Non-Small Cell Lung Cancer

Non-Small Cell Lung Cancer 101  

Lung cancer, which starts when cells from the lung tissue multiply out of control and form a mass (or tumor) in the lung, is the leading cause of cancer death in both men and women. However, as with many types of cancer, the chance of curing the disease is increased when it is caught early. There are two main types of lung cancer, small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). While both cancers affect the lungs, they have several key differences, including how they are treated and the prognosis (or probable course and outcome) of the disease. This article contains information about NSCLC.  

What Is Non-Small Cell Lung Cancer? 

About 80 to 85 percent of lung cancers are NSCLC. Cancer cells originate from lung tissues. NSCLC grows more slowly than SCLC. Early diagnosis is critical in the treatment of NSCLC. The cause of NSCLC is unknown. Although it is usually associated with a history of smoking, this cancer can also occur in non-smokers. Other risk factors for NSCLC include exposure to indoor pollutants such as asbestos, metal dust, or mineral dust; a history of chronic obstructive pulmonary disease or HIV/AIDS; and previous radiation therapy.   

The symptoms of NSCLC and SCLC are similar:  

• Difficulty breathing or wheezing 
• Chest pain or discomfort 
• A cough that does not go away or gets worse over time 
• Blood in saliva 
• Difficulty swallowing 
• Hoarseness 
• Loss of appetite 
• Unexplained weight loss 
• Swelling in the face and/or neck veins 
• Fatigue

What Are the Types of Non-Small Cell Lung Cancer? 

The most common subtypes of NSCLC are adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.  

• Adenocarcinoma: This is the most common type of NSCLC in many parts of the world. Adenocarcinoma is usually found in the outer parts of the lung and may spread to the lymph nodes. Lung adenocarcinomas begin in cells that normally secrete substances such as mucus. It is more common in women than men. Although this form of NSCLC is associated with a smoking history, it can also occur in non-smokers. 
• Squamous cell carcinoma: This form of NSCLC starts in squamous cells, which are flat cells that line the inside of the lungs, and most often in the main airway (or bronchus). This type of cancer has also been associated with a history of smoking. 
• Large cell carcinoma: These malignancies can appear anywhere in the lung. They tend to grow and spread rapidly, which can make treatment a challenge. Sometimes called undifferentiated carcinoma.

What Is The Difference Between Non-Small Cell Lung Cancer and Small Cell Lung Cancer? 

• NSCLC has a better prognosis than SCLC. 
• When SCLC cells are examined under a microscope, they appear small and round. Non-small cell lung cancer cells are larger. 
• NSCLC grows slowly, while SCLC grows much more aggressively. 
• NSCLC is far more common, accounting for up to 85 percent of lung cancer cases. SCLC is rarer and accounts for 10 to 15 percent of cases. 
• According to the National Cancer Institute, the overall five-year survival rate for NSCLC is 26 percent. The overall five-year survival rate for SCLC is 7 percent. 

NSCLC is classified in four stages: 

• Stage I: The cancer is in only one lung. 
• Stage II: The cancer is larger than in stage I and may have spread to lymph nodes in the chest. 
• Stage III: The cancer has reached lymph nodes and other structures in the lungs and chest area. 
• Stage IV: The cancer has spread to both lungs and/or other parts of the body.

SCLC is generally classified in two stages: 

• Limited stage: The cancer is limited to one side of the chest, which typically means one lung and possibly nearby lymph nodes. 
• Extensive stage: The cancer has spread widely throughout one or both lungs, and possibly to other parts of the chest and other distant organs. 

Sources: American Cancer Society, Cleveland Clinic, MedicineNet, WebMd 

 

Living and Managing With NSCLC 

Lung cancer is characterized as small cell and non-small cell. Small cell lung cancer is the less common type, but it spreads faster than non-small cell lung cancer (NSCLC). Small cell cancer cells appear small and round under a microscope compared to non-small cell cancer cells. Lung cancer is the leading cause of cancer-related mortality, not only in the United States but also around the world. 

NSCLC accounts for 85 percent of all lung cancers in the United States. NSCLC is the most common type of lung cancer and has several different subtypes, including: 

• Adenocarcinoma 
• Squamous cell carcinoma 
• Large cell carcinoma 
• Other rare types 

Coping With Treatment 

Treatment can be difficult physically and emotionally, so it is important to ask your doctor about tips specific to your treatment as side effects. Other variables can differ depending on what is being used (chemotherapy, surgery, radiation therapy, etc.). Good communication will help improve the quality of the care you receive. The following tips may help you communicate better with your health care team.  

• Start a health care journal 
• Prepare a list of questions and write down your doctor’s answers 
• Bring someone with you to your appointments 
• Keep important papers together in an accessible file 
• Talk to your doctor about a second opinion  

Coping With Physical Side Effects 

Physical side effects of NSCLC can depend on multiple factors such as subtype of NSCLC, stage of disease, medical history, and the treatment option used. Clinical trials are evaluating new ways to help alleviate and manage side effects in NSCLC. 

Common side effects of treatment include: 

• Troubled breathing 
• Persistent fatigue 
• Frequent infection 
• Stomach issues such as nausea, vomit, or diarrhea 
• Hair loss 
• Infertility and other changes in sexual function 

Some patients may experience more serious side effects when being treated with chemotherapy, such as low levels of white blood cells and heart function complications. It is important to discuss potential side effects with your doctor before treatment begins, so you know what to expect. 

Coping With Emotional and Social Effects 

NSCLC patients respond in different ways to being diagnosed and living with cancer. You may feel a wide range of emotions, which might change very quickly. Below are some common emotional side effects: 

• Shock, fear, or anger: You could feel any or all these things when you’re told you have prostate cancer.  
• Denial: If you feel well, you may find it difficult to accept that you have prostate cancer.  
• Frustration and disappointment: How you think about yourself, your life and your plans might have changed.  
• Stress: It can be difficult to decide what treatment to have, and you might feel stressed.  

• Worries about side effects: If you have side effects like erection, urinary and bowel problems, then coping with these could also make you feel down or worried.  
• Sense of loss: Hormone therapy can cause physical changes to your body, such as putting on weight, reduced physical strength, or changes to your sex life. This might make you feel very different about your body and cause a sense of loss.  
• Mood swings: Hormone therapy and other treatments can make you feel emotional and down. It can also cause mood swings, such as getting tearful and then angry.  
• Anxiety: Some NSCLC patients worry about getting test results during treatment. Even after treatment has finished, some patients feel anxious and find it hard to move on and think about the future.  
• Feeling alone: You might feel isolated, especially if your treatment has finished and you’re no longer seeing your doctor or nurse.  

