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Lung cancer research

All treatments must be fully researched before they can be adopted as standard treatment for everyone. This is so that we can be sure they work better than the treatments we already use. And so we know that they are safe.

First of all, treatments are developed and tested in laboratories. Only after we know that they are likely to be safe to test are they tested in people, in clinical trials. Cancer Research UK supports a lot of UK laboratory research into cancer and also supports many UK and international clinical trials.

Researchers are looking into new treatments and also new ways of using existing treatments. These include

Other research is focusing on trying to find out which symptoms could show that a lung cancer has come back.

 

CR PDF Icon View a summary of treating lung cancer.

 

 

Why we need research

All treatments have to be fully researched before they can be adopted as standard treatment for everyone. This is so that

  • We can be sure that they work
  • We can be sure they work better than the treatments that are available at the moment
  • They are known to be safe
 

The research process

First of all, treatments are developed and tested in laboratories. For ethical and safety reasons, experimental treatments must be tested in the laboratory before they can be tried in patients. If a treatment described here is said to be at the laboratory stage of research, it is not ready for patients and is not available either within or outside the NHS. Cancer Research UK supports a lot of UK laboratory research into cancer.

Tests in patients are called clinical trials. Cancer Research UK supports many UK and international clinical trials.

Our trials and research section has information about what trials are including information about the 4 phases of clinical trials. If you are interested in taking part in a trial, visit our searchable database of clinical trials

If there is a trial you are interested in, print it off and take it to your own specialist. If the trial is suitable for you, your doctor will need to make the referral to the research team. The database also has information about closed trials and trial results.

The video below tells you more about clinical trials:

 

Testing for changes in genes

Doctors decide how to treat cancer by looking at factors such as what type of cancer it is, its size and how far it has grown (the stage), and what the cancer cells look like under the microscope (the grade). This works for many people but not for all. This could be because there are slight differences in the cancer cells from person to person, even if they have the same type of cancer. 

Researchers have been looking at the differences between cancer cells caused by changes in the genes. They now want to find a way to test for these genetic changes. In the future, doctors hope they can match treatment to the gene changes in cancer cells. This is called stratified medicine

In the SMP2 study, researchers are collecting samples of cancer tissue from people with non small cell lung cancer. They will test the cells for genetic changes and will gather information about what treatment the people have and what happens to them. They are also looking at what the costs are for this type of testing and how it can be used as part of routine care for cancer patients in the future.

 

Radiotherapy research for lung cancer

Radiotherapy can help to control lung cancer but it does not work well for everyone. Researchers want to develop better tests to work out who will respond to radiotherapy before they start treatment. They also want to see if they can tell who is at the most risk of side effects.

The RADAR study is being partly funded by Cancer Research UK. It is looking at genes and proteins (biomarkers) in the blood and cancer tissue of people who are having radiotherapy for lung cancer or who have already finished it. The researchers will also use special PET scans and MRI scans to look at how radiotherapy affects healthy and cancerous lung tissue.

A small study has been looking into planning radical radiotherapy for people with non small cell lung cancer using a 4D CT scan. This scan takes into account the way your chest moves when you breathe. Doctors hope that this will help them minimise the amount of healthy tissue that is exposed to radiotherapy. This study is no longer recruiting patients, and we are waiting for the results.

Another study is looking at a new type of MRI scan called Helium 3 MRI to see how well the lung tissue not affected by cancer is working. The scan shows healthy lung tissue more clearly than other scans. This may help doctors to target the radiotherapy at the cancer more clearly and reduce the risk of scarring of healthy lung tissue due to the radiotherapy (radiation pneumonitis). This type of scan may also help the doctors to see how well radiotherapy works for non small cell lung cancer.

The ASyMS-R study is looking at using mobile phones to help people cope with the side effects of radiotherapy for lung cancer. Patients can use the mobile phones to send information about their symptoms or side effects directly to a computer. The computer alerts a doctor or nurse at the hospital if someone at home needs help. The system is called Advanced Symptom Management System – Radiotherapy (ASyMS-R). This study aims to find out how well the system works and whether it can help patients to have a better quality of life. 

