Update on lung cancer

Abstract

Lung cancer is the leading cause of cancer deaths in Canada and worldwide. Major scientific advances in the last decade have dramatically changed the way we detect and treat lung cancers. British Columbia, Ontario and Quebec have recently launched lung cancer screening programs for high-risk individuals using evidence-based risk prediction models, and many other provinces are in the active planning phase. This review focuses on non-small cell lung cancer (NSCLC), which comprises 80-85% of lung cancers. For patients diagnosed with advanced or metastatic NSCLC, we now have systemic therapy options—targeted therapies, chemotherapies and immune checkpoint inhibitors (ICIs)—that are tailored to the molecular characterization of individual tumor samples for DNA/RNA alterations and PD-L1 protein expression. Molecular characterization is also becoming increasingly crucial for patients diagnosed with earlier and potentially curable NSCLC, as targeted therapies and ICIs make their way into the adjuvant and neoadjuvant therapy space, partnering with radiation and surgery to improve outcomes for patients receiving multimodality curative-intent treatment.