All these are very normal ways to feel. These feelings may stay with you, but some patients find they gradually improve over time with the available resources around you, such as support groups, social workers at your hospital, therapists, family members, and more.  

Caring for a Loved One With Cancer 

When it comes to caring for someone with NSCLC, there is no one-size-fits-all solution. Caregivers are on their own journey while individuals begin their lung cancer journey. They, too, require assistance, and addressing their requirements becomes a valid objective. 

Here are some tips to get started in your caregiver role:  

• Patients coping with cancer may not hear everything and miss important information about their care. Go to the doctor’s appointments and take notes so they don’t have to rely on remembering what was said.  

• If asked, help explore treatment options. All NSCLC treatments have side effects; it is important to discuss with your loved one how you’ll be involved in supporting him.  
• Take time to do what nurtures you. Take a walk, talk to friends, read and play music. You and your well-being matter too.  
• If your loved one is overwhelmed, talk to them and the doctor about counseling.  
• Remember that both of you will experience a wide range of emotions. Do not suppress these feelings. Talk about them together and know that they are normal.  

Family and caregivers of NSCLC patients may also want to seek support. There are support groups, counseling, and online forums specific to caregivers that can provide the support they need. 

NSCLC Follow-Up Care 

Additional treatment might be given to patients who reach remission to lower the risk of the cancer returning. This can cause more side effects and complications but helps to ensure that all remaining cancer cells in the body are killed. 

Some patients will receive palliative care, which aims to relieve symptoms and improve the quality of life of cancer patients. This secondary treatment can be used at any stage and for patients of any age. Talk with your doctor to see if palliative care can help relieve some of the stress and complications from NSCLC treatment. They may also be able to provide information on your overall prognosis. 

Watching for Recurrence 

Recurrence refers to cancer that has come back after being in remission for a period of time (typically between two and six years in NSCLC). This is also known as a relapsed or recurrent cancer. The cancer can come back in the same location or a new one elsewhere in the body.  

It is estimated that between one-third and one-half of all NSCLC patients will experience a recurrence. This risk depends on the treatment used, stage of disease, and subtype of NSCLC. Talk with your doctor to understand your individual risk of recurrence.   

Sources: 

www.webmd.com 

www.winchesterhospital.org 

www.cancersupportcommunity.org 

Non-Small Cell Lung Cancer Symptoms and Signs  

Non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) are the two main kinds of lung cancer. These two cancers, which were named after the way cancer cells appear under a microscope, account for 230,000 newly diagnosed lung cancer cases in the United States each year.  

The great majority of lung cancer (85 percent) are classified as non-small cell lung cancer. Despite the fact that this kind of lung cancer grows more slowly than SCLC, 40 percent of NSCLCs have gone beyond the lungs by the time they are detected.  

In this guide, we will cover the signs and symptoms to watch out for in NSCLC!    

What Are the Symptoms of Non-Small Cell Lung Cancer?  

NSCLC symptoms are similar to those of SCLC, and can include the following:  

• A cough that doesn’t go away 
• Coughing up blood  
• Chest pain  
• Difficulty Breathing  
• Wheezing  
• Hoarseness  
• Loss of appetite  
• Weight loss 
• Fatigue  
• Difficulty Swallowing  
• Swelling in the face and/or neck   

Where Does Non-Small Cell Lung Cancer Start?  

NSCLC develops at the cellular level, as do other cancers, and causes abnormal cells in the lungs to multiply rapidly and uncontrollably. NSCLCs are carcinomas or cancers of the cells that line the surface of the airways in the lungs. The bronchi, bronchioles, and alveoli are among these.    

What Are the 7 Signs of NSCLC?  

Because the lungs do not have many pain receptors, symptoms do not normally appear in the early stages of lung cancer. Many early lung tumors are discovered by chance while undergoing a test for another reason. Knowing the warning symptoms of lung cancer will help you be checked early if they do arise. Early detection of lung cancer provides for more individualized treatment choices and a higher success rate. Having one of the following lung cancer symptoms is usually not reason for concern, but if you have many symptoms over a prolonged period of time, you should speak with your doctor.    

Number 1  

Symptom: Persistent Cough  

Coughing is a protective mechanism that your body uses to keep particles out of your airways and lungs. One of the most prevalent signs of lung cancer is a persistent cough that turns into a chronic cough. Consult your doctor right away if you’re coughing up blood or rust-colored spit/phlegm.     

Number 2  

Symptom: Shortness of Breath  

Shortness of breath may be a symptom of lung cancer. Shortness of breath may occur if a lung cancer tumor blocks a main airway. Breathing difficulties can be caused by fluid in the lungs, which might be an indication of lung cancer. If you’re concerned about your difficulty to breath or shortness of breath, see your doctor.   

Number 3  

Symptom: Hoarseness  

Have you changed your tone of voice? Does it have a raspy tone to it? Do you have a raspy voice? Has anyone mentioned that your voice is a little high-pitched? Vocal cords vibrate open and closed to produce sound, but lung cancer can impair the nerve that causes this movement. Lung cancer might be indicated by these changes in your voice. However, hoarseness or other changes in your voice are frequently linked to a variety of different disorders, including laryngitis. Make an appointment with your physician to have any changes in your voice evaluated.   

Number 4  

Symptom: Bronchitis, Pneumonia, or Emphysema  

Chronic bronchitis, pneumonia, or emphysema that doesn’t go away or returns might be an indication of lung cancer, and studies show that the two disorders are linked. If you experience bronchitis or pneumonia symptoms, such as a cough, shortness of breath, a mild fever, chills, or chest pain, contact your doctor as soon as possible for treatment.    

Number 5  

Symptom: Chest Pain  

If you feel chest discomfort, it might be a sign of a blockage in your lungs caused by tumors, swollen lymph nodes, or fluid accumulation. Keep track of if your chest discomfort gets worse when you inhale deeply, cough, or laugh. Keep an eye out for acute, dull, continuous, or intermittent pain. If you feel chest discomfort that grows worse when you breathe deeply, cough, or laugh, see your doctor.    

Number 6  

Symptom: Unexplained Weight Loss  

Have you recently lost weight for no apparent reason? Unexpected weight loss is one of the first indicators of cancer, especially lung cancer. This might be because cancer cells shift energy from meals away from regular metabolic activities and toward uncontrolled cell development.    

Number 7  

Symptom: Bone Pain  

Have you been suffering from unexplained aches and pains? It may be difficult to tell the difference between bone and muscular pain, but pay attention if your pain worsens when you move, sleep, or lie on your back. Shoulder, arm, and neck discomfort are less common symptoms of lung cancer. Metastasis into the bones, particularly the spine, pelvis, and upper bones of the arms and legs, can cause bone pain as a result of lung cancer.    

What Does NSCLC Feel Like When It Starts?  

Because there are no nerve endings in the lung or small nodules, masses seldom cause discomfort. Lung cancer symptoms vary depending on the tumor’s location and pace of spread, or metastasis, therefore there is no set period when they should develop. If you have lung cancer in its early stages, you may notice the following symptoms:  

• noticeable, continuous coughing  
• worsening of bronchitis  
• hemoptysis, which means coughing up blood or bloody mucus  
• weight loss  

While coughing and bronchitis might be irritating, the condition progresses to the point where other, more severe symptoms emerge, such as bone pains and headaches. These symptoms appear when cancer has moved to secondary places within the body away from the lungs, and they only produce discomfort when they impact a structure nearby, such as a growth in the ribs.   

Sources: 

https://lcfamerica.org  

https://www.yalemedicine.org 

https://www.roswellpark.org  

https://www.cancer.org  

https://www.cancer.net  

NSCLC Statistics 

There are approximately 541,000 lung cancer patients and survivors in the United States today, a majority of which were diagnosed in the last five years. 80 percent of lung cancer survivors are over the age of 60. Lung cancer is classified into two main types, small cell and non-small cell lung cancer (NSCLC). Small cell lung cancer is the less common type of lung cancer, but it spreads faster than NSCLC. Small cell cancer cells under a microscope appear small and round compared to non-small cell cancer cells. NSCLC accounts for 85 percent of all lung cancer cases in the United States. 

Lung cancer is the leading cause of cancer-related mortality, not only in the United States, but around the world. 1 in 4 cancer deaths are attributed to NSCLC in the United States. It Is important to note that survival rates depend on several factors such as the subtype of disease and stage at diagnosis.  

This guide contains statistics to help you better understand the incidence and survival rates of NSCLC. 

NSCLC In Numbers 

Lung cancer is more common in males than females. However, there are more female lung cancer patients currently than male lung cancer patients. The rate of lung cancer in the United States has steadily declined in the last four decades for men but increased drastically for women. This is thought to be due to a rapid increase of female smokers in the 1980’s.  

As far as racial disparity, the ethnic group most vulnerable to NSCLC is black men and women. This risk is roughly 30 percent higher than in white men. This contrasts with white men and women smoking more than black men and women, the biggest risk factor for lung cancer. 

It is believed that nearly 90 percent of NSCLC cases are caused by smoking. Smoking in men increases your risk by 23 times, compared to women smokers being 13 times more likely to develop NSCLC. Even if you do not smoke, secondhand smoke from those around you can increase one’s risk by 20 to 30 percent. Overall, the risk for lung cancer is 1 in 15. 

The second biggest risk factor for lung cancer is exposure to radon, accounting for around 10 percent of all cases. For most, this is an afterthought when considering lung cancer risk factors. 

There are 961 clinical trials actively recruiting lung cancer patients in the United States. 586 of which are specific to NSCLC. Clinical trials are research studies intended to evaluate the safety and effectiveness of new treatments for cancer types such as NSCLC. Massive Bio specializes in finding advanced clinical treatments for every NSCLC type. If you’ve been diagnosed with any of the following NSCLC subtypes, we’re here to help. If you don’t know which type of NSCLC you have, that’s okay. Additional testing can help you determine your exact diagnosis. 

NSCLC Survival Rates 

The overall survival rate over five years for lung cancer is 19 percent, one of the lowest among all cancer types. However, when the disease is caught and treated in early stages, the survival rate is over 50 percent. This makes awareness of early signs and symptoms in NSCLC crucial for detection in localized stages.  

Below are the five-year survival rates based on the stage of disease by Surveillance, Epidemiology, and End Results (SEER): 

• Localized (64 percent): The cancer is only located within the lung 
• Regional (37 percent): The cancer has spread to a nearby structure of lymph node 

• Distant (8 percent): Cancer has spread from the lung to distant parts of the body, typically in the liver, brain, or bone. 
• All SEER stages combined (26 percent) 

There are 8 million individuals with risk factors for lung cancer in the United States currently. Annual low-dose CT scan screenings can decrease mortality rate in lung cancer due to detecting the disease at early-stages.   

Sources: 

https://www.cancer.org 

https://www.cancer.net 

https://www.lung.org 

Non-Small Cell Lung Cancer Diagnosis

Non-small cell lung cancer (NSCLC) occurs when certain cells in the lungs begin to grow uncontrollably and form a malignant tumor. Doctors use several different tests to diagnose NSCLC. If your doctor suspects that you may have NSCLC, he or she will use one or more of the following tests to confirm the diagnosis. The test or tests a doctor uses to diagnose any form of cancer will depend on several factors, including the patient’s age and overall health, his or her signs and symptoms, the cancer suspected, and the results of other tests that may have been performed.

 

How Is NSCLC Diagnosed?

One of the first steps a doctor will take is to determine whether a tumor in a lung originated there or traveled to the lung from another site, which is called metastasis. Determining whether a lung tumor originated somewhere else in the body is important to know for treatment decisions. For example, breast cancer that has metastasized to the lungs is still referred to and treated as breast cancer, while a tumor that began in the lungs is treated as lung cancer.

 

To determine where a lung tumor originated, your doctor will consider your symptoms, medical history and risk factors, physical examination, the results of imaging tests, which may include one or more of the following:

 

Computed Tomography (CT or CAT) Scan

A CT scan is the product of multiple x-rays taken from different angles, which computer software turns into a single highly detailed 3-dimensional image. A CT scan can show doctors the size and location of a tumor in the lungs. In some cases, a patient will be injected with or asked to swallow a special dye (in pill or liquid form) called a contrast medium prior to undergoing a CT scan. This dye will help create a sharper, more detailed image.

 

Positron Emission Tomography (PET) Scan

The purpose of a PET scan is to show the functioning of organs and tissues in the body. Prior to undergoing a PET scan, a patient receives a small amount of harmless radioactive material, which enters the blood and is absorbed by cells that consume the most energy, including cancer cells. The patient is placed in a PET scanner, which produces real-time images of structures, as cancer cells appear brighter than other cells. A PET scan is often combined with a CT scan for the purpose of diagnosing lung cancer (known as a PET-CT scan).

 

Magnetic Resonance Imaging (MRI) Scan

Unlike a CT scan, an MRI uses magnetic fields to produce images of structures inside the body. Before having an MRI, a patient receives contrast medium (as an injection, tablet, or liquid), which helps produce a crisper image. Because MRIs are less desirable for creating images of moving organs, such as the breathing lungs, they are not often used to diagnose NSCLC, though they may be useful in locating lung cancer that has spread.