Some studies are trying giving radiotherapy in different doses than usual. A higher dose of radiotherapy given over a shorter time than usual is called dose escalated radiotherapy. Some trials are combining different ways of giving radiotherapy with chemotherapy. Having both treatments together is called chemoradiation.

The REST trial is looking at giving radiotherapy after chemotherapy for people who have small cell lung cancer (SCLC) that has spread beyond the lungs (extensive disease). Doctors hope that giving radiotherapy to the chest will help to delay the cancer coming back after chemotherapy.

Doctors know that radiotherapy can help people with non small cell lung cancer (NSCLC). Now with modern radiotherapy techniques, doctors want to find out more. The aim of the LungART trial is to see if giving radiotherapy after surgery helps to stop NSCLC from coming back. The researchers also hope to find out more about the side effects of radiotherapy after lung cancer surgery.

The I-START trial is looking at higher dose radiotherapy for non small cell lung cancer. The researchers think that giving a higher dose of radiotherapy may kill off more cancer cells. But they want to do this without damaging the surrounding healthy tissue such as the food pipe (oesophagus). This early trial aims to find out the maximum safe dose of radiotherapy to the food pipe, how well this dose works, and whether this causes more or worse side effects. This trial has now closed and we are waiting for the results.

You can find lung cancer trials on our clinical trials database. If you want to see all the trials, tick the boxes for closed trials and trial results.

 

Chemotherapy research for lung cancer

Chemotherapy is the main treatment for small cell lung cancer and is also commonly used for non small cell lung cancer. Research continues into improving the timing and doses of drugs used. And researchers also hope to find new combinations of drugs that may give better results. Examples of drugs being tested in trials in the UK include

Trials are also looking into other aspects of chemotherapy such as

Having chemotherapy at home

Researchers are also looking into where patients have treatment. Some hospitals have been looking at giving chemotherapy capsules or tablets, such as topotecan (Hycamtin) capsules, to people in their own homes. One study is looking at giving pemetrexed at home through a drip into a vein. Having treatment at home rather than having to go into hospital may give people a better quality of life.

Combining chemotherapy with other drugs

Researchers also try to combine different types of treatment in new ways to improve results. A phase 2 trial looked at having the chemotherapy drug pemetrexed, a type of biological therapy called erlotinib (Tarceva), or a combination of both. The people taking part had NSCLC that was locally advanced or had spread to another part of the body, and were non smokers. The trial showed that having both drugs together worked better. The people having both drugs did have more side effects, but these were manageable. You can read the results of this trial on our clinical trials database.

Other trials are combining chemotherapy with thalidomide, a drug that may help to block a cancer's blood supply

Another trial (The TS Study) is looking at whether a substance produced in the body (thymidylate synthase) affects how well the chemotherapy drugs pemetrexed and cisplatin work in people with non small cell lung cancer (NSCLC).

An international trial added a new type of biological therapy called vandetanib (Caprelsa) to the chemotherapy docetaxel (Taxotere) for people who had already had chemotherapy for advanced NSCLC. Vandetanib is a cancer growth blocker. The results showed that the combination of the 2 drugs worked slightly better than docetaxel on its own. We need more research to confirm this. 

Resistance to chemotherapy

A common problem with many cancers is that they become resistant to chemotherapy after one or more courses of treatment. In other words, the chemotherapy works well at first, but future courses do not help as much. The CHEMORES study aims to understand more about why chemotherapy to treat lung cancer can stop working. It is looking for changes in blood and tissue samples before and after chemotherapy for lung cancer. It aims to try to find out how cancer cells stop themselves being harmed by chemotherapy.

Research has also involved a drug called decitabine to see if it can make resistant cells respond to chemotherapy drugs again. Researchers at Cancer Research UK are also studying a protein called FGF-2 that may be involved in helping cancer cells survive chemotherapy. They want to find out if it is possible to block this protein.  One trial is testing a drug called LY218308. Researchers want to see if it can help to stop non small cell lung cancer cells becoming resistant to the chemotherapy drug docetaxel.

