The non-small cell lung cancer (NSCLC) is the most common type of lung cancer. It represents between 85 and 90% of cases. This type of cancer develops in the cells that line the pulmonary bronchi and in certain parts of the lungs such as the bronchioles and alveoli.

What are the subtypes of non-small cell lung cancer?

Non-small cell lung cancer can be divided into three histological subtypes: lung adenocarcinomas, squamous cell carcinomas, and large cell carcinomas.

Les adenocarcinomas represent 40% of NSCLCs and are formed, in general, in the peripheral areas of the lungs. In fact, tumors of this subtype of cancer are initially formed in the cells ofglandular epithelium, which line the respiratory tract. These cells produce mucus, a viscous substance that protects the lungs. This histology may also be associated with genetic mutations ; the most frequent being those of the EGFR, AKL or even ROS1 genes.

Les squamous cell carcinomas constitute between 25 and 30% of cases of lung cancer and develop from epithelial cells. The main function of these cells is to cover the inner walls of the lungs to protect them. The tumor therefore forms, most often, in the central parts of the lung.

Les large cell carcinomas represent between 10 and 15% of cases. For large cell carcinoma, its cancerous tumor has the particularity of originating from lung cells visible under the microscope, which are therefore relatively large. It can thus form in any section of the lung.

Regardless of its histology, the smoking is the cause of the majority of non-small cell lung cancers.

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How is non-small cell lung cancer treated?

The treatments administered to patients with non-small cell lung cancer depend on several factors: the stage of the cancer, the PDL-1 status, the presence of biomarkers... At the localized stage, there are in particular local treatments such as surgery or radiation therapy that can be combined with systemic treatments: chemotherapy, immunotherapy, targeted therapies...

With regard to chemotherapy, combinations including Cisplatin Or of Carboplatin are the most frequently used. For advanced or metastatic cancers, other types of chemotherapy may be given: Gemcitabine (Gemzar®), Docetaxel (Taxotere®), Etoposide (Celltop®) and Paclitaxel (Taxol®).

With regard to immunotherapies, we find in particular: Pembrolizumab (Keytruda®), Nivolumab (Opdivo®), Atezolizumab (Tecentriq®)...

Regarding targeted therapies, there are several treatments depending on the targets identified; such as anti-EGFR drugs: Osimertinib (Tagrisso®), Erlotinib (Tarceva®)... or the anti-ALK: Alectinib (Alecensaro®), Brigatinib (Alunbrig®)...

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There are also other therapeutic options available via clinical trials.

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Sources: European Society for Medical Oncology, Second Opinion, Canadian Cancer Society, ELSAN