 

Bone Scan

Lung cancer can spread to other tissues, including bones, so in some cases doctors will perform bone scans. A harmless radioactive tracer is injected into the patient, which causes cancer that has metastasized to bones to “light up” on the scanner. Bone scans are not used as frequently today in diagnosing lung cancer, having been replaced in large part by PET scans.

 

Doctors may use other tests to diagnose NSCLC, including:

 

Biopsy

If imaging tests detect a suspicious mass that could be a tumor, a doctor will perform a biopsy to confirm the diagnosis. In a biopsy, a doctor removes a small sample of tissue (either with a needle or a scalpel), which is examined in a lab under a microscope to determine if it contains cancer cells. In the case of NSCLC, the biopsy sample will also be studied to determine the subtype of cancer, which can influence treatment decisions. This lab evaluation is performed by a pathologist, which is a doctor who specializes in diagnosing disease by performing tests on cells, tissues, and organs.

 

Bronchoscopy

This procedure not only allows a doctor to peer inside the lungs, but it can also be used to remove tissue for examination by a pathologist. A bronchoscope is a thin, flexible tube with a light on the end, which a doctor inserts through the patient’s mouth or nose, and is then guided to the main windpipe and lungs. The doctor uses a bronchoscope to look for suspicious masses and can remove samples of fluid or tissue. Lymph nodes may be examined, too. Bronchoscopy may be performed by a surgeon or a pulmonologist, which is a doctor who specializes in the diagnosis and treatment of lung disease. This procedure is often guided by ultrasound.

 

Other tests for NSCLC include:

 

Thoracentesis

Fluid can accumulate in the area between the lung and the wall of the chest, so a sample may be removed and checked for the presence of cancer cells. To do so, a doctor numbs the chest with anesthetic, then inserts a needle into the gap between the lung and the chest.

 

Thoracoscopy

A doctor may decide it’s necessary to examine the inside of a patient’s chest with this procedure. The patient first receives general anesthesia, the surgeon makes a small slit in the chest. Through this opening, a tube with a small video camera is inserted that allows the doctor to inspect the inside of the chest. Thoracoscopy may be used in a procedure called video-assisted thoracoscopic surgery, or VATS.

 

Mediastinoscopy

The purpose of this procedure is to examine and remove a sample of the lymph nodes in the middle of the chest. Mediastinoscopy is performed in an operating room, with the patient under general anesthesia. The surgeon makes a small incision at the top of the breastbone, then removes a sample of tissue from the lymph nodes.

 

Thoracotomy

Although not often used to diagnose lung cancer, this procedure may in some cases be necessary to remove a lung tumor completely. The patient is given general anesthesia, then a surgeon makes a cut between the ribs.

 

Biomarker Testing of the Tumor

Biomarkers are genes, proteins, and other molecules that are specific to an individual tumor. Your doctor may recommend biomarker testing of your tumor to determine if you are a candidate for certain treatment strategies. This form of testing is sometimes referred to as tumor molecular testing.

 

In lung cancer, certain genes may have mutations, or alterations, that can help the disease grow and spread. These mutations only occur in tumor cells and not in healthy cells. Because of this, they are not inherited or passed along to your children.

 

The results of these tests, as well as information about your stage of NSCLC, can help your doctor decide if you are a candidate for targeted treatments, which work by taking direct aim at particular mutations. Several targeted therapies for treating NSCLC have become available in recent years.

 

Sources: Cancer.net, Mayo Clinic, Yale Medicine

NSCLC Follow Up Care 

When active treatment is ended, care for those who have been diagnosed with non-small cell lung cancer (NSCLC) does not. Your medical team will keep an eye out for any side effects, handle any cancer recurrence, and evaluate your general health.  

Regular physicals, medical tests, or both may be a part of your follow-up treatment. In the coming months and years, doctors want to monitor your progress. 

A wide range of therapies, including physical therapy, career counseling, pain management, dietary planning, and/or emotional counseling, may be advised as part of cancer rehabilitation. Rehabilitation is to aid individuals in regaining control over a variety of elements of their life and maintaining as much independence as possible.  

Creating a Survivorship Care Plan 

A thorough plan provided to a patient after treatment is finished that includes advice for post-treatment care and a synopsis of the patient’s medical history. The strategy for cancer depends on the patient’s treatment history and the type of cancer they have. Schedules for physical examinations and medical testing to determine whether the cancer has returned or spread to other body areas may be part of a survivorship care plan. Getting follow-up care also aids in monitoring for health issues, such as new cancers, that might emerge months or years after treatment is finished. The patient’s emotional, social, legal, and financial requirements may also be taken into account in a survivorship care plan. It could also provide suggestions for a healthy lifestyle and referrals to professionals.   

Watching for Recurrence or Second Cancer 

Checking for a recurrence, which indicates that the cancer has returned, is one purpose of follow-up care. Small pockets of cancer cells in the body may go undiagnosed, leading to cancer recurrence. These cells may multiply over time to the point where they appear on test results or produce symptoms. A physician who is knowledgeable with your medical history can provide you with tailored information regarding your risk of recurrence during follow-up treatment. As part of routine follow-up care, some patients could have imaging or blood tests, but the best course of action depends on a number of variables, including the kind and stage of cancer that was first identified as well as the type of treatment used. 

Additionally, second lung development is more likely to occur in those with NSCLC. 

For the first two years following therapy, it is advised that the majority of patients who underwent effective treatment for stage I to stage III NSCLC undergo imaging scans every six months to look for a recurrence. A chest CT scan is the test of choice. People should get a low-dose chest CT scan once a year after the first two years. Blood tests, brain MRIs, or PET-CT scans with fluorodeoxyglucose (FDG) are not advised for regular cancer recurrence monitoring.   

Managing Long-Term and Late Side Effects 

The majority of individuals anticipate adverse effects from medical therapy. However, it frequently comes as a surprise to survivors that some adverse effects may persist after the course of therapy. We refer to these as long-term adverse effects. Late effects are additional negative effects that might appear months or even years later. Physical and emotional changes are examples of long-term and late consequences. 

Based on the kind of cancer you have, your unique treatment plan, and your general health, discuss with your doctor your likelihood of experiencing these side effects. You could have particular physical exams, scans, or blood tests to assist discover and manage late effects if your therapy was known to have them. 

Pain, exhaustion, and breathlessness are typical side effects of therapy. You can create a strategy to handle any issues that continue after therapy with the assistance of your doctor, nurse, and social worker. 

