Lung cancer: Limited progress in 2012; future could be brighter

December 30, 2012 | by Tami Dennis

When assessing the treatment advances made against lung cancer in 2012, the term “banner year” does not spring to mind. That doesn’t mean the battle has been lost – far from it.

 

The outcomes for lung cancer are much better when the disease is spotted early. For that, we need more screening, expert says. The outcomes for lung cancer are much better when the disease is spotted early. For that, we need more screening, expert says.

 

City of Hope researchers are currently investigating new, more powerful ways of treating lung cancer, and a new genetic test shows promise in helping physicians predict survival of patients diagnosed with early-stage lung cancer. What the relatively slow progress against lung cancer does mean, however, is that early screening is paramount.

Lung cancer expert Dr. Dan Raz, assistant professor in the Department of Surgery at City of Hope, maintains that early screening has merits from the high-risk individual’s standpoint – and from a health economics standpoint. He uses a recent article from the journal Health Affairs to back his claims.

In that study, researchers at the consulting firm Millman and at Rush Medical Center at Rush University concluded:  “Although lung cancer screening is not established as a public health practice, recent data show that such screening reduces lung cancer mortality. In our investigation of lung cancer screening as a commercial insurance benefit in the high-risk U.S. population ages 50–64, we found that both the cost of screening and the cost per life-year saved compared favorably with published rates for other cancer screenings.”

To Raz, the conclusion is frustratingly clear. “The health economics of lung cancer screening shows that it is cost-effective -- in fact more cost-effective than mammography to prevent death from breast cancer,” he says. “The cost to an insurance company to cover lung cancer screening is also significantly less expensive than mammography.”

But though targeting of high-risk populations (older, former smokers) is one way of combating lung cancer, it’s not the only way.  We also must learn more about lung cancer overall.

Lung cancer expert Karen Reckamp, M.D., associate professor in the Department of Medical Oncology & Therapeutics Research, says that, in California, many people with lung cancer have never smoked.

Such non-smoking-related cases are harder to find in a population in which a higher percentage of people use cigarettes -- but here, they stand out. Those patients’ experiences, and their individual tumors, speak volumes about potential new ways to combat lung cancer, she says.

“We see a different type of patient here and are able to target their therapy better based on the biology of their tumor,” she says.

Such targeted therapy includes developing medications to combat resistance to treatment, as well as creating drugs for hard-to-treat cancers.

In the meantime, physicians have their work cut out for them. Some are even using electricity – via a device called the NanoKnife – to combat tumors that don’t respond to chemotherapy or radiation. Others are developing additional drug approaches.

As for the genetic test that shows promise in predicting survival, Raz has  called it an "important first step" for patients with early-stage lung cancer. The test, which has been acquired by Life Technologies, could ultimately be used by physicians to tailor therapy to the individual more effectively.

Earlier screening, genetic tests, more targeted therapies, more knowledge about lung cancer in general… Perhaps 2013 will look considerably different.

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