EXCLUSIVE: Therapy in Lung Cancer: The new advancements you need to know about

According to WHO, cancer is a leading cause of death worldwide, accounting for nearly 10 million deaths in 2020. Lung cancer is at the highest with 1.80 million deaths and 2.21 million new cases. In India, approximately 72,510 new lung cancer cases are reported each year and 66,279 deaths. According to GLOBOCAN 2020, a project led by the International Agency for Research on Cancer (IARC), lung cancer is the fourth amongst all other cancers on the list with a 5.5 percent.
Though women are more prone to cancer than men, number of cases related to lung cancer is more in men, making it second amongst the other cancers. The lung cancer condition has lesser chances of survival as compared to other cancers and the lung cancer cases are more in men due to smoking and tobacco consumption. In the last few years, the cases of lung cancer are also increasing in non-smokers due to the rise in air pollution. Breathing is now injurious to health.

Lung cancer can be of two types: Small cell lung cancer and non-small cell lung cancer.

Small cell cancer is usually found in non-smokers, and it metastasizes faster than the non-small cell. Small cell tumours are inoperable and pose a great risk to lives. Non-small cell lung cancer can affect both smokers and non-smokers alike. Non-small lung cancer accounts for 85 per cent of the cases. If there are any of the symptoms like persistent cold, lingering cough, accompanied by sputum or blood and signs of breathlessness call for the doctor’s attention and most importantly — the affected patient’s attention. But these conditions are often attributed to changing weather, prompting home remedies or over-the-counter antibiotics. This delays the visit to a doctor, thereby reducing the chances of timely detection and initiating treatment.

There are many advanced treatments available for lung cancer and research related to therapy has progressed at a very rapid pace in unravelling the molecular complexity of lung cancer. This has improved our understanding of managing lung cancer patients more effectively. This has also allowed medical science to develop different tests and targeted treatments for each type of lung cancer to derive better outcomes.

Listed below are some major developments in treatment options:
Immunotherapy, also called biologic therapy is a type of cancer treatment that boosts the body's natural defences to fight cancer. The therapy has resulted in a dramatic change in cancer management. Immune checkpoint inhibitors are one example of drugs that may release the brakes on the body’s immune system, so they can destroy cancer cells. Once the immune system is able to find and respond to cancer, it may be able to slow cancer growth or even stop. The expansion of immunotherapy continues to grow new insights into how and when these new treatments work best.

Liquid Biopsy, also known as fluid biopsy or fluid phase biopsy, is the sampling and analysis of non-solid biological tissue, primarily blood. It is a revolutionary technique that helps find cancer at an early stage to find out how well treatment is working. Multiple blood samples over a period of time may also help doctors understand what kind of molecular changes are taking place in a tumour.

Artificial Intelligence (AI) is the simulation of human intelligence processes by machines. The new study conducted by the Institute of Cancer Research, London, shows that AI can recognise patterns that are beyond the limit of the human eye. Such therapies will develop in future for lung cancer taking the help of these advances. This shows new avenues of treatment among those who have stopped responding to standard hormone therapies.

Multiparametric-magnetic resonance imaging (mp-MRI) and Fluorescence lifetime imaging (FLI): These imaging process helps detect lung and other cancers. The scan tells the doctor if the patient has proteins that are helping the cancer cells grow which in turn helps decide the best treatment for the patient.

With a multitude of cancer treatments breakthroughs, along with technological platforms and new approaches to cancer prevention such as screening and imaging, we can hope to achieve better patient outcomes.  
As part of the Sustainable Development Goals, India is committed to achieving a one-third reduction in cancer-related deaths by 2030. There are many initiatives and programmes by the Government such as Ayushman Bharat, Swasthya Bharat, Swachh Bharat Abhiyan, Poshan Abhiyaan, Pradhan Mantri Bhartiya Janaushadhi Pariyojana and FSSAI’s new labelling and display regulations and drug price control can encourage inter-sectoral and multi-sectoral action, to unload the burden of cancer from the country. Also, there are other initiatives such as National Health Policy, the National Tobacco Control Programme, and the National Programme for Prevention and Control of Cancer etc., paving the way for progress.

Further, the cancer burden in the country can be reduced by making universal health coverage, health education, treatment compliance, and early detection centres at the community level.

About the author: Dr. Kshitij Joshi - Director and Consultant Medical Oncologist, Mumbai Oncocare Centre

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