Proteins that affect how chemotherapy works

A trial is checking if chemotherapy without platinum drugs works better than platinum based chemotherapy in people with high levels of a body protein called ERCC1. ERCC1 helps to repair damage to cancer cells caused by platinum drugs. So the trial wants to find out if different chemotherapy may work better for people who have high levels of ERCC1. You can find out about the ERCC1 trial on our clinical trials database.

Reducing chemotherapy side effects

One trial is looking at reducing chemotherapy side effects. It is recruiting people who are having chemotherapy to help control the growth and symptoms of non small lung cancer. Doctors often use palliative chemotherapy to help lessen the symptoms of non small cell lung cancer. But sometimes chemotherapy can make the leg muscles weak. 

You can find lung cancer trials on our clinical trials database. If you want to see all the trials, tick the boxes for closed trials and trial results.

 

Radiotherapy and chemotherapy

Some research trials are looking at different ways of giving radiotherapy alongside chemotherapy for lung cancer. One example is the CONVERT trial for small cell lung cancer. Doctors want to find out if the radiotherapy works better if it is given once a day, or twice a day over a shorter period of time.

There is another trial comparing a combination of pemetrexed and cisplatin chemotherapy plus radiotherapy with etoposide and cisplatin chemotherapy plus radiotherapy. This trial is for people with non small cell lung cancer that has spread into structures close to the lung. Doctors want to find out whether pemetrexed or etoposide work better in combination with the other treatments.

A recent meta analysis looked at having chemotherapy and radiotherapy together (concurrent treatment) rather than having radiotherapy after chemotherapy (sequential treatment). It found that having chemotherapy and radiotherapy together works better for people with locally advanced non small cell lung cancer. 

The SOCCAR trial was also comparing radiotherapy and chemotherapy given together to radiotherapy after chemotherapy. It has finished recruiting and we are waiting for the results to see if it confirms the results of the meta analysis. This trial was for people with locally advanced lung cancer.

There is more information about these trials on our clinical trials database.

 

Biological therapy research for lung cancer

Biological therapies use substances made naturally in the body to kill cancer cells or stop them from growing. Current research in lung cancer is looking at

Targeting faulty genes

In lung cancer, researchers are working on drugs that can correct damage to the p53 gene so that it will work normally again. P53 is a tumour suppressor gene that repairs genes that are damaged and are encouraging cells to grow abnormally. P53 is damaged in a lot of different types of cancer, including lung cancer. This is early research and this treatment is still at the experimental stage.

Erlotinib (Tarceva)

This drug is used to treat patients with advanced non small cell lung cancer that has continued to grow despite having chemotherapy or who are too unwell to have chemotherapy. It is a type of drug known as a tyrosine kinase inhibitor. It works by blocking epidermal growth factor receptors (EGFR) on cells. 

Large international trials have found that erlotinib can increase the length of time that the cancer is controlled for some people compared to chemotherapy. Trials are going on in the UK to find the best way of using this drug. Some trials are using erlotinib as a first treatment for advanced non small cell lung cancer. Some trials are using it combined with chemotherapy or other biological therapy drugs. Doctors also want to find out more about the side effects of erlotinib.

We have more information about erlotinib side effects.

Gefitinib (Iressa)

This drug is used as a treatment for people with locally advanced or metastatic non small cell lung cancer. It is approved by the National Institute for Health and Care Excellence (NICE) for people with non small cell lung cancer that is locally advanced or has spread, provided they have not had any other treatment for their cancer. To get the drug, people must test positive for an alteration (mutation) on a growth factor receptor that the drug acts on called epidermal growth factor receptor tyrosine kinase (EGFR-TK)

NICE say that between 10 and 15 people out of every 100 with non small cell lung cancer (10 to 15%) have the EGR-TK mutation. The Scottish Medicines Consortium (SMC) has decided not to recommend gefitinib as a first line treatment within the NHS in Scotland. Research is continuing to try to find the best way of using gefitinib.

We have more information about gefitinib side effects.

Cetuximab (Erbitux)

Another biological therapy drug called cetuximab has also been used, with chemotherapy, in trials for advanced non small cell lung cancer. Cetuximab is a monoclonal antibody which blocks growth factor receptors on cells.  The early results were encouraging, in terms of helping people to live longer. However, in July 2009 the European Medicines Agency (EMA) did not licence it for non small cell lung cancer. Trials are still going on in Europe and the US.

