Lung cancer: the world’s deadliest cancer
More people die as a result of lung cancer each year than from breast, colorectal and prostate cancer combined.1 While in recent years there has been a stream of new life-extending treatments for lung cancer, it still remains a deadly disease. “For several decades, lung cancer has been the most common type of cancer, accounting for 1 in 5 cancer deaths,” explains Dr Alan Sandler, Group Medical Director at Roche. “It remains one of the most difficult-to-treat cancers.”
Characterised by uncontrolled growth of abnormal cells in the lung, the two main forms of lung cancer are non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). NSCLC is the most common form and accounts for about 85% of all cases.2
It’s not always smoking
It is well documented that tobacco smoking is the most common cause of lung cancer, and is associated with around 80% of all diagnoses.3 However, it is not the only cause, as approximately 270,000 new cases are diagnosed per year that are not linked with smoking. Other notable risk factors for NSCLC include:3
- Radiation – people treated with radiotherapy are at a moderately increased risk of developing lung cancer
- Occupational risks – workers employed in certain industries and occupations that involve high-risk cancer-promoting (carcinogenic) agents, such as asbestos and combustion fumes, may be at an increased risk
- Urban air pollution – evidence suggests that lung cancer rates are higher in cities, mainly due to urban air pollution, than in rural settings.
- Indoor air pollution – non-smoking women in areas of China and other Asian countries may be at an increased risk due to poorly ventilated homes where coal, wood or other solid fuels are regularly burned
- Other lung diseases – people with pulmonary tuberculosis or chronic obstructive pulmonary disorder (COPD) are at an increased risk of lung cancer
Lung cancer survival
Unfortunately, more than two-thirds of all lung cancer patients are diagnosed at a late stage when tumours are present in more than one site in the body4. “Despite recent advances, 5-year survival rates for lung cancer are still poor when compared with other common cancers, particularly in the advanced setting,” said Dr Sandler. As with many other types of cancer, the earlier a patient is diagnosed the greater their chance of survival.*
(*5-year survival rates based on patients in the United States4)
Treatment options for lung cancer vary depending on the type and stage of the cancer, in addition to its size and position in the lung. Treatment also depends on whether it has spread to other parts of the body and the overall physical health of the patient. Historically, the treatment options for NSCLC have been:
- Surgery: people with early-stage, localised NSCLC may be successfully treated using surgery.
- Radiotherapy: for people whose cancer cannot be removed by surgery, radiotherapy may be offered alone or in combination with chemotherapy.
- Chemotherapy: used to treat people with advanced disease, which is when most cases of NSCLC are diagnosed.4 At this advanced stage, the cancer has already spread to another part of the body and can no longer be successfully surgically removed.
- Targeted therapies: these can include monoclonal antibodies, small molecules, vaccines and gene therapies that target certain pathways.
It is clear that lung cancer remains a significant challenge, both in the clinical and research settings. The dawn of cancer immunotherapy, a new treatment option, alongside existing treatments provides hope for patients and their families.
Breathing new life into cancer treatments
A significant medical need remains for therapies that extend lives and are tolerable, particularly in the previously treated advanced and metastatic NSCLC setting, which is where immunotherapies could play an important role. “At Roche, we are committed to addressing this medical need for lung cancer patients”, said Dr Alan Sandler.
1. Ferlay J, et al., GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide [document on the Internet]. International Agency for Research on Cancer; 2013 [cited 2016 Nov 21]. Available from: http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx
2. Barzi A, Pennell NA. Targeting angiogenesis in non-small cell lung cancer: agents in practice and clinical development. Europ Journ Clin Med Onc. 2010 [cited 2016 Nov 21];2(1): 31–42.
3. World Health Organization. World Cancer Report 2008 [document on the internet]. Lyon; 2008; [cited 2016 Nov 21]. Available from: http://www.iarc.fr/en/publications/pdfs-online/wcr/2008/wcr_2008.pdf [Calculation: 960,000 (new cases per year in men) + 390,000 (new cases per year in women) = 1,350,000 (new cases per year) / 1,350,000/100 = 13,500 (1% of cases diagnosed each year) / 13,500 * 20 = 270,000 (new cases per year not linked to smoking)]
4. National Cancer Institute. SEER Stat Fact Sheets: Lung and Bronchus Cancer [document on the internet]. NCI online; 2016; [cited 2016 Nov 21]. Available from: http://seer.cancer.gov/statfacts/html/lungb.html