Abstract
Despite advances in targeted treatments, lung cancer remains a common and deadly malignancy, in part owing to its typical late presentation. Recent developments in lung cancer screening and ongoing efforts aimed at early detection, treatment, and prevention are promising areas to impact the mortality from lung cancer. In the past several years, lung cancer screening with low-dose chest computed tomography (CT) was shown to have mortality benefit, and lung cancer screening programs have been implemented in some clinical settings. Biomarkers for screening, diagnosis, and monitoring of response to therapy are under development. Prevention efforts aimed at smoking cessation are as crucial as ever, and there have been encouraging findings in recent clinical trials of lung cancer chemoprevention. Here we review advancements in the field of lung cancer prevention and early malignancy and discuss future directions that we believe will result in a reduction in the mortality from lung cancer.
Highlights
Lung cancer accounts for more cancer-related deaths than the three deadliest cancers combined[1]
In order to impact lung cancer mortality, efforts aimed at prevention and early detection are crucial
Detection: advances in lung cancer screening The high mortality from lung cancer has inspired investigators for decades to search for effective lung cancer screening modalities
Summary
Lung cancer accounts for more cancer-related deaths than the three deadliest cancers combined[1]. Building on preclinical evidence that this pathway may be important in lung cancer chemoprevention, a clinical trial of iloprost, an oral prostacyclin analog, demonstrated improved endobronchial histology, which is an accepted secondary endpoint for squamous cell lung cancer development This improvement was seen in former smokers only, whereas current smokers in the trial did not show benefit and this again highlights the importance of tobacco cessation in lung cancer prevention. The ability to identify patients with pre-malignant lesions, and which lesions may progress to invasive carcinoma, would significantly improve the precision of monitoring and the early detection of lung cancer This would intersect with chemoprevention as primary and secondary chemoprevention efforts could be applied in a more targeted, and more effective, manner. Grant information The author(s) declared that no grants were involved in supporting this work
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