The medical community has made significant progress in understanding that lung cancer is not a single cancer, and are treating it accordingly. We’ve stopped carpet bombing the body and have started using targeted weaponry to assassinate some forms of cancer. As a result, some patients are alive now, over a decade after being diagnosed with metastatic lung disease.
We can credit much of that progress to research into three specific mutations that drive distinctive forms of lung cancer. Instead of treating patients with these different mutations the same, we now give them individualized treatments that work differently based on their cancer’s mutation.
If you or someone you know is diagnosed with non-small cell lung cancer (NSCLC), there are three major subtypes the cancer should be tested for:
- ALK positive. A change in the cancer’s ALK gene allows the cancer cell to grow uncontrollably, but several drugs on the market have shown incredible responses and durations of disease control for patients. Even patients’ whose cancer has spread to the brain are now living years, not just weeks.
- ROS1 positive. A change in the cancer’s ROS1 gene, which is similar to the ALK gene, makes cancer cells grow and divide. Only one to two percent of lung cancer patients have it but with one highly effective drug on the market and several others being explored in clinical trials, even rare subtypes of cancers are focusing the attention of scientists, physicians, and the pharmaceutical industry alike.
- EGFR mutant. This was the first molecular marker that really showed a test done on lung cancer could predict who would respond to a specific targeted treatment. Now, our increased understanding of how the cancer can later evolve to grow in the presence of the first generation drugs has led to the development of next generation therapies which can regain cancer control in nearly 60% of cases, giving patients a second lease on life.
It is hard to overstate the awesomeness of these breakthroughs.
Around the world, a diagnosis of lung cancer leads to more cancer-related deaths than those from breast cancer, colorectal cancer, prostate cancer, and pancreas cancer combined. Yet for a growing number of distinct molecular subtypes of this disease, even advanced lung cancer can now be a controllable disease. Beyond the three subtypes described above, many other different mutations and genetic changes which could allow lung cancer therapy to be personalized are receiving testing in clinical trials. Most recently, the advent of immunotherapy – using drugs to stimulate the body’s own immune system to attack the lung cancer – has also shown promise, and how these two areas – personalized medicine and immunotherapy - will overlap and interact represent some of the major research directions for the future.
So, this is great news, right? Oncologists throughout the country are testing their patients’ tumors, and people are living longing and better than they could have ever imagined, yes?
Despite all of this great news, many NSCLC patients do not get their tumors tested for ALK, ROS1, or EGFR mutations. Improving these numbers falls to the patients or their caregivers to educate themselves and advocate for molecular testing.
Fortunately, organizations like the Global Resource for Advancing Cancer Education (GRACE) exist solely to help patients become shared decision makers when it comes to their cancer care.
GRACE is working with the University of Colorado Cancer Center in Aurora to hold a patient event on Aug. 20th for those living with ALK, ROS1, or EGFR mutant lung cancers. The organizers have already solicited questions in advance from patients in the internet lung cancer community.
The Targeted Therapies in Lung Cancer Patient Forum is open to patients and their caregivers. Renowned lung cancer experts from around the U.S. will present, and patients who are living with lung cancer will serve as moderators of the discussions that take place between the doctors and the audience.
The morning sessions will help attendees understand their mutation, learn of open clinical trials, and hear about treatment options;.all to help patients develop their plans A, B, C, and D. The afternoon will focus on survivorship in all its aspects, from finances to sex, to diet, to exercise – how to live life to the fullest with lung cancer.
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