Lung Cancer Overview

The leading cancer killer in both men and women in the U.S., lung cancer claimed an estimated 158,040 Americans in 2015, according to the American Lung Association. However, as science and technology continue to advance, major medical innovations may lead to a decline in this number in 2016.

Much of the recent progress can be attributed to developments in areas of new targeted therapies and early detection methods. This push toward early discovery of malignance has additionally led to a greater awareness about lung cancer screening options.


Enhanced screening options have prompted the American Lung Association to launch the LUNG FORCE initiative. This program is working to not only change the way people view lung cancer, but also to raise awareness and, in turn, prompt innovations in research that will lead to earlier detection and more personalized treatment.

The LUNG FORCE initiative plans to invest $10 million in lung cancer research and $5 million in increasing public health promotion, including awareness of early detection tools such as low-dose computed tomograophy (CT) screening. It also intends to provide patients with information about clinical trials and biomarker testing, as well as to advocate for increasing federal funding for lung cancer research, from its current $213 million to $300 million by 2020.

Increased Screening Availability

Annual low-dose CT screenings can help identify lung cancer at early stages, when it is easier to treat. Although these scans are currently reserved for patients who meet certain criteria, the National Cancer Institute affirms through its “Evidence of Benefit Associated With Screening” study that screening patients aged 55 to 74 who have cigarette smoking histories of 30 or more pack-years and who, if they are former smokers, have quit within the last 15 years, reduces lung cancer mortality by 20% and all-cause mortality by 6.7%.

“This study demonstrated a significant reduction in both lung cancer death and all-cause mortality in the screened population,” said David M. Waterhouse, MD, MPH, chair of the Department of Clinical Research at Oncology Hematology Care, Inc. “The US Preventive Task Force now recommends lung cancer screening. In 2016, we anticipate more institutions adopting and executing screening protocols for their at-risk populations.”

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CMS announced in February 2015 that it would offer the benefit of screening for lung cancer with low-dose CT to approximately 5 million American older adults ages 55 to 77 at no cost. This coverage includes a visit for counseling and shared decision-making on the benefits and risks of lung cancer screening.

This insurance coverage, in combination with most private insurance plans now being required to cover screenings for high-risk patients, can truly work to progress early detection, leading to more lives saved.

New Immunotherapy Drugs

The approval of seven new lung cancer drugs contributed to the advancement of cancer detection and treatment in 2015. Immunotherapy medications are included in this mix, and they work by inducing, enhancing or suppressing an immune response to fight the cancer. According to the Bonnie J. Addario Lung Cancer Foundation, drugs approved by the FDA in 2015 were:

  • Nivolumab (Opdivo), to treat squamous non-small cell lung cancer (NSCLC)
  • Gefitinib (Iressa), to treat patients with metastatic NSCLC and tumor mutations
  • Pembrolizumab (Keytruda), for patients with advanced, metastatic NSCLC whose disease has progressed after other treatments (chemotherapy or targeted therapy) and whose tumors express the protein PDL1
  • Nivolumab (Opdivo), for the treatment of both squamous and nonsquamous NSCLC
  • Osimertinib (Tagrisso), for patients whose disease has progressed on EGFR-targeted therapies
  • Necitumumab (Portrazza), for the treatment of advanced, metastatic squamous NSCLC patients who have not been previously treated for their advanced lung cancer
  • Alectinib (Alecensa), for patients with anaplastic lymphoma kinase (ALK)-rearranged metastatic NSCLC who have progressed on or are intolerant to crizotinib (Xalkori)

“Targeted therapies are part of the standard of treatment for NSCLC, the most common lung cancer type in the US,” explained Rabih Bechara MD, FCCP, division director of pulmonary, interventional and critical care medicine at Cancer Treatment Centers of America at Southeastern Regional Medical Center in Atlanta. “There are several types of treatments, such as vaccines, antibodies and cell-based immunotherapies, that work in different ways with the immune system against cancer cells. In lung cancer, PD-L1 (programmed cell death ligand) and PD-1 (programmed cell death) pathways have emerged as promising treatment options for patients with advanced NSCLC.”

Proton Therapy

Another new method of treatment for lung cancer is proton therapy, a particularly beneficial measure for patients who need concurrent chemotherapy, have had prior radiation, or have limited or poor pulmonary function. This advanced form of radiation therapy destroys cancer cells by preventing them from dividing and growing, but unlike standard x-ray radiation, it uses protons-positively charged, subatomic particles.

The proton beam then delivers its radiation to the site of the tumor and stops there, incurring no “exit dose.” This reduces damage to the healthy tissues and organs near the tumor, and potentially allows patients to receive higher, more effective doses of radiation but with low risk of side effects from treatment.

“In most lung cancer cases, the cancer can be close to the patient’s heart, spinal cord, healthy lung, and other vital organs. The unique properties of proton therapy allow it to precisely target lung tumors while avoiding those healthy, functioning organs,” explained Henry Tsai, MD, a radiation oncologist at ProCure Proton Therapy Center in Somerset, NJ. “With proton radiation, we’re seeing patients who are experiencing less side effects and a better quality of life through treatment-being able to work and participate in normal day-to-day activities.”

Lindsey Nolen is a staff writer. Contact:

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