Researchers continue to look at new ways to combine, schedule, and sequence the use of chemotherapy, surgery, and radiation to treat lung cancer.
New Treatment Combinations
For instance, in one large study, patients with non-small cell lung cancer that had spread to nearby tissues or lymph nodes took radiation and chemotherapy at the same time instead of sequentially. Their five-year survival rates rose from about 6 percent to 16 percent.
Another study compared treatments given to two groups of people with small cell lung cancer. One group had chemotherapy plus two daily radiation treatments. The other had chemotherapy with only one daily radiation treatment.
Researchers found that the group receiving two daily radiation treatments with their chemotherapy had better survival rates.
Various combinations of the new drugs with traditional agents, such as cisplatin and carboplatin, are now either in clinical trials or have reported early results of the trials.
Other researchers are working to develop drugs called "molecularly targeted agents" which kill cancer cells by targeting key molecules involved in cancer cell growth. One of these drugs, called Avastin, helped patients live a few months longer when it was combined with traditional chemotherapy.
New Ways to Schedule and Deliver Therapies
New ways to schedule and deliver radiation therapy are under study, too. In conformal radiotherapy, doctors try to assess the tumor in 3 dimensions and focus the beam of radiation directly on the area of the tumor.
With brachytherapy doctors can deliver radiation directly to the tumor using radioactive pellets that are inserted into the site of the tumor.
These two techniques -- conformal radiotherapy and brachytherapy -- have the advantage of reducing damage to surrounding tissue.
Detecting Lung Cancer Earlier
Researchers are constantly trying to come up with new ways to find and diagnose lung cancer in order to catch it and treat it in its earliest stages. The chest x-ray was one of the most common tools used to test for lung cancer. However, less than a third of lung cancer cases detected by chest x-ray were found early enough to be cured.
Because the benefits of chest x-ray were uncertain, in the summer of 2002, the National Cancer Institute launched a trial called the National Lung Screening Trial, or NLST, to determine if spiral CT was better than conventional x-ray at finding dangerous lung cancers and distinguishing between cancers and non-cancerous changes in the lungs, and ultimately, whether detecting these changes actually saves lives.
The initial results of the NLST, which was the only randomized clinical trial in the U.S. looking at this issue, came out in October 2010 and showed conclusively that spiral CT reduced the risk of dying by 20 percent compared to those who received a chest x-ray among heavy smokers. These results will be analyzed carefully over the next several years for cost effectiveness and other factors but currently only apply to current and former heavy smokers. It is not yet known if spiral CT will be an effective tool for detecting lung cancer in light or non-smokers.
There are also clinical trials under way to find out how well some substances can work to prevent an additional, secondary form of cancer in patients who have had early-stage lung cancer.
An aerosol spray to deliver drugs directly to the lungs and a vaccine for nicotine addiction are among the treatments researchers are studying. Common use of these treatments may be years away, however.
In December 2005, the National Cancer Institute and the National Human Genome Research Institute, both part of the National Institutes of Health, launched a project called The Cancer Genome Atlas (TCGA). The goal of TCGA is to increase our understanding of changes in genes that can lead to cancer. The project announced that lung cancer would be one of the first three cancers that would be studied. The overall goal of this project is to improve our ability to diagnose, treat, and prevent cancer.