Small cell lung cancer (SCLC) and Non-small cell lung cancer (NSCLC) are two broad categories of lung cancer. NSCLC is the most common type which is accountable for more than 80% of the total lung cancer cases.
Lung cancer can be classified into two categories, SCLC and NSCLC
Lung cancer is one of the most common cancer and leading cause of cancer related death worldwide. Lung cancer is further classified into two broad types "Small cell lung cancer (SCLC) and Non-small cell lung cancer (NSCLC)". NSCLC is most common form of lung cancer, accounting for 80-85% of all lung cancer. Due to delay in diagnosis of lung cancer at an early stage, approximately more than 50-60% of the lung cancer patients have metastatic disease (cancer has spread to other body parts) at the time of diagnosis.
When asked about advancements in lung cancer, Dr Priya Tiwari, Senior Consultant - Medical Oncology at Artemis Hospitals (Gurugram), says- "The prognosis and survival of metastatic NSCLC has improved in the last decade because of advancements in diagnosis and discovery of newer & effective therapies. Discovery of targetable therapies against epidermal growth factor receptors (EGFR) and anaplastic lymphoma kinase (ALK) has significantly changed the treatment landscape for lung cancer. With these newer targetable therapies, known as EGFR tyrosine kinase inhibitors (TKI) and ALK inhibitors, we can prolong the survival of the patient and the side effects of these TKIs can be easily managed and are comparatively less serious to the conventional chemotherapy. Other advantage of the targeted therapies is that they can be administered orally which reduces the requirements of hospitalization when compared with chemotherapy."
Senior Consultant – Medical Oncology at Artemis Hospitals (Gurugram)
Highlighting the increasing role of immunotherapies, Dr Amol Dongre, Senior Consultant - Medical Oncology at Alexis Multi-Speciality Hospital (Nagpur), says "The discovery of molecules targeting cytotoxic T lymphocyte antigen-4 (CTLA-4) and programmed death-1 receptor (PD-1) has provided us new hope in lung cancer management. These are called Immune checkpoint inhibitors or immunotherapies and they use our own immune system to recognize and destroy cancer cells. Immune checkpoints are part of our immune system that prevent our immune responses from being too strong. Sometimes the cancer cells use these checkpoints to escape from being recognized and killed by our immune system. Immune checkpoint inhibitors target such cancer cells and are our new hope for management of lung cancer. Immune checkpoint inhibitors are also relatively more safe as compared to the conventional chemotherapy."
Senior Consultant – Medical Oncology at Alexis Multi-Speciality Hospital (Nagpur)
After the discovery of driver mutations (driver for cancer development) in NSCLC, molecular testing has played an important role in individualization of treatment for NSCLC. Dr Pradip Kumar Mondal, Consultant - Medical Oncology at Narayana Superspeciality Hospital (Howrah), said "The discovery of ROS1, BRAF, MET, RET, HER2, and KRAS has led to development of potential targeted therapies against these receptors. In future, we will have multiple drugs available which will target specific mutations and help better manage a patient's treatment for better quality of life and survival. As compared to NSCLC, Small cell lung cancer (SCLC) have very limited availability of targeted therapies. However, immunotherapy could be a game changer for the management of SCLC, though at present strong clinical evidences and experience is still lacking."
Consultant – Medical Oncology at Narayana Superspeciality Hospital (Howrah)
The landscape of management of lung cancer has significantly changed over the last decade and the new era is of personalized medicine. Based on patient's genetic & molecular biology and histological profile, patients can now be treated with newer targeted therapies & immunotherapies, targeting specific mutations and boosting our immune response to cancer, and with reduced side effect compared to chemotherapy.
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