How common is Non-Small Cell Lung Cancer
and what Molecular Features does it display?
Lung cancer is the most frequently diagnosed cancer and the leading cause of cancer-related deaths worldwide. In 2008, there were 1.6 million new cases of lung cancer and almost 1 million deaths related to this disease.1 Exposure to tobacco smoke is by far the most important cause of lung cancer. It accounts for approximately 90% of cases in the United States and other countries where cigarette smoking is common.2 Other causes include genetic factors and respiratory carcinogens, such as radon, asbestos and air pollution.
Lung cancer can be broadly divided into two major types – non-small cell lung cancer (NSCLC) and small cell lung cancer. NSCLC is the most prevalent and accounts for approximately 85% of all cases.3 NSCLC includes three main subtypes:
- squamous cell carcinoma
- large cell carcinoma
The prognosis for patients with NSCLC is poor with a 5-year survival rate of only 15%.4 Only about 20% of patients present with early stage disease that is potentially curative with surgery, and most present with inoperable or metastatic disease and are treated palliatively from the time of initial diagnosis.
Chemotherapy remains the most widely prescribed treatment for patients with advanced disease, although this approach seems to have reached a therapeutic plateau. New targeted therapy options are emerging as a result of a better understanding of the molecular biology of NSCLC. These include agents targeting the epidermal growth factor receptor (EGFR).
Where personalised healthcare comes in
Up to now, surgery and chemotherapy have been important treatment options. Today, however, patients suffering from non-small cell lung cancer and having the specific mutations mentioned above first, can be identified by a molecular test.
There are already some medicines that block these receptors and disrupt the signal transmission pathway to the inside of the cell, thus blocking tumour growth and triggering tumour cell death.
1. Ferlay J, Shin HR, Bray F, et al. GLOBOCAN 2008, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 [Internet]. Lyon,
France: International Agency for Research on Cancer; 2010. Available from: http://globocan.iarc.fr
2. Peto R, Lopez AD, Boreham J, et al. Mortality from smoking in developed countries 1950–2000: indirect estimates from national vital statistics.
Oxford, UK: Oxford University Press, 1994.
3. Navada S, Lai P, Schwartz AG, et al. Temporal trends in small cell lung cancer: Analysis of the national Surveillance, Epidemiology, and End-
Results (SEER) database. J Clin Oncol 2006; 24 (abstr 7082).
4. Molina JR, Yang P, Cassivi SD, et al. Non-small cell lung cancer: epidemiology, risk factors, treatment, and survivorship. Mayo Clinic
Proceedings 2008; 83: 584-594.