Additionally, heart disease, stroke, emphysema, and chronic bronchitis are all quite common in former smokers. These risks may be significantly elevated by some cancer therapies. Healthy lifestyle decisions made after cancer are crucial for general wellbeing, even for individuals who don’t smoke.   

Keeping Personal Health Records 

To create a unique follow-up care plan, you and your doctor should collaborate. Any worries you may have regarding your potential physical or mental health should be brought up.  

Discussing who will oversee your follow-up treatment with your doctor at this time is also a smart idea. Some cancer survivors visit their oncologist on a regular basis, while others switch back to their primary care physician or another healthcare provider. The kind and stage of the cancer, any side effects, the insurance company’s policies, and your personal preferences all play a role in this choice. 

Share your cancer treatment summary and survivorship care plan forms with them and any upcoming healthcare providers if a physician who was not directly involved in your cancer care will oversee your follow-up care. The medical personnel who will look after you will find information regarding your cancer treatment to be extremely helpful.  

Resources: 

www.cancer.net 

www.cancer.gov 

www.yalemedicine.org 

Gene Mutations in NSCLC 

Genes hold the instructions for making proteins needed for the healthy functioning and replication of every cell in your body. Mutations (also called variants) can occur in a gene and lead a cell to function abnormally. As this abnormal cell replicates, or divides, it passes mutations onto new cells. When these abnormal cells grow and spread uncontrollably, cancer can develop. 

Lung cancer patients who test positive for certain gene mutations often have a more aggressive and faster-spreading form of the disease than patients who don’t have those variants. There are two basic types of lung cancer, known as small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). NSCLC is by far the more common, representing 86 percent of all lung cancer cases. However, gene mutations can occur in both types of lung cancer.   

Types of Gene Mutations in NSCLC 

There are two main types of mutations that can occur in genes, germline and somatic. 

Germline mutations are hereditary, meaning that a person has no influence over whether they occur. In contrast, somatic mutations happen during one’s lifetime and can be caused by external factors, such as exposure to chemicals or toxins, as well as lifestyle choices, such as smoking. 

In NSCLC, mutations in the KRAS and BRAF genes are associated with smoking, while ROS1 and ALK gene mutations are seen more often in younger cancer patients with no history of smoking. Several other gene mutations have also been linked to NSCLC. Drugs designed to target these mutations have been developed—some are approved by the U.S. Food and Drug Administration (FDA), while others are being investigated in clinical trials.   

EGFR 

Epidermal growth factor receptor (EGFR) is a protein present on the surface of cells that helps them grow and divide. Mutations in the EGFR gene, which produces this protein, cause it to remain turned “on” all the time and overproduce cells, leading to tumor growth. EGFR gene mutations are linked to pancreatic cancer, head and neck cancers, and lung cancer. About 23 percent of NSCLC tumors have the EGFR mutation present. 

Thanks to drug development in clinical trials, the FDA has approved medications such as gefitinib (Iressa) and erlotinib (Tarceva) that interfere with tumor growth by binding to the EFGR-1 receptor to prevent it from working, leading to the death of cancer cells.   

TP53 

The TP53 gene is responsible for producing a protein called tumor protein 53, whose role is to stop tumors from forming by repairing damaged DNA and preventing cells with mutations that could cause cancer from dividing. TP53 gene mutations have been linked to many different types of cancer, including NSCLC. The TP53 gene mutation is the most common one associated with lung cancer and is present in about half of all NSCLC cases. There are currently no approved targeted therapies for TP53-positive NSCLC.   

KRAS 

KRAS is a gene that makes proteins involved in cell signaling pathways that facilitate the growth and maturation of cells. Mutations in KRAS and similar genes (called oncogenes) can cause normal cells to become malignant and form tumors. KRAS mutations occur in several cancers, including colorectal cancer, pancreatic cancer, and lung cancer. Almost a third of patients with NSCLC have a KRAS gene mutation present, which is particularly common in smokers, who often have a poor prognosis. However, patients who test positive for this gene mutation may be candidates for therapies that target KRAS, such as FDA-approved sotorasib (Lumakras) and drugs being studied in clinical trials.    

MET 

The MET gene makes a protein that sends signals within cells that play an important role in their growth and survival. Mutated forms of the MET gene can cause abnormal cells to grow uncontrollably and spread throughout the body. MET gene mutations are found in patients with liver, head and neck, and lung cancers. 

A particular error in MET, called exon 14 skipping, has the most impact on lung cancer therapy. Normally, when the MET protein is no longer needed, a protein called CBL helps break it down so it can be removed from the cell. However, when there is a mistake in a section of MET’s code that causes a segment known as exon 14 to be missing, CBL can’t interact with the MET protein. As a result, the MET protein remains longer and sends growth signals that can promote cancer. About 5 percent of lung cancer patients have MET exon 14 skipping present and are often treated with drugs such as capmatinib (Tabrecta) and tepotinib (Tepmetko).   

ALK 

The ALK (anaplastic lymphoma kinase) gene plays a role in human development, specifically in the formation of the gut and nervous system. Normally, this gene turns “off” while a fetus is still in the womb. However, ALK can be turned back “on” during a person’s lifespan and fuse with other genes, especially one called EML4. ALK gene fusion can cause cancer. ALK was originally discovered in cases of lymphoma, but most tumors that are ALK-positive cancer are NSCLC. Each year, roughly 72,000 patients around the world are diagnosed with ALK-positive lung cancer, which is the cancer type with the highest occurrence of ALK fusions and mutations, followed by lymphoma. ALK-positive NSCLC is often treated with lorlatinib (Lorbrena).  

ROS1 

Like many other genes linked to cancer, ROS1 carries the instructions for making a protein that is involved in signaling within cells that promotes growth. And as with the ALK gene, ROS1 can fuse with other genes and promote cancer. ROS1 fusions are linked to several malignancies, including NSCLC. In lung cancer, ROS1 most commonly fuses with the CD74 gene. Cancer patients with these fusions are said to be ROS1-positive. Roughly 1 to 2 percent of NSCLC patients have ROS1 fusions (also called rearrangements) and are often treated with crizotinib (Xalkori) or entrectinib (Rozlytrek).   

BRAF 

The BRAF gene carries the code for making a protein that helps regulate many functions, including how a cell grows, develops specialized roles, moves about, and self-destructs when it’s no longer needed. Many forms of cancer have been linked to BRAF mutations. That includes about 3 to 4 percent of patients with NSCLC. BRAF-positive NSCLC is typically treated with one of two FDA approved drugs, dabrafenib (Tafinlar) and trametinib (Mekinist).   

How Are Gene Mutations Diagnosed in NSCLC? 

To determine if your lung cancer is positive for any of the above biomarkers, a doctor will use one or more of the following tests: 

• FISH analysis: examines tissue under a microscope to detect changes in chromosomes  
• Immunohistochemistry: looks for specific proteins in abnormal cells under a microscope  
• Next-generation sequencing (or comprehensive biomarker testing): tissue from a patient’s tumor (obtained from a biopsy) is placed in a machine that scans many genes for mutations at one time 

Testing positive for a gene mutation associated with NSCLC may mean you’re a candidate for approved targeted therapies or treatments under investigation in clinical trials.  

  

Sources: American Lung Association, National Cancer Institute, National Library of Medicine  

Risk Factors and Prevention of Non-Small Cell Lung Cancer 

A risk factor is anything that increases the likelihood of developing a disease. Some risk factors are non-modifiable, such as family history, race, and age. Other risk factors are considered modifiable, such as diet and alcohol consumption. While investigators continue to study how and why malignancies form in the airways, non-small cell lung cancer (NSCLC) and other forms of lung cancer occur most often in current or past smokers, though non-smokers may develop lung cancer, too. Researchers have identified other risk factors for NSCLC, as well.    

What Are the Risk Factors for Non-Small Cell Lung Cancer? 

The most common risk factor for NSCLC is well known, but some less-obvious influences can also increase the likelihood of developing this form of lung cancer.    

• Smoking: Smoking tobacco harms lung cells, which may result in changes that can cause cancer. People who smoke are 15 to 30 times more likely to develop lung cancer or die of the disease than nonsmokers, according to the Centers for Disease Control and Prevention (CDC). Smoking marijuana and using electronic cigarettes (“e-cigarettes”) may also increase the risk of lung cancer, though more research is needed.  
• Secondhand smoke: Inhaling smoke from someone else’s cigarette, cigar, or pipe also damages the lungs and increases the risk of NSCLC.  
• Radon exposure: Radon—an odorless gas given off by rock, soil, and water—is the second-leading cause of lung cancer. Radon can leak into buildings, where it fills the air and is inhaled. Tests are available to determine whether radon is present in your home or workplace.  
• Asbestos exposure: Asbestos is found in nature, but it’s also sometimes used to make fireproof insulation in building materials. Certain manufacturing jobs also involve exposure to asbestos. Breathing asbestos fibers irritates the lungs and appears to increase the risk for cancer. People who work with asbestos have an increased risk of developing NSCLC, so they should wear protective respiratory equipment while on the job. 
• Exposure to other cancer-causing agents in the workplace: Toxic gases and chemicals such as diesel exhaust, arsenic, nickel, and chromium can pollute the air in a workplace and increase the risk of cancer.  
• Radiation: If you have received radiation therapy to the chest for any reason, you may have an increased risk of NSCLC. 
• Genetics: Your risk for NSCLC appears to be increased if a close family member had the disease, even if neither of you ever smoked. That suggests to researchers that certain inherited gene changes may be associated with NSCLC. 

Can I Prevent Non-Small Cell Lung Cancer? 

The single most effective way to lower your risk for NSCLC is to avoid smoking and the use of other tobacco products. Between 80 to 90 percent of lung cancer deaths are associated with cigarette smoking, according to the CDC. If you currently smoke, stopping will reduce your risk for lung cancer. Testing your home for the presence of radon and using respiratory protection when exposed to air pollution and noxious fumes makes sense, too.  

Sources: American Society for Clinical Oncologists, Centers for Disease Control and Prevention, Johns Hopkins Medicine, Lung Cancer  

Non-Small Cell Lung Cancer Treatment Options 

Non-small cell lung cancer (NSCLC) accounts for 80 to 85 percent of lung cancers. As with many types of cancer, NSCLC responds best to treatment and is more likely to be cured when detected early. Treatment options vary according to a variety of factors, including the stage of the disease, the patient’s overall health, and, in some cases, his or her genetic profile. Early-stage NSCLC may only require surgery, though in some cases that may mean removing a portion of or an entire lung, a high-risk procedure with a challenging recovery. For more advanced malignancies, chemotherapy, radiation therapy, and other treatments are usually necessary. This guide describes the various treatment options for NSCLC.  

How Is Non-Small Cell Lung Cancer Treated? 

When NSCLC is diagnosed early, doctors may want to remove the tumor from the body primarily by surgical intervention. Radiation therapy, chemotherapy, immunotherapy, and targeted therapies are other methods used to treat NSCLC.   

Surgery 

Surgery is often the primary treatment for early-stage cancer that has not spread to other parts of the body. Here are the various surgical procedures used to treat NSCLC:  

• Lobectomy: Your two lungs are made up of five lobes (three in the right lung, two in the left lung). In a lobectomy, a lobe containing a tumor is removed. 
• A wedge resection: If lobectomy isn’t an option, a surgeon may perform a wedge section, in which only the tumor and some surrounding tissue is removed. 
• Segmentectomy: Similar to a wedge resection, but in a segmentectomy a greater portion of lung tissue is removed, as well as lymph nodes, in some cases.  
• Pneumonectomy: In this procedure, a surgeon removes the entire lung.   

Radiation Therapy 

This form of treatment uses high doses of radiation to kill cancer cells. Radiation therapy (also known as radiotherapy) has several different potential roles in the management of NSCLC, including:  

• Treating tumors that can’t be removed with surgery, usually in combination with chemotherapy. 

• Prior to surgery, to shrink a tumor and make it easier to remove. 
• After surgery (sometimes with chemotherapy), to destroy any remaining cancer cells.  
• Treating malignancies that have spread to the brain, bone, or certain other parts of the body. 
• For symptom relief when cancer has advanced and causes pain and other problems.   

The most common form of this treatment is external beam radiation, in which a machine applies rays of energy from outside the body. Radiation therapy is directed at cancer cells, but can also damage healthy cells and cause side effects, which is why it is preferred for small tumors that have not spread to other parts of the body.   

Chemotherapy 

Chemotherapy drugs are used alone or in combination to stop cancer cells from growing and spreading. Most “chemo” drugs for NSCLC are infused directly into the bloodstream in a clinic, though some are available in pill form. Because they travel through the blood, these medicines can affect healthy cells, so various side effects may occur during the treatment process. These side effects usually disappear when treatment ends.   

Some common forms of chemotherapy used to treat lung cancer include:  

• Carboplatin  
• Cisplatin  
• Docetaxel  
• Etoposide 
• Gemcitabine 
• Paclitaxel   
• Pemetrexed  
• Vinorelbine  

Targeted Therapy 

As with many malignancies, NSCLC appears to have various “triggers” that cause cells to grow uncontrollably and form tumors. Researchers have identified several gene mutations that trigger abnormal production of proteins that can set this process in motion and result in cancer, including NSCLC. Targeted therapies focus on these genes and the proteins they produce to stop cancer cells from growing. Because it focuses on specific proteins, targeted therapy may be less likely to damage healthy cells and cause side effects. In recent years, many targeted therapies have been approved for treating NSCLC, usually in advanced stages. Genetic tests can determine if you’re a candidate for a targeted therapy.    

