There are new treatments for lung cancer

There are new treatments. Many clinical trials are going on, seemingly all the time. Go to clinicaltrials.gov for updates. Remember that there are MANY different types of lung cancer, however, and not all treatments work with each type. There are promising new immunotherapy treatments, there are effective targeted treatments for specific DNA mutations, etc. Some of these have been observed to cause full remission, even with relatively advanced cancers.
But in general, in each of aspect has its own new ones: 

Surgery: Doctors now use video-assisted thoracic surgery (VATS) to treat some small lung tumors. It lets doctors remove parts of the lung through smaller incisions, which can result in shorter hospital stays and less pain for patients. Doctors are now studying whether it can be used for larger lung tumors.

In a newer approach to this type of operation, the doctor sits at a specially designed control panel inside the operating room to maneuver long surgical instruments using robotic arms. This approach, known as robotic-assisted surgery, is now being tested in some larger cancer centers.

Real-time tumor imaging: Researchers are looking to use new imaging techniques, such as four-dimensional computed tomography (4DCT), to help improve treatment. In this technique, the CT machine scans the chest continuously for about 30 seconds. It shows where the tumor is in relation to other structures as a person breathes, as opposed to just giving a ‘snapshot’ of a point in time, like a standard CT does.

4DCT can be used to determine exactly where the tumor is during each part of the breathing cycle, which can help doctors deliver radiation to a tumor more precisely. This technique might also be used to help show if a tumor is attached to or invading important structures in the chest, which could help doctors determine if a patient might be eligible for surgery.

Chemotherapy: New combinations: Many clinical trials are looking at newer combinations of chemotherapy drugs to determine which are the safest and most effective. This is especially important in patients who are older and have other health problems. Doctors are also studying better ways to combine chemotherapy with radiation therapy and other treatments.

Lab tests to help predict if chemo will be helpful: Doctors know that adjuvant chemotherapy after surgery may be more helpful for some people with early (stage I or II) cancers than for others, but figuring out which patients to give it to is not easy. In early studies, newer lab tests that look at patterns of certain genes in the cancer cells have shown promise in telling which people might benefit most. Larger studies of these tests are now trying to confirm their usefulness.

Other lab tests may help predict whether a lung cancer will respond to particular chemo drugs. For example, studies have found that tumors with high levels of the ERCC1 protein are less likely to respond to chemo that includes cisplatin or carboplatin, while tumors with high levels of the RRM1 protein seem less likely to respond to chemo with gemcitabine. Doctors are now looking to see if tests for these markers can help guide the choice of treatment, so these are not a part of standard treatment.

Maintenance chemotherapy: For people with advanced lung cancers who can tolerate chemotherapy, combinations of 2 chemo drugs (sometimes along with a targeted drug) are typically given for about 4 to 6 cycles. Some recent studies have found that with cancers that have not progressed, continuing treatment beyond the 4 to 6 cycles with a single chemo drug such as pemetrexed or a targeted drug such as erlotinib may help some people live longer. This is known as maintenance therapy. A possible downside to this continued treatment is that people may not get a break from having side effects from chemotherapy. Some doctors now recommend maintenance therapy, while others await further research on this topic.

Targeted therapiesResearchers are learning more about the inner workings of lung cancer cells that control their growth and spread. This is being used to develop new targeted therapies. Some of these treatments, such as bevacizumab (Avastin), erlotinib (Tarceva), cetuximab (Erbitux), and crizotinib (Xalkori) are already being used to treat non-small cell lung cancer. Others are now being tested in clinical trials to see if they can help people with advanced lung cancer live longer or relieve their symptoms.

Other targeted drugs being studied include ganetespib, custirsen, and dacomitinib. Some targeted drugs already approved for use against other types of cancer, such as sorafenib (Nexavar) and sunitinib (Sutent), are also being tested for use against NSCLC.

Researchers are also working on lab tests to help predict which patients might be helped by which drugs. Studies have found that some patients do not benefit from certain targeted therapies, whereas others are more likely to have their tumors shrink. For example, a test can find changes in the EGFR gene that make it much more likely that a person’s lung cancer will respond to treatment with erlotinib (Tarceva), an EGFR inhibitor. Similar gene tests for other treatments are now being studied. Predicting who might benefit could save some people from trying treatments that are unlikely to work for them and would probably cause unneeded side effects.

Immune treatments: Researchers are hoping to develop drugs that can help the body’s immune system fight the cancer.

Drugs that block PD-1 and PD-L1: Cancer cells may use natural pathways in the body to help avoid detection and destruction by the immune system. For example, they often have a protein called PD-L1 on their surface that helps them evade the immune system. New drugs that block the PD-L1 protein, or the corresponding PD-1 protein on immune cells called T cells, can help the immune system recognize the cancer cells and attack them.

Nivolumab (Opdivo) and pembrolizumab (Keytruda) are anti-PD-1 drugs that have been shown to shrink or slow the growth of some tumors. They are now approved for use in advanced NSCLC, and are typically used after certain other treatments have been tried.

Other, similar drugs such as atezolizumab (MPDL3280A) and MEDI4736 might also shrink some lung cancer tumors. Larger studies of these new drugs are now being done.

Vaccines: Several types of vaccines for boosting the body’s immune response against lung cancer cells are being tested in clinical trials. Unlike vaccines against infections like measles or mumps, these vaccines are designed to help treat, not prevent, lung cancer. These types of treatments seem to have very limited side effects, so they might be useful in people who can’t tolerate other treatments.

Some vaccines are made up of lung cancer cells that have been grown in the lab, or even of cell components, such as parts of proteins commonly found on cancer cells. For example, the MUC1 protein is found on some lung cancer cells. A vaccine called TG4010 causes the immune system to react against that protein. A recent study compared combining the vaccine with chemotherapy to treatment with the same chemotherapy alone in patients with advanced lung cancer. The cancers in the group that got the vaccine were more likely to shrink or stop growing than the cancers in the group that just got chemo. More studies are planned to see if the vaccine will actually help patients live longer.

L-BLP25 (tecemotide) is another vaccine that targets the MUC1 protein. It is made up of the protein (MUC1) encased in a fat droplet (liposome) to try to make it more effective. A small study of patients with advanced NSCLC suggested it might improve survival time, although recent results from a larger study did not find it helped people live longer. This vaccine is now being studied for patients with stage III disease after treatment with chemotherapy and radiation, in efforts to improve the cure rate.

However, if you need any additional help online from people who have fought or are fighting cancer kindly visit the web page or Facebook page of an NGO named Yoddhas. They provide online support for Cancer Patients.