Navigating New Horizons: Lung Cancer Clinical Trials

What is Lung Cancer?

It is a type of cancer that begins in the lungs. Like all cancers, it happens when cells in your lungs grow in an uncontrolled way. This growth can then spread to other parts of your body.

There are two main types of lung cancer:

Non-Small Cell Lung Cancer (NSCLC): This is the most common type, making up about 85% of cases. It generally grows and spreads more slowly than the other type. There are several subtypes of NSCLC, including adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.

Small Cell Lung Cancer (SCLC): This type accounts for about 15% of lung cancer cases. It grows more quickly and is more likely to spread to other organs in the body.

Lung cancer grows into nearby areas or spreads to other parts of the body through lymph nodes and the blood. This process, called metastasis, creates new tumors far from the original cancer site.

Doctors classify the cancer as stage III when it remains near its origin. When it moves to distant places like the brain or bones, they classify it as stage IV.

It’s a question asked by many, and the answers are evolving. Lung cancer encompasses several types, with non-small cell lung cancer being the most prevalent. Standard treatments vary by stage, with stage III lung cancer often requiring a combination of approaches.

Spotting the first signs of lung cancer isn’t always easy, but catching them early can help find the disease sooner and improve success.

Next-Generation Sequencing (NGS) is vital in linking patients with specific genetic mutations in their cancers to clinical trials for targeted options. This approach, part of personalized medicine, increases the effectiveness and success rates of these trials by ensuring patients receive approaches most likely to work for their particular cancer type.

The genetic mutations are also known as biomarkers, and many are known to be related to the origin of the disease. Some of the more common biomarkers found to cause lung cancer are the following:

EGFR (Epidermal Growth Factor Receptor) Mutations: These are changes in the EGFR gene found in some types of lung cancer, particularly non-small cell lung cancer (NSCLC). They can indicate a good response to EGFR inhibitors, a type of targeted approach.

ALK (Anaplastic Lymphoma Kinase) Rearrangements: This genetic change is found in a small percentage of NSCLC patients. ALK-positive lung cancers can be treated with ALK inhibitors, which are targeted approaches specifically designed to combat this mutation.

KRAS (Kirsten Rat Sarcoma Viral Oncogene Homolog) Mutations: KRAS mutations are common in NSCLC. They can provide information about prognosis and are currently being studied for targeted options.

PD-L1 (Programmed Death-Ligand 1) Expression: PD-L1 is a protein that helps keep the immune system from attacking normal cells in the body. High levels of PD-L1 on lung cancer cells might indicate that the cancer could respond well to immunotherapy drugs that target the PD-1/PD-L1 pathway.

ROS1 Rearrangements: Similar to ALK, ROS1 rearrangements in NSCLC can be targeted by specific inhibitors. Patients with this mutation may respond to approaches targeting the ROS1 protein.

MET Mutation: This is a less common mutation in NSCLC but can be important for targeted approach decisions.

In the treatment of lung cancer, a variety of medications are employed, each tailored to the specific type and progression of the disease. Chemotherapy options include well-known drugs such as Cisplatin, Carboplatin, and newer agents like Pemetrexed and Gemcitabine. However, it’s important to consider the potential side effects of these drugs.

Targeted approaches, which act on specific cellular mechanisms of cancer cells, include Erlotinib and Afatinib, along with ALK inhibitors like Crizotinib and Alectinib. Immunotherapies like Nivolumab and Pembrolizumab boost the body’s immune response to fight cancer cells.

Additionally, Bevacizumab, an angiogenesis inhibitor, works by cutting off the blood supply that tumors need to grow. Healthcare providers may use these treatments individually or combine them, forming the foundation of lung cancer drug treatment.

Clinical trials play a crucial role in the treatment of stage III and stage IV lung cancer for several reasons:

Access to New Options: Clinical trials offer patients a chance to try new options that could work better, especially for serious illnesses like advanced lung cancer.

Improving Outcomes: By participating in clinical trials, patients contribute to knowledge that could improve survival rates and quality of life for future lung cancer patients.

Comprehensive Care: Patients in clinical trials often receive a high level of care and are closely monitored by a dedicated team of healthcare professionals and researchers.

Hope for the Future: For many patients with advanced lung cancer, participating in a clinical trial provides hope—both for themselves and the possibility that their participation will help others in the future.

Advancing Research: These trials are essential for research, helping scientists understand how new options work and for whom they work best. This can lead to the development of more effective strategies and personalized medicine.

Cancer is an unfortunate reality that touches most of us at some point in our lives. If you or a loved one has cancer, you may have heard or read that clinical trials could offer access to innovative new options. But what exactly is a clinical trial? In this video, Massive Bio co-founder Arturo Loaiza-Bonilla, MD, explains how clinical trials work, what to expect if you enroll in one, and why a clinical trial can be an important option for many cancer patients.

We dream of the day when cancer disappears from our lives. Massive Bio is working tirelessly on achieving that goal.