‘Thanks’ for progress on lung cancer, but more is needed

By European Alliance for Personalised Medicine (EAPM) Executive Director Denis Horgan

Tomorrow (the fourth Thursday in November, 26 November) is the Thanksgiving holiday in the United States as citizens show their appreciation for a good harvest and for having food on the table.

But it seems that the very first Thanksgiving was actually celebrated on 21 February 1621 (rather than in the autumn, as it is today) when a group of starving pilgrims were saved at the last minute by the arrival of a ship - The Lyon - which had sailed from Ireland loaded with food.

It appears from local records that the wife of one of the brethren was the daughter of a Dublin merchant. The latter chartered the vessel, filled it with provisions and sent it to Plymouth. So, it looks as though the Irish, as well as subsequent annual harvests, are to be thanked for the holiday.

Thanksgiving will also be celebrated by American expatriates living in Brussels, and many other places of course, and the European Alliance for Personalised Medicine (EAPM) would like to give its own ‘thanks’ for new developments that are helping to tackle lung cancer - the leading cause of cancer deaths in the US. At the same time, the Alliance looks forward to further developments in the future.

And there’s some good news for patients in America as, yesterday, the US Food and Drug Administration approved a new treatement in combination with two forms of chemotherapy to treat patients with advanced (metastatic) squamous non-small cell lung cancer (NSCLC) who have not previously received medication specifically for treating their advanced lung cancer.

On the other hand, small cell lung cancer (SCLC) is a fast-growing type of cancer and spreads more quickly than the non-small cell version. It is the most common type and is divided into two types, named for the kinds of cells found – squamous cell and non-squamous cell (which includes adenocarcinoma).

Lung cancer is the biggest global killer of all cancers. Fewer than half of newly diagnosed sufferers live beyond a year, with only 16% surviving for five years.

It is such a huge killer partly because it is harder to detect in its early stages. By the time a person begins to notice symptoms, it has often spread to other parts of the body and is, therefore, difficult to treat.

In the US alone, there were an estimated 221,200 new diagnoses and 158,040 deaths in 2015 from the disease.

Back in Europe, earlier this month EAPM launched a White Paper aimed at tackling unnecessary deaths caused by lung cancer, alongside calls to promote greater access to innovative treatment and more efficient organisation of research.

The Alliance believes that lung cancer patients urgently need action at the highest level. Therefore, the document is a direct appeal to EU and member state policymakers, legislators and regulators.

The majority of lung cancers in both sexes are caused by smoking, but about 15% are not, and the majority of those non-smokers are women, mostly young women.

Lung cancer in women has increased by a staggering 600% over the past 30 years. Today, more are killed each year by lung cancer than they are by breast, ovarian and uterine cancer combined.

Various theories have been posited for this (estrogen as a tumour promoter, is one example) but, put simply, scientists are just not sure. The paper adds: “It is clear that physicians need more effective ways to detect and target these cancers.”

EAPM Secretary Gordon McVie said this week: “More effort is needed in prevention. Public awareness of the disease and the risk factors should be developed, particularly among younger people, women and front-line healthcare professionals.”

“When it comes to smoking, prevention offers the greatest opportunity to fight lung cancer, because smoking is still responsible for four-out-of-every-five lung cancer deaths,” he added.

With the increased knowledge of the human genome, physicians can analyse a patient’s genetic make-up —with careful consideration to the tumour cells, which can be unique — and target subsequent therapy to treat the individual patient and the individual tumour.

Personalised medicine allows scientists to investigate a tumour and try to identify genes to predict for drug sensitivity, or genes that may possibly predict patients who will do better and need no further treatment, or those who might benefit from further treatment.  

Professor McVie said: “In the future, more and more treatment decisions will be based upon the molecular characteristics of an individual tumour. More research could lead to identifying lung cancer earlier, which would increase the cure rates immensely.”

And that would certainly be a great cause for celebration - this and every Thanksgiving.

Lung Cancer - Smoking’s Undisputed Biggest Killer

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