genetic alterations
that can drive lung cancer growth.

The highlights of this research including clinical advances that

may soon translate into improved care, NCI-supported
programs that are fueling progress, and research findings from
recent studies.

Early Detection of Lung Cancer

A great deal of research has been conducted in ways to find
lung cancer early. Several methods are currently being
studied to see if they decrease the risk of dying from lung
Lung cancer cells driven by the KRAS
cancer.
oncogene, which is highlighted in
CT Scan purple.
The NCI-sponsored National Lung Screening Trial Credit: National Cancer Institute
(NLST) showed that low-dose CT scans can be used to screen
for lung cancer in people with a history of heavy smoking.
Using this screening can decrease their risk of dying from
lung cancer. Now researchers are looking for ways to refine CT screening to better predict whether cancer is
present.

Markers in Blood and Sputum

Scientists are trying to develop or refine tests of sputum and blood that could be used to detect lung cancer
early. Two active areas of research are:

• Analyzing blood samples to learn whether finding tumor cells or molecular markers in the blood will help
diagnose lung cancer early.
• Examining sputum samples for the presence of abnormal cells or molecular markers that identify
individuals who may need more follow-up.

Machine Learning
Machine learning is a method that allows computers to learn how to predict certain outcomes. In lung
cancer, researchers are using computer algorithms to create computer-aided programs that are better able to
identify cancer in CT scans than radiologists or pathologists. For example, in one artificial intelligence study,
researchers trained a computer program to diagnose two types of lung cancer with 97% accuracy, as well as
detect cancer-related genetic mutations.

Lung Cancer Treatment

Treatment options for lung cancer are surgery, radiation, chemotherapy, targeted therapy, immunotherapy, and
combinations of these approaches. While researchers continue to look for new treatment options for all stages of
lung cancer, scientists currently have some promising results for advanced-stage disease, which are listed below.

Immunotherapy
Immunotherapy is a major focus in lung cancer treatment research today. Clinical trials are ongoing to look at
new combinations of immunotherapies with or without chemotherapy to treat lung cancer.

An immune checkpoint inhibitor is a drug that blocks proteins on immune system cells which then allows them to
fight cancer. Several immune checkpoint inhibitors have recently been approved for advanced lung cancer. These
inhibitors, which increase the strength of anticancer immune responses, target the proteins PD-L1 and
PD-1. Patients whose tumors test high for PD-L1 proteins may be more responsive to this type of treatment than
others, but more studies are needed.

Immune checkpoint inhibitors for treating lung cancer include:

• Atezolizumab (Tecentriq)
• Durvalumab (Imfinzi)
• Nivolumab (Opdivo)
• Pembrolizumab (Keytruda

A key issue with immunotherapies is identifying which patients are most likely to benefit. One marker for
immunotherapy response is tumor mutational burden, or TMB, which is the total number of mutations in the DNA
of the cancer cells. In lung cancer, positive responses to checkpoint inhibitors have been linked with a high TMB
in some trials.

Targeted Therapies
Targeted treatments identify and attack certain types of cancer cells with less harm to normal cells. In recent
years, many targeted therapies have become available for advanced lung cancer and more are in development. The
following are some targeted treatments for lung cancer:

Anaplastic lymphoma kinase (ALK) Inhibitors

ALK inhibitors target the cancer-causing alteration in the ALK gene. These drugs continue to be refined for the
five percent of lung cancer patients who have an ALK gene alteration. In addition to approved treatments such as
ceritinib (Zykadia) and crizotinib (Xalkori), there have been recent approvals of:

• Alectinib (Alecensa)
• Brigatinib (Alunbrig)
• Lorlatinib (Lorbrena)
 These recently approved ALK inhibitors are improvements from previous ones in their enhanced ability to cross
the blood–brain barrier. This progress is critical because, in non-small cell lung cancer patients
with ALK alterations, disease progression tends to occur in the brain.

