Health topic

Lung cancer

Lung cancer is the second most common cancer in both men and women1

Lung cancer is the leading cause of cancer death, making up almost 25% of all cancer deaths. In the United States, approximately 1 in 15 men and 1 in 17 women will be diagnosed with lung cancer in their lifetime. In 2021, the American Cancer Society estimates about 235,760 new cases of lung cancer and projects over 131,000 deaths.1

Lung cancer is as distinct as each individual patient

There are many types of cancer that can start in the lung or related structures. Each type of lung cancer can behave differently. Oncologists who specialize in lung cancer work closely with pathologists to identify the origin and nature of the cancer.  

Lung cancer is divided into two main subtypes, non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Up to 85% of all lung cancers are NSCLC, which can be further subtyped into adenocarcinoma, squamous cell carcinoma and large cell carcinoma.2 The need for accurate classification of these subtypes has been amplified with the introduction of targeted therapies.3

Targeted therapies have shifted the lung cancer treatment paradigm away from being based only on histological subtype, to incorporating subtyping involving oncogenic mutations and fusions.3

Roche is committed to helping identify the best possible treatment for each patient by accurately identifying the type of cancer and the likely course of the illness

Our commitment to lung cancer includes over 40 antibodies/markers that enable pathology labs to deliver accurate results with confidence. With this knowledge, doctors can identify more patients for the right therapy at the right time.

Identifying lung cancer subtypes

A pathologist who is experienced in lung cancer assesses the type of cancer based on histology, what the cells look like under a microscope, and a biomarker profile. A biomarker profile may also be referred to as a molecular profile, genomic profile, or signature profile. Oncologists use other tests to determine the stage, or how far the lung cancer has advanced.

Typical approach to testing in lung cancer

Lung cancer

*If conducting broad molecular testing.

NSCLC

Adenocarcinoma - 40% of NSCLC cases3,4

This is the most common type of lung cancer. Adenocarcinomas tend to have more favorable prognoses than other types of lung cancer. Like other subtypes, this subtype is associated with smoking. But, it is also seen in non-smokers, especially women.

Squamous Cell Carcinoma – 20-30% of NSCLC cases3,4

This type of lung cancer has declined in recent decades, likely because of changes in smoking behavior. It typically occurs in the central part of the lung, along airways, and can eventually form cavities within the lung.

Large Cell Carcinoma – 10-15% of NSCLC cases3,4

Large cell carcinomas are the least common type of NSCLC. They can appear in any part of the lung. This type of cancer is highly likely to spread to other parts of the body.

Neuroendocrine

Small Cell Lung Cancer3,4

This is the most aggressive type of lung cancer. It can rapidly spread to other parts of the body. Because of this, it is difficult to diagnose early.

Carcinoid3,5

This is a rare type of lung cancer that is more common in the younger age group. There are 2 types of carcinoid tumors: typical and atypical. Of the 2, typical are more common, tend to grow slowly, and rarely spread beyond the lungs.

Large Cell Neuroendocrine6

This is a rare, fast-growing tumor that often spreads to lymph nodes and other organs. Primary surgery is an option in some patients. However, there is no standard treatment for this type of lung cancer.

Lung cancer data

lung_cancer_data

Over the past few decades, diagnostic and treatment advances have gradually improved survival rates

lung_cancer_data

Diagnostic advances to improve the efficiency of a treatment decision

Accurate diagnosis and disease classification are critical to improving patient outcomes.  

Scientists are exploring all aspects of tumor metastasis, cell division and signaling, and antitumor immunity in an effort to identify the many different genetic alterations that can drive lung cancer growth. 

Identifying new genetic biomarkers gives oncologists a way to further distinguish a tumor’s origins such as with the proteins PD-L1 and PD-1, the anaplastic lymphoma kinase (ALK-1), neurotrophic tyrosine receptor kinase (NTRK) gene fusions, and epidermal growth factor receptor (EGFR), a protein found at higher levels than normal on cancer cells. The ROS1 gene and the BRAF gene are also the focus of additional ongoing NSCLC research.9

New techniques opening door to personalized treatment

Enabling early cancer cell detection is the goal of ongoing studies of exhaled breath biomarkers and imaging of blood and sputum samples. If successful, these techniques may allow for faster diagnosis and quicker initiation of targeted treatments. A separate field of research is employing artificial intelligence (AI) to help identify cancer. In one trial, computer programs were taught to diagnose two types of lung cancer with 97% accuracy, as well as detect cancer-related genetic mutations.9

Scientists continue to look for new treatment options for all stages of lung cancer and have seen promising results with innovative new therapies and combinations of therapies. The ultimate goal is to be able to match treatment to the patient's specific tumor characteristics. This offers the greatest opportunity for improved outcomes, particularly in patients with advanced disease.

Explore our robust lung cancer portfolio

Roche has developed a leading, comprehensive lung cancer immunohistochemical portfolio, with biomarkers that support multiple guidelines for the diagnosis and stratification of lung cancers.10-12

Learn more

References

 

  1. American Cancer Society. Key statistics for lung cancer. Accessed August 4, 2021. https://www.cancer.org/cancer/lung-cancer/about/key-statistics.html
  2. American Cancer Society. What is lung cancer? Accessed May 2021. https://www.cancer.org/cancer/lung-cancer/about/what-is.html
  3. Zheng M. Classification and pathology of lung cancer. Surg Oncol Clin N Am. 2016:25(3):447-468.
  4. WedMD. Types of lung cancer. Accessed August 7, 2021. https://www.webmd.com/lung-cancer/lung-cancer-types
  5. American Cancer Society. What are lung carcinoid tumors? Accessed August 2021. https://www.cancer.org/cancer/lung-carcinoid-tumor/about/what-is-lung-carcinoid-tumor.html 
  6. Fasano M, et al. Pulmonary large-cell neuroendocrine carcinoma: from epidemiology to therapy. J Thorac Oncol. 2015;10(8):1133-1141.
  7. American Cancer Society. Cancer Facts & Figures 2019. American Cancer Society; 2019.
  8. American Cancer Society. Lung cancer survival rates. Accessed August 4, 2021. https://www.cancer.org/cancer/lung-cancer/detection-diagnosis-staging/survival-rates.html
  9. National Cancer Institute. Advances in lung cancer research. Accessed August 4, 2021. https://www.cancer.gov/types/lung/research
  10. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology Non-Small Cell Lung Cancer, Version 5. June 15, 2021. Accessed September 8, 2021. https://www.nccn.org 
  11. National Comprehensive Cancer Network. NCCN Guidelines Version 5. 2021 Non-Small Cell Lung Cancer NCCN Evidence Blocks. Accessed September 8, 2021. https://www.nccn.org/professionals/physician_gls/pdf/ nscl_blocks.pdf
  12. Lindeman NI, et al. Updated molecular testing guideline for the selection of lung cancer patients for treatment with targeted tyrosine kinase inhibitors. Arch Pathol Lab Med. 2018;142(3):321–346.
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