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Ways We’re Making Progress in Approaching Lung Cancer

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Ways We’re Making Progress in Approaching Lung Cancer

June 13th, 2012 - by Susan C. Mantel

http://blog.lungevity.org/2012/06/13/wa ... ng-cancer/

With a week’s distance to reflect on my sixth American Society of Clinical Oncology (ASCO) meeting, I am struck by three major areas of change from the first one I attended back in 2005.

First of all, there are a LOT more people attending lung cancer-relevant sessions, and there is a LOT more lung cancer research progress being presented and discussed. For someone working in what was once the neglected stepchild of the cancer world, this is hugely exciting—we need as many brilliant minds working on solutions for this challenging disease as possible.

Second, there has been real progress in understanding the range of cancers that originate in the lung. We talk about them as “lung cancer” for convenient short-hand, but it’s really a pretty broad range. We have known for years that the cells of the major histological subtypes look different under a microscope and that they differ in how well or poorly they respond to therapy—I’m thinking adenocarcinoma vs. small cell, for example. Now we know that even within those subtypes, there are different changes to the DNA of the cells that cause the development of a cancer in the lung, like EGFR or ALK mutations for adenocarcinoma. A couple of particularly exciting presentations in this area were on the molecular characterization of squamous cell lung cancer, which has had few advances in the past couple of decades.

Importantly, some of the squamous cell mutations that were identified are “druggable”, so we can hope to DO something with that new knowledge. In fact, numerous drugs are being developed through clinical trials to target the specific changes in cancer cells, hopefully adding to existing advances like Tarceva and Xalkori. Since lung cancer is such a wily foe, follow-on or combination treatment with those is often needed, and that too is being studied and developed. One of the notable areas with a surge of activity is immunotherapy, with some exciting early results in NSCLC patients who had previously been treated with other therapies. Research is vital for moving all of these areas forward.

That increase in understanding seems to apply to how we treat specific patient populations too, like the elderly or those with early stage lung cancer. Both of these groups have potentially been “undertreated” in the past, with therapies scaled back due to age, instead of health status, and some early stage patients who theoretically were cured relapsing repeatedly. Based on the studies presented last week, it looks like personalized medicine may be practiced in more and more ways.

The third area that struck me was the proactive approach to managing costs and quality that ASCO members were discussing. We all know the environment has changed, and while politicians posture and battle over legislating change, those on the front lines seem to be coming up with their own solutions. This includes everything from integrating non-physician healthcare providers more heavily into collaborative teams, to more rigorous assessment of evidence-based care.

I find all of these changes visible at ASCO encouraging. The medical community is actively engaged in transforming care for our lung cancer community on multiple levels. I didn’t see any home runs this year, but there seemed to be a lot of base hits. As any baseball fan knows, you can score that way too.

Join our Ask the Experts webinar on June 28th to learn more about the advances in lung cancer treatment presented at ASCO 2012 or download the podcast later if you can’t join live.

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