Lung cancer is the second most common cancer worldwide, with more than 2.2 million new cases of lung cancer reported in 2020. Survival rates depend on the stage of diagnosis, and, According to statistics from Cancer Research UK, in the UK, more than 55% of people with stage 1 lung cancer survive for five years or more, compared to only about 5% of people with advanced stage 4 lung cancer.
Overall, there are two main types of lung cancer: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC).
SCLC is more aggressive than NSCLC, and is almost always caused by smoking.
Meanwhile, NSCLC is the most common, accounting for about 80% of lung cancer cases, and has three main subtypes: adenocarcinoma, which begins in the cells of the mucus-making glands in the lining of the airways; squamous cell carcinoma, which develops in the flat cells that cover the surface of the airways; and large cell carcinoma, which can occur in any part of the lung and gets its name from the fact that cancer cells appear larger than normal cells under a microscope.
Due to the fact that it is the second most common cancer worldwide, there is a lot of research being done to improve treatment and early diagnosis for both types of lung cancer. Here, we list five of the most recent advances in lung cancer research over the past year.
The pill halves deaths among early-stage lung cancer patients
In a phase 3 trial called ADAURA, it was found that the once-daily pill reduced the risk of death by 51% compared to placebo among patients with stage 1, 2, and 3 NSCLC with certain abnormal EGFR genes who had had surgery. And, it was found that 88% of patients in the entire trial population were alive at five years compared to 78% on placebo.
The pill from AstraZeneca is called osimertinib – sold under the brand name Tagrisso – and it acts as an ‘off’ switch for the mutated EGFR receptor. These receptors normally help cells grow, but mutations can instead make cells divide and reproduce excessively, potentially causing cancer.
“These highly anticipated overall survival results, with 88% of patients surviving within five years, are an important milestone in the treatment of early-stage EGFR-mutated lung cancer. These data underscore that adjuvant treatment with osimertinib gives patients the best chance of long-term survival,” commented Roy Herbst, deputy director and chief medical oncologist at Yale Cancer Center and Smilow Cancer Hospital, New Haven, Connecticut, and principal investigator on the trial.
ADAURA is an international study of 682 lung cancer patients, and included people from more than 20 countries in the US, Europe, South America, Asia and the Middle East.
Tagrisso has been approved as monotherapy in more than 100 countries, including in the US for patients with advanced lung cancer who worsen during or after other treatments, as well as for patients with early-stage lung cancer.
Immunotherapy improves overall survival rates for advanced NSCLC
In more lung cancer studies, a global study, led by UCL and UCLH, and sponsored by Roche, has shown that atezolizumab — an immune checkpoint inhibitor — significantly improves the overall survival of patients with advanced NSCLC who are unable to treat cancer. treated with standard of care chemotherapy containing platinum because of concerns around their ability to withstand treatment.
More than 40% of patients with advanced NSCLC are in poor health and are often elderly with medical comorbidities. This means that treatment with platinum-based doublet chemotherapy may not be suitable for them due to poor tolerance or toxicity issues, leaving them with limited treatment options.
In addition, most current treatment guidelines do not recommend immunotherapy treatment due to a lack of randomized results demonstrating that the treatment is safe for this patient population.
However, the Roche-sponsored atezolizumab study is now the first reported randomized phase 3 trial of a first-line immunotherapy treatment in a population of advanced NSCLC who cannot undergo standard platinum-based chemotherapy.
The study demonstrated that atezolizumab significantly improves overall survival and produces clinically meaningful long-term survival benefits; at 24%, twice as many patients treated with the drug survived at two years as those treated with chemotherapy.
A type of white blood cell called a macrophage can usually initiate a response to a tumor. However, when they enter a process called senescence, they stop dividing; but not all cells die when they stop dividing, and instead they continue to age, eventually accumulating in tissues.
These senescent cells then assume what is known as an senescence-associated secretory phenotype (SASP), meaning they begin secreting substances that are harmful to the cells around them.
Although it was originally believed that aging was the body’s way of suppressing cancer, a new study has now shown that aged cells in the lungs may actually promote tumor formation, with researchers finding that aged cells appear to block the immune system from suppressing cancer. can develop. to respond to and eliminate abnormal cell growth, which leads to tumors.
Through different experiments and analyses, researchers were able to differentiate senescent macrophages from other macrophages, and found that if they removed them through genetic or pharmacological approaches, they could delay tumor formation.
Genprex received a US Food and Drug Administration (FDA) fast-track designation for a lung cancer drug candidate
It was recently announced that clinical-stage gene therapy company Genprex received fast-track approval from the FDA for its lead drug candidate, REQORSA Immunogene Therapy, for use in combination with Tecentriq Genentech (atezolizumab) in patients with advanced-stage SCLC who do not develop tumor progression after received Tecentriq and chemotherapy as standard initial treatment.
REQORSA contains a plasmid that expresses a tumor suppressor gene – because the tumor suppressor gene is deleted or deactivated early in the cancer development process – called TUSC2. Nearly all SCLCs expressed decreased amounts of the tumor suppressor protein TUSC2, and 41% lacked TUSC2 protein expression entirely.
Genprex has received two other fast-track designations for REQORSA; for use in combination with Tagrisso AstraZeneca in patients with end-stage NSCLC whose disease progresses after treatment with Tagrisso, and for use in combination with Merck & Co’s Keytruda in patients with end-stage NSCLC whose disease progresses after treatment with Keytruda.
The company now expects to enroll its first patients in a phase 1/2 clinical trial called Acclaim-3, which is an increased dose and clinical response study of a maintenance therapy evaluating REQORSA in combination with Tecentriq.
Researchers use molecular biology to predict future lung cancer
Because terminal lung cancer currently carries a poor prognosis, detecting and treating lung cancer as early as possible is critical to saving lives.
Now, the University of Liverpool Lung Cancer Research Group, in collaboration with Janssen, has shown that proteins circulating in the blood could potentially be used to predict lung cancer.
For long-term studies, researchers analyzed blood samples taken from healthy participants between one and 10 years before lung cancer diagnosis, which they then compared with people who did not develop lung cancer. Comparisons show that the protein in plasma is able to identify people who are most likely to develop lung cancer in the future.
In addition, this study also shows that some proteins are associated with the presence of undiagnosed tumors.
This could potentially allow scientists to see patterns of proteins in blood samples to help better understand cancer and who may be affected, so they can ultimately prevent cancer from reaching more advanced stages, allowing them to treat it more effectively.