We have more information about cetuximab side effects.

Ramucirumab

This is a type of drug called a monoclonal antibody. Doctors are looking at using this alongside chemotherapy. A trial is comparing ramucirumab and docetaxel chemotherapy with docetaxel alone. This phase 3 trial is for people with advanced non small cell lung cancer (NSCLC) that has come back after platinum chemotherapy. As well as finding out if ramucirumab and docetaxel are better than docetaxel on its own, the researchers want to learn more about the side effects of ramucirumab.

Nivolumab

Nivolumab is another monoclonal antibody. It works by blocking a substance called PD-1. Blocking PD-1 helps the body's immune system to attack cancer cells.One trial is looking at nivolumab for NSCLC that has spread (CA209017). The researchers are comparing it with the chemotherapy drug docetaxel. This trial has closed and we are waiting for the results.

The CA209026 trial is looking at nivolumab as a first treatment for NSCLC that has spread to another part of the body. The researchers are comparing it to chemotherapy.

Ipilimumab (Yervoy)

This is a treatment for advanced melanoma. It works by stimulating T-cells in the body’s immune system. T-cells help to fight cancer and disease. CTLA-4 is a molecule found on the surface of T-cells and it switches them off. Ipilimumab blocks CTLA-4 so that the T-cells stay switched on and active and can attack the cancer cells. 

The ICE trial is looking at using ipilimumab with chemotherapy to treat small cell lung cancer that has spread beyond the lung (extensive disease). The trial aims to find out if giving ipilimumab with chemotherapy helps to delay or stop small cell lung cancer coming back. Researchers also want to find out more about the side effects. This trial has closed and we are waiting for the results.

The CA184156 trial is also looking at ipilimumab with chemotherapy for people recently diagnosed with small cell lung cancer (extensive stage disease). This trial has closed and we are waiting for the results.

The IDEATE trial is looking at ipilimumab with carboplatin and paclitaxel chemotherapy for NSCLC that has spread to another part of the body or come back after treatment. The researchers think that combining ipilimumab with chemotherapy may be better than chemotherapy alone to treat advanced NSCLC. The researchers also want to find out how safe this combination of treatment is and to learn more about the side effects. This trial has closed and we are waiting for the results.

We have more information about ipilimumab side effects.

Bevacizumab (Avastin)

This is also called Avastin. It is a monoclonal antibody (MAB) that stops cancers making blood vessels. Bevacizumab is licensed in Europe to treat advanced non small cell lung cancer. It is used in combination with platinum based chemotherapy, such as cisplatin or carboplatin. But this treatment has not been approved by the National Institute for Health and Care Exellence (NICE). An American study published in 2012 looked at adding bevacizumab to chemotherapy in people who were older than 65 years with stage 3B or stage 4 non small cell lung cancer. The results showed that adding bevacizumab didn't work any better than the chemotherapy alone. 

The CA196005 trial is comparing bevacizumab with a new biological therapy CT-322 alongside treatment with chemotherapy for advanced non small cell lung cancer or NSCLC that has come back after surgery or radiotherapy. Like bevacizumab, CT-322 stops the cancer from growing blood vessels. The aim of this study is to see if the drug combination of paclitaxel, carboplatin and CT-322 helps people with advanced NSCLC more than paclitaxel, carboplatin and bevacizumab.

The BELIEF trial is looking at bevacizumab and erlotinib for NSCLC that has spread and has changes to genes affecting a protein called EGFR. The researchers want to see how well the 2 drugs work for advanced NSCLC and to learn more about the side effects. This trial has now closed and we are waiting for the results.

We have more information about bevacizumab side effects.

Denosumab

Denosumab is another type of monoclonal antibody. A phase 2 trial is looking at giving denosumab with chemotherapy for NSCLC that has spread to another part of the body. The researchers want to find out more about how denosumab works in people with NSCLC. And how it works alongside platinum chemotherapy drugs, such as cisplatin and carboplatin.

