Chapter 1: Understanding Lung Cancer

Lung cancer is recognized as the second most common cancer worldwide, impacting both genders significantly. According to the World Cancer Research Fund International (WCRFI), it has the highest incidence among males and ranks second for females. In 2020 alone, over 2.2 million new lung cancer cases were reported globally. There are two major classifications of lung cancer: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC).

NSCLC is the predominant type, constituting around 80–85% of lung cancer cases, whereas SCLC accounts for approximately 10–15%. This disease is often linked to long-term exposure to tobacco smoke, whether from active smoking or secondhand smoke. However, it can also affect non-smokers, influenced by factors like environmental pollutants, genetic factors, or prior lung health issues.

Recently, a significant clinical trial orchestrated by Yale University unveiled promising results regarding a daily medication that could dramatically lower death rates for a specific variant of lung cancer. The drug, known as ‘osimertinib’ or Tagrisso, showcased a remarkable 51% reduction in mortality risk for patients who had their tumors surgically removed.

“Three decades ago, we had no options for these patients. Now, we possess this powerful medication. A 50% reduction is significant in any disease, especially in a condition like lung cancer, which has historically resisted treatment.”

~ Dr. Roy Herbst, Lead Author of the Study

AstraZeneca, a prominent pharmaceutical company, has created a targeted therapy aimed at a particular subtype of lung cancer—non-small cell cancer, which is the most frequently diagnosed form and linked to a specific genetic mutation. This mutation is found in about 10 to 25% of lung cancer patients in the U.S. and Europe, while its prevalence increases to 30 to 40% in Asia.

To investigate the effects of the treatment, approximately 682 patients diagnosed with non-small cell lung cancer participated in the study. Their ages ranged from 30 to 86, and they were recruited from 26 countries. Among them, 339 received the ‘osimertinib’ medication, while 343 were given a placebo.

All trial participants exhibited a mutation in the EGFR gene (epidermal growth factor receptor), which is present in nearly 25% of lung cancer cases globally and up to 40% in Asia. This mutation is more common in women and those who have never smoked or have a light smoking history.

At the five-year follow-up, an impressive 88% of patients who consistently took the daily pill after tumor removal were still alive, compared to 78% of those who received the placebo. Those treated with ‘osimertinib’ experienced a significant 51% lower risk of mortality than those on the placebo. This groundbreaking advancement provides new hope for individuals facing this particular form of lung cancer.

The complete findings were published in The New England Journal of Medicine.

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