About Lung Cancer

Lung cancer is a disease of uncontrolled cell growth in tissues of the lung. This growth may lead to metastasis, which is the invasion of adjacent tissue and infiltration beyond the lungs. The vast majority of primary lung cancers are carcinomas of the lung, derived from epithelial cells. Lung cancer, the most common cause of cancer-related death in men and also the most common in women, is responsible for 1.3 million deaths worldwide annually. The most common symptoms are shortness of breath, coughing (including coughing up blood), and weight loss.

For information on diagnosis, staging and treatment of non-small cell and small cell lung cancer visit the Bonnie J. Addario Lung Cancer Foundation.

There are two main forms of lung cancer: small cell and non-small cell. The two types of lung cancer are distinguished by the way cells look and the way the cancer spreads through the body. It is important to distinguish non-small cell from small cell because the two types of cancer are treated in different ways.

Non-small cell lung cancer (NSCLC) is the most common form of lung cancer, accounting for approximately 80% of all cases. Within NSCLC, there are three major sub-types based on the histopathologic nature of the cancer:

Epidermoid or squamous carcinoma: generally arises in one of the large breathing tubes known as the bronchi and tends to grow relatively slowly.

Adenocarcinoma: generally arises near the outside surface of the lung and can vary in size and how fast it grows. Bronchioloalveolar carcinoma, or BAC, is a type of adenocarcioma that is generally considered to be resistant to chemotherapy. It presents two to six percent of all lung cancers and typically forms a line of smaller, consecutive masses.

Large cell carcinoma: may appear in any part of the lung and tends to grow and spread more quickly.

Small cell lung cancer(SCLC) is clinically and biologically distinct from NSCLC. It is considered an aggressive form on lung cancer as it is fast-growing and tends to spread though the body early in the course of the disease. SCLC account for 10% to 15% of all lung cancers.

For information on diagnosis, staging and treatment of non-small cell and small cell lung cancer visit the Bonnie J. Addario Lung Cancer Foundation.

Because of the historically poor outcomes of lung cancer patients, suboptimal therapeutic efficacy, and significant side effects of chemotherapy, and the need to choose more efficacious treatment regimens, and patients most likely to benefit from them, there is a need to predict a priori whether an individual patient’s tumor will respond to a particular therapeutic agent. However, virtually all lung cancer tumor samples available today are from resection specimens so direct, intra-patient molecular-clinical therapy correlations are impossible. In other words, a given resected patient may have been cured without the intervention or because of it – it is impossible to tell. In addition, since the major target of systemic therapy, including adjuvant therapy, is the metastatic lesion, the lack of biospecimens from patients with advanced disease is a major hurdle to advancing the state of the art in applying individual tumor characteristics to the real-world management of patients.

Patients with more advanced disease, those who are determined to be medically inoperable, and patients whose cancer recurs after surgery as well as patients with SCLC, are treated with chemotherapeutic agents, radiotherapy, or a chemotherapy and radiotherapy combination. Only a minority of tumors show objective clinical responses to chemotherapy: the best platinum-based regimens can induce a clinical response in about 30 to 40% of tumors, while gefitinib or erlotinib, low-toxicity tyrosine kinase inhibitors induce an objective response in about 10% of cases.

Specific molecular features of tumors, particularly EGFR mutations and EML4-ALK fusions, have been shown in multiple studies to have prognostic importance and/or be associated with benefit from specific interventions. Other candidate biomarkers are under study that could be of great clinical significance. In spite of this knowledge, only a tiny minority of patients with lung cancer, especially advanced stage lung cancer, are having these molecular assessments performed.

In response to this widely-acknowledged and systematic barrier to progress against lung cancer, the Addario Lung Cancer Medical Institute (ALCMI) has developed and launched targeted, multi-institutional tissue and data repositories. ALCMI is already helping to revolutionize the current standard of care for lung cancer patients through its inaugural collaborative research project termed CASTLE. The purpose of this clinical trial is to facilitate application of the known biomarkers to patients presenting today, and to establish such a collection of biospecimens that will be useful for discovering and validating new biomarkers for future use.

“Prior to the formation of ALCMI, less than 20% of diagnosed lung cancer patients were benefiting from molecular testing. Hopefully this is the beginning of personalized medicine for lung cancer patients.”

– Robert O. Dillman, M.D.,F.A.C.P. Executive Medical and Scientific Director, Hoag Cancer Institute

Over 450 people die each day of lung cancer in the U.S. – that is 19 people an hour.

Lung Cancer is the #1 cancer killer. Lung Cancer kills more people than breast, prostate, colon, liver, melanoma, and kidney cancers combined.

In 1971, the National Cancer Act declared the War on Cancer. At that time, the overall 5-year survival rate for lung cancer was 13.6%. In 2008, the estimated 5-year survival rate was 15%.

Despite being the #1 cancer killer, the NIH only spent $281m on lung cancer in 2010 compared to $1.349billion on breast, prostate, colon, melanoma, and kidney cancers. (NCI Office of Budget and Finance)