Recent advances in the management of lung cancer

Abstract

Historically, the prognosis for individuals diagnosed with lung cancer has been bleak. However, the past 10 years have seen important advances in treatment and diagnosis which have translated into the first improvements seen in lung cancer survival. This review highlights the major advances in treatments with curative intent, systemic targeted therapies, palliative care and early diagnosis in lung cancer. We discuss the pivotal research that underpins these new technologies/strategies and their current position in clinical practice.

Keywords: Lung cancer; curative treatment; early diagnosis; lung cancer management; targeted therapies.

© Royal College of Physicians 2018. All rights reserved.

Figures

Fig 1.

Age standardised ratios of lung cancer in the UK since 1979. Reproduced with permission. Web content: Cancer Research UK, http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/lung-cancer/incidence ASR = age standardised ratio

Fig 2.

International Association for the Study of Lung Cancer (IASLC) 8th edition lung cancer stage groupings. International Association for the Study of Lung cancer 2015.

Fig 3.

Video-assisted thoracoscopic surgery (VATS). Reproduced with permission of the © ERS 2018: The European Lung White Book Respiratory Health and Disease in Europe, 2nd Ed. European Respiratory Society, Sheffield, UK, 2013. Print ISBN: 978-1-84984-042-2, Online ISBN: 978-1-84984-043-9.

Fig 4.

A planning CT thorax for Stereotactic Ablative Radiotherapy (SABR). Reproduced and adapted with permission from Frontiers in oncology: www.frontiersin.org/articles/10.3389/fonc.2015.00213/full CT = computed tomography

Fig 5.

CT scan demonstrating multiple radiofrequency ablation probes being deployed within a peripheral tumour. Reproduced with permission from the Global Resource for Advancing Cancer Education (www.cancerGRACE.org) CT = computed tomography

Fig 6.

First stage of the ­optimum lung cancer pathway. 0 on the maximum waiting times bar corresponds to the date of referral onto the cancer pathway. CRX = chest X-ray; CT = computed tomography; NICE = National Institute for Health and Care Excellence