Lung cancer

Cancer research is a long and careful process. It often takes many years for tests and treatments that researchers are studying to be ready for use in people with cancer.

Most research starts in a lab (laboratory) where researchers will test ideas, procedures or treatments in cells or animals. If lab researchers find promising ways to treat, manage or prevent cancer, these need to be tested in people (called clinical research). All research is an important part of learning and improving cancer care, even if it’s not studied in people.

As research is done, the results are published in scientific or medical journals and presented at conferences around the world – adding to our collective knowledge of cancer. Doctors use what they learn from research studies to offer the most effective treatments and screening methods for cancer.

We are always learning more about cancer. The following is some promising research in lung cancer.

Some drugs target specific molecules (such as proteins) on cancer cells or inside them. These molecules help send signals that tell cells to grow or divide. By targeting these molecules, the drugs stop the growth and spread of cancer cells and limit harm to normal cells.

An antibody drug conjugate (ADC) combines a chemotherapy drug with a monoclonal antibody. ADCs can recognize if there is too much (an overexpression) of an antigen on the surface of cancer cells. ADCs only release the drug once inside the cancer cells, destroying the cancer cells while minimizing toxicity in the body.

Researchers are looking at making ADCs that can target receptors found in lung cancer cells, such as epidermal growth factor receptor 2 (EGFR-2), human epidermal growth factor receptor 3 (HER-3) and trophoblast cell surface antigen 2.

Immunotherapy helps strengthen or restore the immune system’s ability to find and destroy cancer cells.

Bispecific antibodies are a new type of immunotherapy designed to attach to 2 different targets: an immune cell and a cancer cell. Bispecific antibodies bring the 2 cells together to help the bodyʼs immune system attack the lung cancer cells.

Bispecific antibodies have been approved in Canada for other types of cancer, such as multiple myeloma. Clinical trials have shown that bispecific antibodies improved survival for people with advanced lung cancer or lung cancer that has spread to other parts of the body (metastatic).

Right now, immunotherapy is typically given for late-stage lung cancer. Perioperative immunotherapy combines immunotherapy with chemotherapy before or after surgery. This treatment is sometimes given both before and after surgery.

Recent studies have shown that giving perioperative immunotherapy can improve the outcomes of people diagnosed with lung cancer.

Immunotherapy and targeted therapy drugs have improved survival for people who have locally advanced or metastatic non–small cell lung cancer. Researchers are looking at whether immunotherapy or targeted therapy can also be used to treat early-stage non–small cell lung cancer.

Another approach that researchers are interested in is whether 2 different ways of attacking cancer cells will make treatment more effective. Researchers are currently looking at combining an immunotherapy drug, such as an immune checkpoint inhibitor, with a targeted therapy drug that targets mutations in lung cancer cells.

Small cell lung cancer is less common than non–small cell lung cancer. Until recently, only chemotherapy and radiation therapy were used for small cell lung cancer. One immunotherapy drug has been approved in Canada for small cell lung cancer, but researchers are looking at other immunotherapy and targeted therapy drugs that can be used as well.

Researchers are studying whether a type of targeted therapy called PARP inhibitors can be used for small cell lung cancer. Poly ADP-ribose polymerase (PARP) is an enzyme that helps repair damage to DNA. PARP inhibitors block PARP so cancer cells can’t repair their DNA, which causes them to die. Another area of targeted therapy research is looking at cell cycle checkpoint inhibitors, which stop cancer cells from repairing themselves during the cell cycle.

The immune system normally stops itself from attacking normal cells in the body by using specific proteins called checkpoints. Checkpoints slow down or stop an immune system response. Some lung cancer cells sometimes use these checkpoints to hide and avoid being attacked by the immune system. Immune checkpoint inhibitors work by blocking the checkpoint proteins so immune system cells (called T cells) attack and kill the cancer cells.

CTLA-4 is a type of checkpoint protein that is often found on small cell lung cancer cells. Studies are looking at combining a CTLA-4 inhibitor with chemotherapy and radiation therapy to treat advanced small cell lung cancer.

Screening for lung cancer is an important area of research. The earlier lung cancer is found and treated, the better the outcome.

Certain people have a higher risk of developing lung cancer. The following research is looking at using biomarkers to identify lung cancer in people who are at high risk, before symptoms appear.

A blood test is being studied that looks for proteins that can appear on lung cancer cells.

A liquid biopsy collects small pieces of DNA from the tumour (called circulating free DNA or cfDNA) or DNA with extra carbon and hydrogen atoms (methylated DNA). Removing these types of DNA from the blood may be able to help detect lung and other cancers

Researchers are continually trying to better understand cancer. What we know about cancer – how to prevent it, how it develops, how to treat it, how to help people cope with it – depends on research at many levels and in many settings. Find out more about different kinds of cancer research.

Some people choose to participate in cancer research through clinical trials. Clinical trials are designed to find out if a treatment or tool is safe and effective before it becomes widely available. Find out more about clinical trials.