New Treatments in Lung Cancer

As announced at the World Cancer Congress in the past months, advances in lung cancer treatments increase survival rates. Anadolu Medical Center Medical Oncology Specialist and Oncological Sciences Coordinator Prof. Dr. Necdet Üskent said, "There are many innovations in lung cancer treatments, in which many branches act together, such as new immunotherapy agents, adoptive cell therapy, vaccines and smart drugs." prof. Dr. Necdet Üskent made a statement on the occasion of February 4, World Cancer Day.

Lung cancer is one of the top three most common types of cancer in both men and women. Anadolu Health Center Medical Oncology Specialist and Oncological Sciences Coordinator Prof. Dr. Necdet Üskent, “According to experts, the risk factor that is much stronger than environmental (air pollution, passive smoking) and genetic factors is the use of tobacco and tobacco products. The increase in smoking, especially in younger age groups, increases the incidence of lung cancer. Another increase is observed during the pandemic period. Since COVID-19 has consequences such as pneumonia in the lungs and increases the tomography scan in hospitals, there are many cases of lung cancer diagnosed in this way. On the treatment side, there are great advances,” he said.

More successful results are obtained in lung cancer than before

Stating that with the technological and medical developments in recent years, lung cancer is no longer a type of cancer that can be treated as difficult as it used to be. Dr. Necdet Üskent said, "While the scientific world is getting to know the tumor cell better with the new treatment methods it has developed and the innovative medical technologies it uses, we are now in a period where more successful results are gained in lung cancer than in the past."

Cancer cells that go into sleep mode can't escape science

Saying that cancer cells can avoid treatments such as chemotherapy targeting proliferating cells by taking advantage of the evolutionary survival mechanisms, Medical Oncology Specialist Prof. Dr. Necdet Üskent said, “For this reason, they have the ability to go into slow division or even the non-dividing sleep mode called the G0 phase. Cancer cells in sleep mode are not affected by chemotherapy, and they can also mutate by developing drug resistance during sleep mode. Thus, they begin to divide again and continue to ensure the spread of the disease. “This is the main mechanism behind the reappearance of tumors that initially respond well to chemotherapy and shrink.” Reminding that a cancer cell that has been dormant for years can suddenly take action, as is often seen in breast and lung cancers. Dr. Necdet Üskent, “Sleeping cancer cells consume their own cell components or their own proteins to survive (self-eating / Autophagy). However, the scientific world has also produced a cure for this sleep mode of the cancer cell. "Thanks to new drugs that block autophagy, it is now possible to destroy dormant cancer cells as well."

Warrior cells now recognize the enemy

Immunotherapy, which is based on directing immune system cells to tumor cells, is one of the important treatment approaches that have been studied for years. Reminding that many cancer cells take advantage of the mechanism known as checkpoint molecules to escape from the immune system and prevent the warrior cells (T-Lymphocytes) from attacking normal body cells, Prof. Dr. Necdet Üskent said, “Since cancer cells do not look different from normal cells, warrior cells do not attack cancer cells they see as friendly. However, with scientific studies since 2011, it has now become possible for warrior cells to bypass the checkpoint and attack cancer cells. Today, 7 immunotherapy drugs, commonly called 'Immune Check Point Suppressants', are used successfully in many types of cancer, especially lung cancer.

Adaptive cell therapy is also used in the treatment of lung cancer.

Emphasizing that adaptive cell therapy is a treatment based on placing some genetic materials into T-cells and giving them back to the patient after being replicated in the laboratory in order to increase the recognition of the cancer cell by immune cells, Prof. Dr. Necdet Üskent said, “Thanks to this method, known as CAR-T cell therapy, significant successes have been achieved in resistant lymphomas and leukemias, while trials have also started in lung cancers. These warrior T cells, which contain Chimeric Antigen Receptors (CAR), are able to recognize and destroy tumor-specific antigen. TIL cell therapy is another form of treatment. TILs are lymphocytes that collect around the cancer cell. These cells can be isolated from the person and activated to recognize the tumor in the laboratory environment and given back to the patient.

Cancer vaccines and personalized vaccines

Expressing that if there is only a recognizable antigen specific to that cancer on the surface of the cancer cell, it is possible to activate the body's immune system against that antigen. Dr. Üskent said, “The vaccines developed against NeuGmc and EGFR antigens found on the cell surface in lung cancers are treatments that are recognized by the health ministries of some countries and are used as maintenance therapy in selected cases whose tumor burden is reduced by chemotherapy. In addition, Phase 1 and Phase 2 studies of various Peptide vaccines and messenger RNA vaccines are continuing.”

Smart drugs for tumor-specific susceptible mutations

Emphasizing that especially in the non-small cell type of lung cancers called "Adenocancers", genetic changes that are the target of treatment are encountered. Dr. Necdet Üskent said, “If these changes, which are between 1 percent and 35 percent depending on the type of genetic mutations and changes, are detected, they can be blocked with drugs in tablet form, which are usually taken orally. Thus, since the genetic target that activates the tumor is eliminated, the tumor begins to shrink rapidly. While the number of smart drugs that were previously directed only at genetic targets such as EGFR, ALK and ROS-1 is increasing, new targets are also being determined. Thanks to these drugs, the tumor is brought under control even in advanced stages, and life expectancy is extended in patients with special mutations.