Olaparib

This is a type of drug called a PARP inhibitor. It blocks an enzyme that cancer cells need to repair themselves and grow. The STOMP trial is looking at olaparib for people with small cell lung cancer (SCLC) who have already had one other treatment. The researchers want to see if olaparib can delay or prevent SCLC coming back. This is called maintenance therapy. They will compare olaparib with a dummy drug (placebo). The PIN trial is comparing olaparib with placebo after chemotherapy for advanced NSCLC.

Crizotinib 

This is a new type of biological therapy for people with advanced non small cell lung cancer (NSCLC) that has an overactive version of a protein called ALK. ALK plays an important role in controlling cell growth and survival. Crizotinib works by blocking ALK and stopping the growth of cancer cells. About 1 in 20 people with lung cancer have overactive ALK on their cancer cells.

Trials are looking at crizotinib for advanced non small cell lung cancers that have the abnormal ALK gene. Some trials are comparing crizotinib with chemotherapy. They aim to find out if crizotinib is better than chemotherapy as a first treatment for this type of NSCLC.

We have more information about crizotinib side effects.

LDK378

A trial is comparing a drug called LDK378 with chemotherapy for advanced NSCLC that has changes to the ALK protein (ALK positive NSCLC). The people taking part have already had treatment with crizotinib and chemotherapy that included a platinum drug. The researchers want to find out if LDK378 works better than pemetrexed or docetaxel chemotherapy for this group of patients.

Tivantinib

The MARQUEE trial is looking at a new drug called tivantinib (also known as ARQ 197). It is a type of tyrosine kinase inhibitor. The trial is giving it alongside erlotinib for non small cell lung cancer (NSCLC) that has got worse despite having other treatment. It is for types of NSCLC that are described as non squamous, such as adenocarcinoma or large cell carcinoma. The trial aims to find out if a combination of erlotinib and tivantinib helps people with advanced NSCLC more than erlotinib alone.

Selumetinib

Selumetinib works by targeting a protein called MEK and stops signals that cancer cells use to divide and grow. Researchers for the SELECT-1 trial think that combining selumetinib with docetaxel may improve treatment for NSCLC that has spread into surrounding tissues (locally advanced) or to other areas of the body (advanced). The trial will compare docetaxel and selumetinib with docetaxel and a dummy drug (placebo).

Pazopanib

This is a type of drug called a tyrosine kinase inhibitor (TKI). It is being looked at to help a number of different cancers. The MAPPING-EORTC 08092 study is looking to see if giving pazopanib after chemotherapy can improve treatment for people with advanced non small cell lung cancer.

We have more information about pazopanib aide effects.

Dacomitinib

This drug is a new type of biological therapy. It works by blocking 3 different HER (Human Epidermal Growth Factor) proteins. These proteins are found on lung cancer cells and may help them grow and multiply. Some trials are comparing dacomitinib with other biological therapies to find out which are better at stopping advanced non small cell lung cancer getting worse.

Ganetespib

This drug is a new type of biological therapy called a heat shock protein 90 inhibitor. It stops signals that cancer cells use to divide and grow. In the GALAXY-2 trial, doctors want to find out if ganetespib and docetaxel chemotherapy works better than docetaxel on its own for advanced NSCLC. They also want to learn more about the side effects of this combination of treatment and how they affect quality of life.

Afatinib

The TIMELY trial is looking at afatinib for people with NSCLC who cannot have chemotherapy. Afatinib works by targeting the protein called epidermal growth factor receptor (EGFR). Drugs that target EGFR are more likely to work if the cancer cells have a change (mutation) to a particular gene. People with lung cancer who have never smoked or were light smokers in the past, are more likely to have cancer with this gene change. For that reason, the people taking part in this study are non smokers. They have a type of NSCLC called adenocarcinoma.

The ABLE trial is looking at afatinib before surgery for early stage NSCLC. The researchers want to find out if afatinib shrinks your tumour before surgery, and how your cancer cells change through the treatment. They also want to see if they can identify particular genes and proteins linked to whether afatinib works well or not, and to learn more about the side effects.

Dabrafenib

In a small number of people with NSCLC there is a change in a gene called BRAF. The BRAF gene makes a protein that affects how cancers divide and grow. Dabrafenib (Tafinlar) blocks the BRAF protein, and is called a BRAF inhibitor. A study is looking at dabrafenib for people with advanced NSCLC, who have a change in the BRAF gene. The researchers want to find out how well this treatment works and its side effects.