EGFR Inhibitors
EGFR inhibitors block the activity of a protein called epidermal growth factor receptor (EGFR). EGFR may
be found at higher levels than normal on cancer cells, causing them to grow and divide. Some drugs that
target EGFR that are approved for treating lung cancer are:

• Afatinib (Gilotrif)
• Dacomitinib (Vizimpro)
• Erlotinib (Tarceva)
• Gefitinib (Iressa)
• Necitumumab (Portrazza)
• Osimertinib (Tagrisso)

ROS1 Inhibitors
The ROS1 gene makes the protein ROS1, which is involved in cell signaling and cell growth. A small percentage
of non-small cell lung cancer patients have altered forms of the ROS1 gene. Crizotinib is approved as a treatment
for patients with these alterations.

BRAF Inhibitors
The BRAF gene makes the protein, B-Raf, which is involved in sending signals in cells and cell growth. This
gene may be altered in some patients with non-small cell lung cancer, which can increase the growth and spread
of cancer cells.

A combination of the drug dabrafenib (Tafinlar), which targets a specific mutation in the BRAF gene, and
trametinib (Mekinist), which targets a protein called MET, has been approved as treatment for certain patients
with non-small cell lung cancer.

Other Inhibitors
Some non-small cell lung cancers have mutations in the genes NRTK-1 and NRTK-2 that can be treated with the
targeted therapy larotrectinib (Vitrakvi). Inhibitors of other targets that drive some lung cancers, such as RET,
HER2, MEK, and MET gene, are currently being tested in clinical trials.

Clinical Trials
NCI funds and oversees both early- and late-phase clinical trials to develop new treatments and improve patient
care. Trials are available for both non-small cell lung cancer prevention, screening, and treatment, and small cell
lung cancer prevention, screening, and treatment.

Posted: May 2, 2019

 EMILIO AGUINALDO COLLEGE
Congressional Road, East Avenue, Burol Main, Dasmariñ as City, Cavite 4114
SCHOOL OF NURSING
1st SEMESTER SCHOOL YEAR 2019-2020

NCM-106
Care of Clients with Problems in Cellular Aberrations,
Acute Biologic Crisis
including Emergency and Disaster Nursing
BSN IV – SECTION 1

LUNG CANCER

Submitted by : JORELIEGH ROSE D. GARCIA

 Reflection

Cancer is an unbiased killer that knows no race, sex, age, or importance of its victims. Both of
my grandparents lost because of this “monster” from 2008 to 2010. Research is grossly underfunded
because it has the stigma of being a smoker’s disease. As there are millions of other people who
have been affected by this as well. Lung cancer is a devastating disease. The lungs are two sponge-
like, cone-shaped organs in the thoracic cavity. The purpose of the lungs is to help one breath. The
trachea conducts inhaled air into the lungs through its tubular branches, called bronchi. Our lungs
bring air in and out of the body, taking in oxygen and getting rid of carbon dioxide gas, a waste
product, to be exhaled. Our lungs play an intricate part in sustaining life. Lung cancer develops
when the genetic material responsible for the production of lung cells is damaged. Repeated
exposure to carcinogens such as tobacco smoke may cause damage in lung cells. While tobacco, is
the leading cause of lung cancer, some other carcinogens linked to lung cancer include radon and
asbestos. These mutations in the genetic material of the lung cells cause the instructions for those
cells to go askew. Consequently, those cells and their offspring reproduce wildly, without regard for
the normal shape and function of a lung.
One reason why lung cancer is so deadly is that it is hard to find in its early stages. It may
take years for lung cancer to grow and there usually are no symptoms early on. By the time you start
to notice symptoms, the cancer often has spread to other parts of the body. Lung cancer can be
treated more successfully when it is found early. Researchers are working hard to develop tests that
can find lung cancer in its early stages. This article shows that low-dose CT screening (LDCT) for
high-risk individuals who meet certain guidelines can save lives and also Immunotherapy attempts
to activate the patient’s immune system to fight cancer. This is the first time an immunotherapy drug
has been combined with first-line chemotherapy to treat cells of lung cancer.
Lung health is believed to reach its peak when a person is between 25 and 35 years old, by
getting a baseline measurement of people in this age range, some of the studies identify the
exposures and biomarkers that are associated with susceptible of getting lung disease versus
studying people in their 50s and 60s, which is when lung disease symptoms typically surface and
also are studying new treatments to help people live longer and to even cure lung cancer.