Immunotherapy 

This treatment method strengthens the immune system, the body’s natural defense network, which helps it fight cancer. Immunotherapy drugs may be given alone or in combinations of several medications. Immunotherapy may also be combined with chemotherapy. Immunotherapy treatments often have milder side effects than chemotherapy drugs.   

The FDA has approved the following forms of immunotherapy for treating NSCLC:  

• Atezolizumab (Tecentriq)
• Durvalumab (Imfinzi) 
• Cemiplimab-rwlc (Libtayo) 
• Nivolumab (Opdivo) 
• Pembrolizumab (Keytruda) 
• Ipilimumab (Yervoy) 

Sources: American Cancer Society, American Society of Clinical Oncologists, National Cancer Institute 

Questions To Ask About Non-Small Cell Lung Cancer 

Non-small cell lung cancer (NSCLC) is one of the two major forms of lung cancer. The other is called small cell lung cancer (SCLC). NSCLC is far more common, accounting for 80 to 85 percent of all lung cancer cases. As the name suggests, lung cancer begins in the lungs, two large organs in the chest that take in oxygen and exhale carbon dioxide. NSCLC and SCLC differ in several ways, including how the cells look under a microscope, the regions of the lungs where they tend to originate, and how they are treated. Importantly, NSCLC also grows and spreads more slowly than SCLC.  

If you recently learned that you have NSCLC, here are some questions to discuss with your doctor about this form of cancer and what to expect from treatment.  

Questions To Ask After Getting Diagnosed  

Why did I develop NSCLC? 

The most common cause of NSCLC is smoking cigarettes and other tobacco products, including cigars and pipe tobacco. Exposure to secondhand smoke—fumes from someone else’s cigarette and exhaled smoke—also increases the risk for NSCLC.   

I don’t smoke. Why did I get NSCLC? 

Despite the close link between lung cancer and smoking, a significant portion of cases occurs in people who don’t light up: Around the world, 15 to 20 percent of men and over half of women with lung cancer are nonsmokers. NSCLC is almost always the form of lung cancer diagnosed in nonsmokers. Besides smoking, chronic exposure to certain other substances, such as asbestos in building materials and radon (an odorless gas found in nature that can leak into buildings), have also been linked to lung cancer. Genetics seem to play a role, too. If you have close family members who have had NSCLC, your risk for the disease is increased.   

How serious is my NSCLC? 

A cancerous tumor becomes more dangerous as it grows and spreads to other body parts. Some forms of cancer spread slowly, while others spread more rapidly, making them a more significant threat. To find out how serious your NSCLC is, your doctor will conduct various tests to measure the size of your tumor, determine whether it has spread and to where, and gather other information. In addition to a physical exam and blood tests, your doctor will likely order an imaging test, such as magnetic resonance imaging (MRI), computed tomography (CT), or positron emission tomography (PET) scan. Other tests may include a biopsy, in which a small tissue sample is removed from the tumor and studied in a lab. Doctors use this information in a process called staging, which describes the extent of a patient’s cancer. Stages of NSCLC are generally expressed in roman numerals, from I to IV. Higher numbers indicate more severe cancer. Doctors use staging to decide which treatments to recommend.   

Questions To Ask About Choosing a Treatment and Managing Side Effects 

What’s the best treatment choice for me? 

There are different treatment options available for patients with NSCLC. Your doctor will consider several factors when discussing which plan is best for you, including: 

• Your age and overall health 
• The stage of your cancer 
• How likely a treatment is to help manage or cure your cancer 
• Your personal preferences

How can I avoid or reduce side effects? 

Virtually any effective treatment is likely to cause side effects. Any ill effects you may experience will depend on the treatment you receive. Common side effects of the various treatments offered to patients with NSCLC include fatigue, gastrointestinal problems such as nausea and vomiting, and hair loss. Ask your doctor what side effects you may develop and report any you experience. Your doctor may be able to prescribe medication that can help ease your discomfort. The good news is that side effects usually go away when treatment is completed.  

Questions To Ask About Having Surgery  

Will surgery cure my cancer? 

Surgery is a treatment option for patients with early-stage NSCLC confined to the lung and has not spread to other parts of the body. Surgical removal of a tumor can cure some patients with NSCLC. However, 30 to 55 percent of patients experience a return or recurrence of NSLC and die of the disease. That’s probably because surgeons leave behind microscopic cancer cells that were not visible, or the procedure causes some malignant cells to separate from the tumor and remain in the body, where they replicate and spread again.   

What happens during surgery for NSCLC? 

The type of surgery your doctor performs will depend on several factors, including the size and location of the tumor. Doctors use one of two surgical methods: 1) thoracotomy, in which a surgeon makes an incision in the chest and uses a special instrument to separate the rib cage, which provides access to the lungs, or 2) minimally invasive surgery, which requires one or more small incisions in the chest, which the surgeon uses to insert a camera to visualize the lungs and small instruments for removing tissue. The four procedures for surgically removing lung tumors include:  

• Lobectomy: Your two lungs comprise five lobes (three in the right lung and two in the left lung). In a lobectomy, a lobe containing a tumor is removed. 
• A wedge resection: If lobectomy isn’t an option, a surgeon may perform a wedge section, in which only the tumor and some surrounding tissue are removed. 
• Segmentectomy: Similar to wedge resection, but in a segmentectomy, a more significant portion of lung tissue is removed, as well as lymph nodes in some cases.
•  Pneumonectomy: In this procedure, a surgeon removes the entire lung.

Questions To Ask About Having Chemotherapy, Targeted Therapy, or Immunotherapy 

Will chemotherapy cause me to lose my hair? 

About two-thirds of cancer patients who undergo chemotherapy lose some or all their hair. That can include hair on your scalp and other body parts. Hair loss occurs as chemotherapy damages hair-growing cells. Not all chemotherapy drugs induce hair loss, though some treatments may only cause hair thinning. It’s natural to find this side effect of treatment to be upsetting. Wigs, hats, and scarves may help people feel less self-conscious about hair loss, but keep in mind that it’s only temporary and hair regrowth usually begins shortly after treatment ends.   

What is targeted therapy for NSCLC? 

