Advances in molecular diagnosis and target treatments mean the future is getting brighter in lung cancer.
- Molecular diagnosis and the development of target drugs are achieving lower toxicity, improving prognoses and making the disease chronic.
- Every year, about 25,000 new cases of lung cancer are detected in Spain. At present, life expectancy is 15% 5 years after diagnosis.
- Proton therapy is a new technique allowing the tumor to be attacked by administering higher doses of radiotherapy and causing less damage to the surrounding tissue.
Today, in Madrid, the I International Congress ‘The Future of Lung Cancer: a step forward’, organized by MD Anderson Cancer Center Madrid and The University of Texas MD Anderson Cancer Center Houston, is gathering top investigators, medical oncologists and radiotherapists, pneumologists, thoracic surgeons and pathologists specializing in lung cancer.
Lung cancer is currently the main cause of death by cancer in the world, with life expectancy at 15% 5 years after its detection. In Spain about 25,000 new cases are detected every year, of which more than half already have metastasis when diagnosed.
For that reason, the I International Congress ‘The Future of Lung Cancer: a step forward’ analyzes the latest advances in diagnosis and treatment with the aim of projecting a much more optimistic future for patients. “Nowadays, the development of new techniques and the multidisciplinary interaction of the various clinical fields allow us to obtain better and better results. So, at this forum, we have brought together all those involved in the treatment of lung cancer to offer a integral program on the present and the future of diagnostic and therapeutic methods for this cancer’, explains Dr Jose Miguel Sanchez Torres, medical oncologist at MD Anderson Cancer Center Madrid and joint director of the program with Dr Natalia Carballo, head of the Radiation Oncology Service at the center.
In particular, specialists at the congress will look at the different molecular characteristics and prognostic factors of the two main histological types of non-small-cell lung cancer (adenocarcinoma and epidermoid) as key factors in the choice of treatment. Other aspects dealt with at the meeting are the importance of molecular analysis in choosing the most suitable treatment and the personalization and adaptation of therapies to the specific characteristics of the disease.
Although stopping smoking is still the best way to reduce mortality rates in lung cancer, specialists look to molecular diagnosis (EGFR, ALK, Kras, MET, ROS1,… mutations), in addition to conventional histological diagnosis, as an advanced alternative providing target treatment that gives better results and, therefore, a longer life expectancy.
“Until now, histological diagnosis allowed us to choose a chemotherapy treatment on the basis of limited information, so on occasions, the disease did not respond to the therapy. However, with a molecular study of the tumor, we can go further and identify determined mutations, which are those that do not respond to generic chemotherapy treatment”, explains Dr Carballo.
Meanwhile, more and more directed drugs are being developed to fight these targets, giving patients better results in terms of effectiveness and lower toxicity. “A further advantage is that most of the drugs can be administered orally avoiding the need for intravenous administration and reduces the number of visits to the hospital”, adds Dr Sanchez Torres.
As examples of this we have a subgroup of patients with lung adenocarcinoma, who are carriers of a mutation in the receptor gene of the epidermal growth factor (EGFR), for whom there are drugs capable of blocking the mutation and, consequently, of inhibiting the growth of the tumor. Another known alteration is in the ALK gene, for which there are also directed agents. “Through these treatments we have been able to change the natural history of this disease, improving its prognosis and making it chronic”, states the MD Anderson Cancer Center Madrid specialist.
Furthermore, another of the talks dealt with the individualization of treatments for lung cancer. In that regard, Dr Sanchez Torres points out that personalization of therapies is vital and must be based on the study of genetic profiles: “the analysis of biomarkers in tumor tissue provides information on which drugs are more suited and more effective for each patient. We are not dealing with a single disease, but different pathologies, each with a series of distinct predominant molecular alterations towards which treatment is directed,” adds the doctor.
Another talk analyzes the survival rate for non-squamous cell carcinoma, about which Dr Sanchez Torres status that “the analysis of prognostic markers in tumor tissue could identify the potential of the disease to invade other tissue and, as a consequence, determine in which patients more aggressive treatments must be used”. To confirm the importance of these prognostic markers, the intention is to carry out a joint prospective study between thoracic surgeons and oncologists in Spain and the United States.
Proton Radiotherapy: an emerging technique
“When a patient presents an inoperable tumor in the lung, radiotherapy treatment is prescribed. We know the chances of that tumor being cured depend on the dose of radiotherapy administered, but, unfortunately, the doses these tumors can be given are not high enough, as the surrounding tissue would be irreversibly damaged”, Dr Natalia Carballo points out.
With that in mind, the I International Congress ‘The Future of Lung Cancer: a step forward’ looks at the benefits and projection of the emerging proton radiotherapy, in the talk given by Dr Daniel Gomez, of the Radiation Oncology Service at The University of Texas MD Anderson Cancer Center Houston.
Proton therapy is a new technique that attacks the tumor using the proton particle with great physical advantages over the conventional treatment particle (photon), as this allows the administration of higher doses without causing so much damage to the surrounding tissue. “In spite of its use being restricted and limited due to the high cost of installation, it is currently considered an emerging technique for the treatment of specific cases of lung cancer”, points out Dr Carballo.
About MD Anderson Cancer Center Madrid
MD Anderson Cancer Center Madrid is an affiliate of the prestigious MD Anderson Cancer Center in Houston (Texas, USA). After more than eleven years’ in our country, MD Anderson Cancer Center Madrid enjoys modern facilities with over 150 specialist physicians trained in oncology, a total of 87 beds and vanguard technology for the diagnosis and treatment of the different types of cancer.
Its extensive infrastructure, together with on-going, close collaboration with the MD Anderson Houston center on research and diagnostics and treatment protocols with the work of a multidisciplinary team of specialists, make MD Anderson Cancer Center Madrid one of the leading hospitals in Europe in cancer treatment.