Lung cancer is the number one cause of cancer death worldwide, and smokers aren’t the only ones at risk. There have been several promising advancements in lung cancer detection, diagnosis, and treatment, and essential amino acids play a role! We’ll give a quick overview of lung cancer before detailing the latest advances in lung cancer research.
A Brief Overview of Lung Cancer
The primary cause of lung cancer remains smoking, which is thought to injure the cells that line the lungs. Both smokers and people continually exposed to secondhand smoke are at the highest risk of lung cancer. In addition to smoke exposure and a family history of lung cancer, other potential causes of lung cancer include exposure to:
- Carcinogens like asbestos
- Radiation therapy
- Radon gas
There are two lung cancer types.
- Small cell lung cancer: This type of cancer is the less common of the two and strikes heavy smokers.
- Non-small cell lung cancer: This type accounts for all the other, more specific forms of lung cancer, such as adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.
Advancements in Lung Cancer Research
Due to the stigma of smoking, lung cancer is underfunded compared to other cancers such as breast cancer and leukemia. Still, scientists are working hard to develop new methods for lung cancer screening, prevention, and treatment options.
Awareness holds the key to prevention. In addition to spreading knowledge on the dangers of nicotine and tobacco use so that young people are never tempted to smoke, research is aimed at ways to help people quit smoking, such as this study from Queen Mary University of London, and this review on treatment and recovery from nicotine addiction.
Research is also underway on how different inherited genes can increase susceptibility to lung cancer, and scientists are investigating environmental causes of lung cancer and strategies for limiting exposure.
Early detection of lung cancer has been shown to decrease mortality risk, hence the efforts of researchers to develop and refine screening methods.
The National Cancer Institute (NCI) sponsored the National Lung Screening Trial (NLST), which determined that low-dose CT scans were effective for the early detection of lung cancer in heavy smokers and helped to reduce the risk of dying.
Refinements to CT scanning are currently underway. And computers are leading the charge. One study showed that computer algorithms could detect lung cancer and cancer-related genetic mutations from CT screening with 97% accuracy.
Funding has also been allocated to advance testing for biomarkers such as the presence of abnormal cells in the blood and sputum, a type of phlegm produced by the lungs.
Doctors are also using fluorescence bronchoscopy, also called autofluorescence bronchoscopy, to help catch early-stage lung cancers. A bronchoscope is inserted into the nose or mouth, where a special fluorescent light colors abnormal portions of the airway.
Physicians are also using electromagnetic navigation bronchoscopy to biopsy tumors in the hard-to-reach outer regions of the lungs.
Current treatment of lung cancer involves one or a combination of the following: surgery, chemotherapy, radiotherapy, targeted therapy, and immunotherapy. Let’s take a look at the headway being made with each of these treatments.
Surgeons are now using video-assisted thoracic surgery (VATS) to remove small lung tumors. This type of surgery uses smaller incisions and shortens recovery time and pain. More recent advancements have been made with robotic-assisted surgery in which the surgeon operates from a control panel using long robotic arms, although it has yet to be determined if this is a more effective surgical procedure.
Real-time tumor imaging has advanced radiation therapy by allowing radiation to target the tumor more precisely. Using four-dimensional computed tomography (4DCT) a CT machine can continuously scan the lung for 30 seconds while a person breathes to identify where the tumor sits in relation to other structures. This also helps the healthcare team determine the best course of treatment and if surgery is an option.
Immunotherapy fights cancer through immune system mechanisms, and it’s a promising treatment for advanced stage lung cancer patients.
Immune checkpoint inhibitors are pharmaceuticals that suppress the activity of proteins on immune system cells called T cells, specifically the proteins PD-L1 and PD-1, so that they can fight cancer. Immune checkpoint inhibitors for lung cancer include:
- Atezolizumab (Tecentriq)
- Durvalumab (Imfinzi)
- Nivolumab (Opdivo)
- Pembrolizumab (Keytruda)
While these inhibitors have proved beneficial for patients with tumors with high levels of PD-L1 proteins, these inhibitors won’t work as well for everyone. Patients with high tumor mutational burden (TMB), which is the number of mutations in the DNA of a cancer cell, have also responded well to immunotherapy, but more research is required.
Targeted therapies are designed to destroy cancer cells without harming healthy, normal cells.
- Anaplastic lymphoma kinase (ALK) inhibitors: 5% of lung cancer patients have alterations of the ALK gene, and these types of inhibitors target this cancer-causing alteration.
- Epidermal growth factor receptor (EGFR) inhibitors: These inhibitors block the activity of the EGFR protein that causes tumor cells to grow and divide.
- ROS1 inhibitors: The ROS1 protein plays a role in cell signaling and proliferation, and by suppressing this activity, ROS1 inhibitors can help fight cancer in non-small cell lung cancer patients.
- BRAF inhibitors: These inhibitors target the B-raf protein involved in cell growth and signaling.
Non-small cell cancers can bring about mutations in other genes, such as the NRTK-1 and NRTK 2-genes that can be treated with larotrectinib sulfate (Vitrakvi). Current therapies are being developed for other cancer-driving genes, including RET, HER2, MEK, and MET.
Brain metastases are common in lung cancer patients, and improvements in some of these inhibitors, such as ALK inhibitors, are showing an increased ability to cross the blood brain barrier. Clinical trials of a new EGFR inhibitor called AZD3759 has also shown efficacy with blocking the spread of non-small cell lung cancer to the brain.
The Role of Amino Acids in Lung Cancer Research
Cancer cachexia is a wasting syndrome that causes extreme muscle loss and greatly reduces positive outcomes in cancer cases. Clinical research confirms that essential amino acids have been proven to help protect against cancer cachexia and improve mortality outcomes for cancer patients, including lung cancer patients.
Involuntary weight loss and skeletal muscle wasting characterize non-small cell lung cancer (NSCLC) and reduce the likelihood of recovery and survival. Consuming enough protein to help protect against muscle loss is challenging for patients, as appetite and ability to ingest protein-containing foods are compromised. Just as essential amino acid supplements have been shown to prevent muscle wasting in clinically ill populations with reduced appetite, so too do they help protect muscle health in patients with advanced lung cancer and improve quality of life (1).
You can get this special essential amino acid formulation here.
Lung Cancer and the Coronavirus
The Thoracic Cancers International COVID-19 Collaboration (TERAVOLT) registry has tracked outcomes for lung cancer patients with COVID-19. Results thus far indicate that 33% of patients from the study died from COVID complications and that patients with stage IV non-small cell lung cancer are most at risk (2).
Cancer researchers at Memorial Sloan Kettering Cancer Center study found that 20% of cancer patients with COVID-19 (8% of which had lung cancer) suffered from respiratory distress and 12% died within 30 days. Immunotherapy was linked to a higher risk of complications (3).
Stay in the Know
To stay informed with the latest research in prevention, diagnosis, and new treatments, bookmark the NIC’s full list of lung cancer clinical trials and study updates here.