ADI-PEG 20

In the laboratory, researchers have found that small cell lung cancer cells are destroyed by removing an amino acid called arginine. Arginine helps with many different jobs in the body, including cell growth. Researchers think that removing arginine, by using the new drug ADI-PEG 20 (pegylated arginine deiminase), may be a way of stopping cancer growth. Researchers for the study looking at ADI-PEG 20 want to see how well it works for small cell lung cancer and how safe it is.

Growth blockers

There is a trial looking at two new drugs combined with chemotherapy. The drugs are growth blockers called ganitumab (AMG 479) and AMG 102. The trial is testing how they work in combination with etoposide and either carboplatin or cisplatin chemotherapy in people with advanced small cell lung cancer. AMG 479 blocks a growth factor receptor called insulin like growth factor receptor (IGFR), and AMG 102 blocks the hepatocyte growth factor receptor. Both drugs have been tested in people with advanced cancer, but this study is looking at how well AMG 479 and AMG 102 work with chemotherapy for small cell lung cancer. 

One trial is testing a new drug that blocks a cell signalling system called the PI3K pathway. This trial is looking at BKM120 for people with non small cell lung cancer that has spread. Researchers hope that blocking PI3K proteins may help to stop the lung cancer cells from growing. The aim of the trial is to see if BKM120 helps people who have non small cell lung cancer that has come back, despite having other treatment. This trial has closed and we are waiting for the results.

Another trial is looking at a new drug called AUY922 for advanced non small cell lung cancer. We know from laboratory studies that AUY922 can stop cancer cells with high levels of epidermal growth factor receptor (EGFR positive) from growing. In this trial, researchers will compare AUY922 with the chemotherapy drugs pemetrexed and docetaxel. This trial has now closed and we are waiting for the results.

Using your immune system (immunotherapy)

Some drugs called anti-PD-1 immunotherapy are designed to boost the natural ability of the immune system to recognise and target cancer cells. Lambrolizumab (also called MK3475) is one of these drugs. It blocks a protein called PD-1. PD-1 stops some immune cells from working properly. Blocking PD-1 can trigger the immune system to find and destroy the cancer cells. MK3475 has been tested in early trials with NSCLC. The initial results have been promising and more studies are being carried out.

A trial is comparing MK3475 with docetaxel chemotherapy for NSCLC. The people taking part have already had treatment with a chemotherapy drug from the platinum drugs group such as carboplatin or cisplatin. The researchers are comparing 2 different doses of MK3475 with docetaxel. They want to find out how well MK3475 works, how safe it is and how it affects quality of life.

The PEARL trial is looking at a type of immunotherapy to help delay or stop NSCLC coming back after surgery. The researchers are testing a new treatment called PRAME immunotherapy. It works by teaching your immune system to recognise and destroy cancer cells. You have injections of an antigen that is found in some tumours (PRAME antigen). To help your immune system, another substance called an adjuvant is added to the antigen. The adjuvant is a mixture of natural and manmade substances that help the immune system to respond. The aims of the trial are to see if PRAME immunotherapy is safe and works for NSCLC, and to learn more about the side effects. This trial has now closed and we are waiting for the results.

Cancer Vaccines

This type of treatment is designed to help treat cancer by stimulating the immune system to attack the cancer cells. The START trial looked at a vaccine called tecemotide (used to be called Stimuvax) after chemotherapy and radiotherapy for stage 3 non small cell lung cancer (NSCLC). The researchers found that the vaccine was safe to use but overall tecemotide didn't help this group of people live longer. 

The MAGRIT trial tested a vaccine called MAGE-A3 ASCI. The MAGE-A3 ASCI teaches immune cells to recognise a protein called MAGE-A3, found on some types of non small cell lung cancer cells. The theory was that the immune cells would then find and kill the lung cancer cells. But the vaccine did not seem to help to control the cancer or help people to live longer. Researchers hope that the vaccine may work better for some other types of cancer, such as melanoma skin cancer.

