What does it mean to have locally advanced or metastatic lung cancer? What does “personalized medicine” even mean? And what on earth is a “TKI”? Non-small cell lung cancer (NSCLC) has its own unique terminology, so reading about treatments can be challenging. And whether you or a loved one have been recently diagnosed, have been living with lung cancer for years, or you’re just following lung cancer news, chances are good that you’ve come across NSCLC terms and acronyms and been unsure of their meaning.
NSCLC has been in the news a lot in recent months, as new treatments are receiving approval from the Food and Drug Administration (FDA) and as research continues to increase understanding to help fight this cancer. The need for new therapies still remains significant: in the United States, lung cancer is the leading cause of cancer death among both men and women, accounting for approximately 154,000 deaths and about one-quarter of all cancer deaths – more than breast, prostate and colorectal cancers combined. In fact, in 2018, an estimated 234,000 people will be diagnosed with lung cancer – that is three and a half times the number of seats in a typical professional football stadium.
Learn more below in a quick guide of common NSCLC terms, and download an infographic with more lung cancer facts and statistics here.
Lung Cancer Has Various Stages
Lung cancer stage is determined by tumor size and whether it has spread to nearby areas, lymph nodes, or other organs. Some of these stages have unique names, which can sometimes make understanding the types of lung cancer confusing.
The Role of Tumor Testing
Lung cancers have certain “biomarkers,” which are unique traits of each individual lung cancer that can help patients and their doctors understand its specific characteristics and can play a role in determining what types of medicines the cancer is most likely to respond to. Biomarkers can be identified through “biomarker testing” to inform treatment approaches for each patient. This is often considered a form of “personalized medicine,” which includes treatments specially designed for certain tumor characteristics. Personalized medicines include targeted treatments for lung cancer with certain biomarkers, such as the EGFR mutation.
Treatment Experience and Approaches
If you are newly diagnosed, there are specific medicines that are available for “first-line” treatment – in other words, to be used first. If your disease progresses during or after first-line treatment, there are other medicines approved for “second-line” or “third-line” use. While there are effective and innovative therapies approved for all lines of treatment, your oncologist may choose to use the best – or most effective – medicine first, to give you the best chance of overcoming the disease for the longest possible period of time.
Different Types of Medicines for Lung Cancer
Just as there are different types of biomarkers and stages of disease, many different types of medicines exist to treat lung cancer. While many medicines have unique brand names, they also are often grouped into broader categories based on how they work. For example, there are a number of tyrosine kinase inhibitors (TKIs) – and while they generally work in a similar way, each TKI is a little different. Talk to your healthcare provider about finding the best drug first.
Clinical Trial Results
Before lung cancer medicines are approved by the FDA, they are tested in clinical trials to confirm how well they treat the cancer (often referred to as “efficacy”) and to assess their safety/side effects (often measured as “adverse events”), overall effect on patients (often referred to as “tolerability”). When clinical trials are designed, they are determined to address certain endpoints, including a focus on efficacy, safety, and tolerability. Efficacy endpoints may include progression-free survival (PFS), overall response rate (ORR), duration of response (DoR) or overall survival (OS). Each medicine has unique clinical trial results, which can help inform treatment decisions. Those decisions often take into account factors studied in a clinical trial, such as choosing a therapy that optimizes and balances efficacy and tolerability.
Lung Cancer and Brain Metastases
Lung cancer is the most common type of cancer to spread to the brain. Central nervous system (CNS) metastases are notoriously difficult to treat and can negatively impact quality of life. As mentioned above, metastasis is the spread of cancer from the primary site (lung) to another part of the body – in this case, the brain. The good news is that as science has progressed, treatments have garnered FDA approval that can do a better job of crossing the “blood-brain barrier” – a term generally used to refer to the ability of medicines to reach the brain.
If you are overwhelmed, know that you are not alone.
Many patients find that better understanding their disease and connecting with others can help them feel more supported and in control. Below are several resources that may be helpful.
US-18951 Last Updated 3/18