One locally advanced lung cancer is a cancer that is not operable because it is too large or not accessible for surgery. It is generally treated with radiation therapy and systemic treatments such as chemotherapy, targeted therapies, or immunotherapy.
One metastatic lung cancer means that the cancer has spread to other parts of the lung compared to the original injury and/or to other organs outside of the lung. It is generally treated with systemic treatments such as chemotherapy, targeted therapies, or immunotherapy.
There are two main types of lung cancer:
1. Non-small cell lung cancer (NSCLC), which includes:
- Adenocarcinoma
- Squamous cell carcinoma (or squamous cell carcinoma)
- Large cell lung carcinoma
2. Small cell lung cancer (SCLC) (also called neuroendocrine small cell carcinoma), which is less common but grows and spreads more quickly.
This information is generally provided in the pathophysiological report.
A biomarker, also called, in some cases, a genetic mutation, is a measurable biological characteristic linked to a normal or non-normal process.
In oncology, among biomarkers, certain abnormalities (often mutations) at the level of a gene can predict the action of a targeted drug.
This information can be found on the Molecular Biology Report (or NGS) or a consultation report.
Examples in pneumology: EGFR, ALK, ROS1, KRAS, PD-L1...
In addition to the biomarkers mentioned, other mutations may play a role in lung cancers, such as BRAF, MET, RET, and NTRK (the complete list can be found on Klineo). Knowledge of these mutations can guide the choice of targeted therapies and clinical trials.
The TNM score is a classification system used to assess the stage of a cancer, plan treatment, and predict prognosis.
Three parameters must be taken into account:
This information can be found on the pathologic report or a consultation report.
NB: On the platform, it is a simplified version of the TNM stadium. In the search fields, only the first number following the letter must be selected (ex: “Pt1c N0i+ M0” = “T1N0M0”)
The stage of lung cancer is determined by the TNM system and helps guide treatment. The stages vary from I (cancer that is limited to the lung) to IV (cancer that has spread to other parts of the body).
Chemotherapy is a treatment that uses powerful drugs to destroy cancer cells by stopping them from multiplying or spreading in the body. Chemotherapy medications can be given intravenously (into a vein), orally (as tablets or capsules), or by subcutaneous injection (under the skin).
Chemotherapy may be used alone or in combination with other treatments such as surgery or radiation therapy, depending on the type and stage of the cancer, as well as the patient's overall health. While chemotherapy can be very effective in destroying cancer cells, it can also damage healthy cells, leading to side effects such as hair loss, fatigue, nausea and vomiting, and suppression of the immune system.
In the context of lung cancer, chemotherapy drugs that are often used are:
- Cisplatin
- Carboplatin
- Pemetrexed
- Gemcitabine
- Docetaxel.
- Etoposide
- Paclitaxel (Taxol)
(Full list on the Klineo platform)
Immunotherapy is a treatment that aims to stimulate the body's immune defenses against cancer cells. Its effectiveness has been demonstrated in a large number of cancers, even if its tolerance is marked by a specific toxicity profile linked to the reactivation of the immune system.
In the context of lung cancer, the immunotherapies that are often used are:
- Nivolumab (OPDIVO)
- Pembrolizumab (KEYTRUDA)
- Atezolizumab (TECENTRIQ)
(Full list on the Klineo platform)
Targeted therapy is a drug treatment that specifically targets genetic or molecular abnormalities or alterations present in cancer cells or other diseased cells.
Unlike conventional treatments, such as chemotherapy, which act on all cells in the body, targeted therapies work more selectively, by blocking or inhibiting specific proteins involved in the growth and proliferation of cancer cells or in other diseases.
Targeted therapies are often used in combination with other treatments such as chemotherapy or radiation therapy. They are being used more and more in the treatment of cancer.
In the context of lung cancer, targeted therapies that are often used are:
- EGFR: Osimertinib (TAGRISSO), Erlotinib (TARCEVA), Gefitinib (IRESSA), Afatinib (GIOTRIF)
- ALL: Crizotinib (XALKORI), Ceritinib (ZYKADIA), Alectinib (ALECENSA), Brigatinib (ALUNBRIG), Lorlatinib (LORVIQUA)
- ROS1: Crizotinib (XALKORI), Lorlatinib (LORVIQUA)
- BRAF V600E : Dabrafenib +Trametinib
- KRAS p.G12c: Sotorasib (LUMYKRAS)
- AND: Praseltinib (GAVRETO), Selpercatinib (RETSEVMO)
