The Evolving Role of Chemotherapy in Lung Cancer

Immunotherapies may be a new partner for this class of treatments

While progress made in immunotherapy is bringing hope to many patients, chemotherapy remains the backbone of treatment for the majority of patients living with non-small cell lung cancer. In some ways, researchers continue to evaluate the full potential of this foundational therapeutic class.

UPAL BASU ROY, DIRECTOR OF RESEARCH AND POLICY AT THE LUNGEVITY FOUNDATION EXPLAINS THAT CHEMOTHERAPY AND IMMUNOTHERAPY MAY MAKE A POWERFUL COMBINATION IN THE FUTURE.

UPAL BASU ROY, DIRECTOR OF RESEARCH AND POLICY AT THE LUNGEVITY FOUNDATION EXPLAINS THAT CHEMOTHERAPY AND IMMUNOTHERAPY MAY MAKE A POWERFUL COMBINATION IN THE FUTURE.

“We’re still learning how best to use chemotherapy and personalize it to help lung cancer patients live longer, better lives,” Upal Basu Roy, director of research and policy at the LUNGevity Foundation, said. “The role of chemotherapy in lung cancer treatment is still evolving and improving every day. I don’t see it ever really going away anytime soon.”

Lung cancer remains one of the deadliest forms of cancer, with an approximate 18 percent five-year survival rate. While certain subtypes of non-small cell lung cancer can be treated with targeted therapies, the majority are still treated with chemotherapy.

Fortunately, the experience of chemotherapy today is considerably less challenging than it was decades ago.

“When my grandmother was treated with chemotherapy for cancer in the 1980s, she suffered just as much from the side effects as she did from the cancer,” Basu Roy said. “But when my uncle was treated in the 2000s, his doctors prescribed him anti-nausea medications to help minimize that side effect.” Other medicines used along with chemotherapy aim to battle fatigue and loss of appetite.

By making chemotherapy more tolerable, doctors have expanded its use to earlier stages, when the disease has not spread (“metastasized”) beyond the lungs, so surgeons can attempt to remove the tumor. Chemotherapy before surgery can help shrink the tumor, making it easier to be removed. Giving chemotherapy soon after surgery is meant to kill any cancer cells left behind and has increased the five-year survival rate for patients with non-small cell lung cancer by 5 percent. When the tumor cannot be removed surgically, a combination of chemotherapy and radiation, given at the same time, has helped patients live longer.

We’re figuring out not only which treatment approaches are most effective but also how to combine them and in which order

With immunotherapies, which work with your body’s immune cells to fight cancer, the potential for innovative combination treatments with chemotherapy is growing. These new therapies have significantly reduced, or in rare case even eliminated, the tumor burden of metastatic disease in patients. But they don’t work for everyone. For instance, PD1 inhibitors work for 20 to 30 percent of patients with non-small cell lung cancer, meaning the remainder needs other options. Some studies are combining immunotherapy with chemotherapy to determine whether more patients respond.

With a rapidly changing treatment landscape, community oncologists who treat many types of cancer may not be up to date on the latest advances specific to lung cancer. So patients should learn all they can, ask plenty of questions and seek out second opinions from lung cancer specialists.

To provide the lung cancer community with the information needed to ask the right questions and make the best treatment decisions with their doctors, Celgene has worked with Cancer Support Community and LUNGEVITY to publish an educational resource called “Treatments for Advanced and Metastatic Lung Cancer” as part of the Frankly Speaking About Cancer® series. This guide is designed to help patients feel empowered to take control of their cancer—and their lives – and provides a comprehensive overview of treatment options for metastatic lung cancer, as well as a tear-out discussion guide to help patients understand what questions to ask and the type of information they need to work with their doctor to decide the best treatment options.

“We’re figuring out not only which treatment approaches are most effective but also how to combine them and in which order,” Basu Roy said. “And as we continue to learn, we need to make sure this information gets to the front lines, to the community oncologists who see the majority of lung cancer patients.”

To learn more about the treatment options for metastatic lung cancer, read Treatments for Advanced and Metastatic Lung Cancer at the Cancer Support Community website.