The human body has about 30,000 genes, which carry the instructions for making proteins that build tissue and keep our bodies functioning. Errors in those instructions, known as mutations or variants, can cause cells to behave abnormally and result in cancer, including NSCLC. Targeted therapies focus on these mutated genes and the proteins they produce to stop cancer cells from growing. Because it focuses on specific proteins, targeted therapy may be less likely to damage healthy cells and cause side effects. In recent years, many targeted therapies have been approved for treating NSCLC, usually in advanced stages. Genetic testing can determine if you’re a candidate for targeted therapy.  

What is immunotherapy for NSCLC? 

Your body has a built-in defense network, the immune system, which guards against disease. However, cancer is often able to overwhelm natural immunity and grow uncontrollably. Immunotherapy is a treatment approach designed to bolster the immune system and help it fight cancer. Immunotherapy drugs may be given alone or in combinations of several medications. Immunotherapy may also be combined with chemotherapy. Immunotherapy treatments may have milder side effects than chemotherapy drugs. The U.S. Food and Drug Administration (FDA) has approved about a half dozen immunotherapy treatments for treating NSCLC.  

Questions To Ask About Radiation Therapy  

Will radiation therapy cure my NSCLC? 

Radiation therapy uses highly focused beams of energy to kill cancer cells. In some patients who can’t undergo surgery, radiation therapy is often paired with chemotherapy (a combination sometimes called chemoradiation) to treat tumors. In some cases, chemoradiation results in a cure. Radiation may also be used before surgery to shrink a tumor and make it easier to remove.  

Questions To Ask About Planning Follow-up Care  

What kind of follow-up care will I need after treatment for NSCLC? 

You will continue to have scheduled check-ups with your oncologist and cancer-care team after treatment ends so they can monitor you in case your cancer returns. In addition to physical exams, your doctor will use blood tests and medical imaging scans to screen for a recurrence. The American Society of Clinical Oncologists (ASCO) recommends that patients who underwent successful treatment for stage I to stage III NSCLC should have some form of medical imaging scan every six months for the first two years after treatment. ASCO recommends a chest CT scan as the preferred imaging test. After two years, patients can revert to a less-frequent schedule and receive a low-dose chest CT scan once a year.  

Questions To Ask About Clinical Trials  

What are clinical trials? 

Clinical trials are research studies that evaluate experimental treatments for cancer and other diseases. Patients can volunteer to participate in clinical trials, in which they may receive a therapy that improves symptoms and possibly even cures their disease. If a treatment proves safe and effective in clinical trials, it may be approved for wide use by the U.S. Food and Drug Administration and regulators in other countries.   

Are there any clinical trials for people with NSCLC? 

There are currently hundreds of clinical trials for people with NSCLC, recruiting patient volunteers or in the planning stages. Massive Bio specializes in matching patients with clinical trials of new treatments for all forms of lung cancer. If you’ve been diagnosed with any form of lung cancer and want to discover the latest treatments, we’re here to help. If you don’t know which type of lung cancer you have, that’s okay. Additional testing can help you determine your exact diagnosis.  

Sources: American Cancer Society, American Society of Clinical Oncology, Center for Disease Control and Prevention, Missouri Medicine, National Cancer Institute, National Foundation for Cancer Research, Pharmacy Times, Translational Lung Cancer Research 

Non-Small Cell Lung Cancer Clinical Trials 

Lung cancer starts in the lungs, but may spread to other parts of the body. There are two primary types: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). About 80 to 85 percent of lung cancers are NSCLC. The main subtypes of NSCLC are adenocarcinoma, large cell carcinoma, and squamous cell carcinoma. The treatment and prognosis for NSCLC will depend on the stage of cancer at diagnosis, the patient’s age, and other factors. There are several treatment options for patients with NSCLC, including clinical trials that evaluate new therapies. This article includes information about participating in clinical trials for NSCLC treatments.  

How Is NSCLC Treated? 

Common treatments for NSCLC include: 

• Surgery 
• Radiation therapy 
• Chemotherapy 
• Targeted therapy 
• Immunotherapy 

Some drugs approved by the U.S. Food and Drug Administration for treating NSCLC include the following; 

• Atezolizumab (Tecentriq), cemiplimab (Libtayo), durvalumab (Imfinzi), nivolumab (Opdivo), and pembrolizumab (Keytruda), which are immune checkpoint inhibitors. 
• Ceritinib (Zykadia), crizotinib (Xalkori), alectinib (Alecensa), brigatinib (Alunbrig), and lorlatinib (Lorbrena), which are anaplastic lymphoma kinase (ALK) inhibitors. 
• Drugs that target cancer cells with EGFR mutations that are approved for the treatment NSCLC include afatinib (Gilotrif), dacomitinib (Vizimpro), erlotinib (Tarceva), gefitinib (Iressa), osimertinib (Tagrisso). 
• A combination of the drugs dabrafenib (Tafinlar), which targets a specific mutation in the BRAF gene, and trametinib (Mekinist), which targets a protein called MEK, is approved for the treatment of certain patients with NSCLC. 

The Latest Research on NSCLC 

Researchers are exploring new medicines and techniques for treating NSCLC. They include:  

• Personalized drug therapy 
• Targeted therapy 
• Immunotherapy 
• Improved surgical and radiation techniques 

These and other cutting-edge interventions are being studied in clinical trials. Additionally, scientists are developing new methods for detecting and monitoring NSCLC, as well as searching for ways to minimize symptoms and treatment side effects in patients.  

What Are Clinical Trials? 

A clinical trial is a research study in which scientists test the safety and effectiveness of new drugs and other forms of medicine in humans. The goal of a clinical trial is to improve existing treatment methods for a disease. A clinical trial may compare the safety and benefits of an experimental therapy with standard treatment for a disease. In some trials, combinations of drugs may be tested to determine if they are more effective than a single drug.  

How Can I Find a Clinical Trial? 

According to the U.S. National Library of Medicine, more than 1700 clinical trials of new treatments for NSCLC are underway around the world or have recently been completed. If you have NSCLC and you’re interested in participating in a clinical trial, Massive Bio can help you find the study that’s right for you with our SYNERGY-AI Clinical Trial Matching System. This artificial intelligence (AI)-powered platform searches multiple clinical trials to produce personalized matches based on more than 170 clinical algorithms to find the best treatment for you. 

How Can I Enroll in a Clinical Trial? 

Using the personalized matches produced by our platform, you and your doctor can determine which clinical trial is right for you, based on the type and stage of your cancer, your personal preferences and priorities, and other factors. Before you agree to participate in a clinical trial, contact your insurance company to find out if the cost of treatment will be covered or whether the pharmaceutical company sponsoring the trial will help cover your expenses. 

Sources: Clinicaltrials.gov, Nature, and Cancer.net