Another trial is testing a vaccine called Lucanix for people who have already had chemotherapy for advanced non small cell lung cancer. The trial aims to find out if having Lucanix after chemotherapy can help people with non small lung cancer to live longer. The researchers also want to learn about the side effects of Lucanix.

A trial is looking at an EGF cancer vaccine alongside chemotherapy for non small cell lung cancer that cannot be removed with surgery. Growth factors are natural body chemicals that control cell growth. They work by plugging into receptors which send signals telling the cells to divide and grow. Non small cell lung cancer cells often have a large number of receptors for a growth factor called EGF. The vaccine in this trial targets EGF and stops it attaching to the cancer cell receptors. The researchers hope that giving the vaccine with chemotherapy will help people with advanced NSCLC to live longer.

We have more information explaining cancer vaccines.

You can find trials for lung cancer on our clinical trials database. If you want to see all the trials, tick the boxes for closed trials and trial results.

 

Research into surgery for lung cancer

There is a research study trying to find ways of helping people to recover more quickly after surgery for early stage lung cancer. Getting back to normal is called rehabilitation. The study is comparing normal care with a rehabilitation programme after surgery to remove lung cancer.

The rehabilitation programme includes exercise, education and guidance on what to eat, and help to stop smoking. The study aims to see if the rehabilitation programme can shorten the time spent in hospital, lower the risk of complications and improve your quality of life.

The ErLaPara study is looking at pain control after having surgery for lung cancer or mesothelioma of the lung. After surgery doctors control pain with a drug that numbs the nerves in the area (local anaesthetic). You usually have this through a thin plastic tube that the surgeon places in your chest near the wound. The doctor usually starts this at the end of surgery. The researchers think that pain may be better controlled if the local anaesthetic was started soon after the start of surgery instead. The people taking part will complete questionnaires about any pain they may have on the first couple of days after surgery. This trial has now closed and we are waiting for the results.

 

Microwave treatment research

Doctors and researchers are looking into using microwave treatment for lung cancer. They call it microwave ablation. There is evidence from some studies that microwave treatment can work in controlling the cancer in the lung for a time. But there is no evidence at the moment that this procedure helps people to live longer or improves their quality of life. 

In 2013 the National Institute for Health and Care Excellence (NICE) assessed microwave treatment. They say that doctors can use it to treat patients with lung cancer. But they must explain that it is not clear how much it will help them and that we need more research.

How you have microwave treatment

The microwave treatment aims to destroy the tumour cells and gives very little damage to the surrounding normal tissues. It can treat quite large tumours. You have the treatment under local anaesthetic with a medicine to make you drowsy. Or you may have it under a general anaesthetic. The surgeon puts a microwave probe through the skin over the area of the tumour in the lung. They use X-ray or ultrasound to make sure the probe is in the right place. 

Then the probe gives out high frequency microwave energy to destroy the tumour cells. Sometimes the doctor may use more than one probe during the treatment session.

Possible side effects

As this treatment is quite new there is not much information about side effects. But some people in the trials had a collapsed lung (pneumothorax) soon afterwards. A small number of people had bleeding into the lung (haemothorax), heat damage to structures near the lung, and pain caused by heat on the skin of the chest.

 

Smoking after diagnosis

The LungCAST study is looking at whether smoking affects how well lung cancer treatment works. Some researchers believe that smoking after diagnosis may affect the outcome of the lung cancer. They think it could be possible that smoking affects levels of anti cancer treatment in the blood and body tissue. 

We know from laboratory research that smoking can make some cancer cells more resistant to chemotherapy. And smoking can affect oxygen levels in cancers, making radiotherapy work less well. We don't know at the moment whether smoking after diagnosis does affect lung cancer treatment. So this study aims to find out whether smoking after a diagnosis of lung cancer affects survival.

 

Blood thinning drugs for lung cancer

The FRAGMATIC trial is looking at whether blood thinning drugs can improve treatment for lung cancer. Blood clots are quite common in people who have lung cancer. And cancer treatment can increase the risk of blood clots. Dalteparin is a blood thinning drug (anticoagulant), also called Fragmin. It is used to prevent and treat blood clots. Doctors think that dalteparin may also affect how cancer cells spread through the bloodstream, but they don't know for sure. 

