Lung cancer is the leading cause of cancer death among men and women. There are three major types of lung cancer. Non-small cell lung cancer (NSCLC) is the most common form (85% of all cases) and is further classified into squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. About 10-15% of lung cancers are small cell lung cancer (SCLC), which grows rapidly and shows early widespread metastasis. The third type are lung carcinoid tumors, which are diagnosed in less than 5% of lung cancer patients and this neuroendocrine tumor is characterized by a slow growth rate and a low metastatic potential.
In the last decade, treatment options for advanced, metastatic NSCLC have been revolutionized with the introduction of personalized genotype-directed treatment modalities. Most common driver mutations in NSCLC include components of MAPK and PI3K signaling but also ALK translocation or PDGFRA amplifications are frequently detected by molecular screening. Targeted therapies are available for many of those driver genes and significantly improve overall survival. Yet, primary or secondary resistance challenges the clinical management of advanced NSCLC. Research in the field focuses on the multifaceted and dynamic nature of resistance to targeted therapies, which are mediated in part by genetic heterogeneity, microenvironmental factors or epigenetic mechanisms.
Especially lung cancers in patients with a smoking history are characterized by a high mutational load, which challenges therapies targeting individual mutations, yet, generates a multitude of antigens potentially detectable by the immune system. Accordingly, immune checkpoint inhibitors targeting the PD-L1/PD-1 axis show great clinical benefit in advanced lung cancer patients and are currently approved as second-line treatment for NSCLC. Combination treatment of PD-1 and CTLA-4 inhibition are currently being tested for the use as first line therapies. Importantly, immune checkpoint inhibitors also provide novel therapeutic options in small cell lung cancer, a disease in which no targeted therapy has been proven effective up to date.
TICC Faculty who are involved in Lung cancer research: