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Research into treatment for lung cancer

Researchers around the world are looking at making better and kinder treatments for lung cancer.

Go to Cancer Research UK’s clinical trials database if you are looking for a trial for lung cancer in the UK. You need to talk to your specialist if there are any trials that you think you might be able to take part in.

Click on the ‘recruiting’, ‘closed’ and ‘results’ tabs to make sure you see all the trials.

All new treatments need to be researched so we can be sure they work better than the treatments we already use. We also need to know that they are safe.

Treatments for lung cancer include:

  • radiotherapy
  • chemotherapy
  • surgery
  • targeted cancer drugs and immunotherapy

Radiotherapy

Radiotherapy can help to control and reduce the symptoms of lung cancer.

Most commonly you have radiotherapy Monday to Friday for 4 weeks (standard therapy). Researchers have looked at other timetables for giving radiotherapy and the highest safe dose to give. Researchers are comparing the different radiotherapy timetables with each other and with standard radiotherapy. The aim is to find the most promising way of giving increased doses of radiotherapy.

Researchers are also looking at a targeted type of radiotherapy called either:

  • stereotactic body radiotherapy treatment (SBRT)
  • stereotactic ablative radiotherapy

Stereotactic therapy directs radiotherapy beams at the cancer from different positions around the body. It gives a very high dose of radiation to the cancer and a much lower dose to surrounding tissues. With this type of radiotherapy, you have fewer sessions.

Chemotherapy

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 might give better results.

Examples of chemotherapy being tested in trials in the UK include:

  • pemetrexed
  • carboplatin
  • cisplatin

Researchers are also trying to combine different types of treatment in new ways to improve results. Some are combining chemotherapy with targeted cancer drugs in clinical trials to see if certain combinations work better at treating lung cancer.

A common problem with many cancers is that chemotherapy works well at first but then it stops working so well. Researchers are interested in finding out why chemotherapy can stop working.

Surgery

Doctors can remove early lung cancer with surgery. There are two main ways to remove a lobe of the lung (lobectomy):

  • open surgery, which means making a cut in the chest
  • video assisted thoracoscopic surgery (VATs), which means making several smaller cuts in the chest

Surgeons currently use both types of surgery but they don’t know which works best.

A study is comparing these two types of surgery to find out:

  • what patients think of keyhole and open surgery
  • whether there are different side effects
  • what the cost difference is

Problems after surgery

After having surgery you might have complications. This will affect how well you recover after surgery.

Simvastatin is a drug used to treat people who have a high level of fat (cholesterol) in their blood. Simvastatin can also reduce inflammation. Inflammation is your body's response to injury or illness.

Researchers think simvastatin could help reduce inflammation before and after surgery. And so, prevent the complications of surgery.

Targeted cancer drugs

Targeted cancer drugs change the way that cells work and they help the body control the growth of cancer. Some targeted drugs seek out and destroy cancer cells. Other drugs help the immune system to attack the cancer.

Research has found that some targeted drugs can help to control advanced cancer for some time. Scientists are now looking at using these drugs:

  • with radiotherapy
  • with chemotherapy
  • in cancer that has come back after a first treatment

Monoclonal antibodies

Monoclonal antibodies are a type of targeted cancer drug. They recognise abnormal proteins on cancer cells. They can:

  • change how the cancer cell works
  • take chemotherapy or radiation into the cancer cell to kill it
  • make it easier for the immune system to recognise and kill cancer cells

Monoclonal antibodies that researchers are looking at for lung cancer include durvalumab and pembrolizumab. Pembrolizumab is also called a type of immunotherapy.

Canakinumab is another type of monoclonal antibody. It works by stopping inflammation. Inflammation is how your body responds to illness or injury.

We know that ongoing (chronic) inflammation plays an important role in the development of non small cell lung cancer. Researchers think that stopping inflammation could help stop non small cell lung cancer developing. Scientists are looking at how well canakinumab works for people with lung cancer.

PARP inhibitors

These are drugs that block proteins that help cells repair their DNA. Researchers are looking at the PARP inhibitor olaparib in people with lung cancer.

Cancer growth blockers

Growth factors are chemicals produced by the body that control cell growth. Some growth factors tell cells what type of cells they should become. Some make cells grow and divide into new cells. Some tell cells to stop growing or to die.

Examples of cancer growth blockers researchers are looking at include:

  • lenvatinib
  • afatinib

Vaccines

Vaccines are a newer way of treating cancer, which could make the immune system attack the cancer cells. A study is looking at using a vaccine and chemotherapy to treat people with advanced lung cancer.

Probiotics

MRx0518 is a bacterium or a probiotic. It is made up of a bacterium Enterococcus gallinarum. This is found in the bowels of most people. And it is part of the ‘normal gut flora’ or the microbiome. This is made up of bacteria, fungi or viruses. These bacteria help digest our food and control our immune system.

Some very early studies suggest that MRx0518 might stimulate the body’s own immune system to attack and kill cancer cells. But researchers aren’t sure, so they want to find out more.

Stratified medicine

Stratified medicine means looking at large groups of cancer patients to try and find ways of predicting which treatments cancers are likely to respond to. It involves looking in detail at the cancer cells and their genetic make up. Researchers want to find out whether some treatments are more likely to work in cancers that have particular changes to their genes.

Cancer Research UK is looking at a number of new drugs to treat non small cell lung cancer. The treatments depend on changes in genes in the cancer cells.

It takes time to develop new tests to find the genetic changes in cells. We have to make sure that any new test is sensitive at picking up any changes, and is accurate and reliable. It will be some time before more people can have treatment based on the genetic make up of their cancer.

Why are some lung cancers more difficult to treat?

Cancer varies between different people. Even in an individual person, the cancer can change over time. In a large study, researchers will take samples of blood and cancer tissue at different times over a 5 year period. They will look at them in the laboratory to help them understand which changes affect the way a cancer grows.

The aim of the study is to look at features of non small cell lung cancer, including factors related to genes inside the cell, as they change over time. The study team also hope to see why some lung cancers are difficult to treat.

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