So this trial gave dalteparin alongside standard treatment for lung cancer to half the people taking part. Researchers are checking to see if it reduced the number of blood clots people got. And they will also see if it can help to stop cancer cells spreading through the bloodstream to other parts of the body.

 

Statins and lung cancer

These are medicines that people usually take to lower their cholesterol. Doctors think that they may also have an effect on cancer cells and they want to find out more about this. The LungStar trial is looking at whether adding a drug called pravastatin to chemotherapy can make it work better for advanced small cell lung cancer. 

 

Diabetes drugs in lung cancer research

Several studies have shown that metformin and other diabetes drugs known as thiazolidedione (TZDs) may slow the growth of lung cancer and help some lung cancer patients live longer. A large study reported at a lung cancer meeting in 2010. It found that people taking anti diabetes drugs are generally less likely to get lung cancer. If they do get it, it is less likely to spread and people also tend to live longer. The reason for this is not known. But some research shows that metformin triggers an enzyme, called AMP activated protein kinase, which blocks a protein called mTOR. mTOR can trigger lung cancer cell growth.

But we need more research before we know how helpful anti diabetes drugs are in the treatment or prevention of lung cancer.

 

Research into treating a blocked airway

There is research into relieving symptoms of a blocked airway. In advanced cancer, people sometimes develop a blockage in their airway. This can make you feel breathless. It can also cause noisy breathing, called stridor, which can be upsetting. There are different ways of treating the blockage including radiotherapy to shrink the cancer, or laser surgery to cut away part of the blockage. You may have the more common external beam radiotherapy. Or you may have internal radiotherapy called brachytherapy. This involves putting a sealed radioactive source down a bronchoscope so that it is right next to the blockage. This can work very well.

Another way of relieving breathlessness is by using a stent. This is a hollow tube that is put into the airway during a bronchoscopy. Once the stent is in place, it expands slightly. This eases the blockage and makes it easier to breathe. 

Diagram showing an airway stent

A small trial called RESTORE-AIR is looking into using stents to relieve breathlessness in non small cell lung cancer in the windpipe or a main bronchus. Doctors would usually want to give chemotherapy or radiotherapy to reduce the blockage before putting in a stent. But this trial is looking at how much putting a stent in first can help with breathlessness, and how much this can help you to cope with the rest of your treatment. The trial has now closed and we are waiting for the results. 

 

Radiotherapy for cancer cells in the brain

If lung cancer spreads it often goes to the brain. In this case, doctors often give radiotherapy. But they are not sure if the side effects it causes, such as headaches, feeling tired, or feeling and being sick, cancel out the good effects. 

The Quartz trial is looking at radiotherapy for people with non small cell lung cancer that has spread to the brain. Everyone on this trial has best supportive care from their health care team, plus treatment with steroids. One group will also have a course of radiotherapy to the brain, while the other will not. This trial has now closed and we are waiting for the results.

Another trial, called TACTIC, is looking into whether it is better to give the biological therapy drug erlotinib (Tarceva) with radiotherapy in this situation. The trial has closed and we are waiting for results.

There is more information about these trials on our clinical trials database.

 

Symptoms of cancer that has come back

A study is looking at symptoms which could be caused by cancer coming back after treatment. After treatment for cancer of the breast, lung, prostate or bowel, you have follow up appointments with your specialist doctor. But after a few years, if you stay well, these appointments may stop. You are then asked to see your GP if you have any new symptoms, or are worried about anything.

Researchers looked back at the medical notes of people who went to their GP with symptoms some time after cancer treatment. They looked at people whose cancer had come back as well as people whose symptoms were caused by something else. The trial aims to find common symptoms of cancer recurrence to help doctors spot the signs that cancer may have come back. The trial has now closed. You can find details on our clinical trials database. Choose 'lung' from the dropdown menu of cancer types to find lung cancer trials.

 

More about lung cancer treatment research

We have information about treatments for lung cancer in this section of the website.

You can find out more about the trials mentioned on this page and other lung cancer trials on our clinical trials database. If you want to see all the trials, tick the boxes for closed trials and trial results.

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Updated: 3 April 2014