Lung cancer survival rates have approximately doubled over the past two decades — a remarkable achievement driven by convergent advances in early detection, surgical technique and molecular oncology.

“The response rates and overall survival data we’re observing today represent a significant shift from what was considered possible even just five years ago,” said Nicole Eiseler, M.D., a medical and sarcoma oncologist at Baptist Health Miami Cancer Institute.

Dr. Eiseler and Ian Bostock, M.D., a thoracic surgeon with the Institute, recently presented “Pathways to Hope: Advances in Lung Cancer Care” (watch the webinar here), a comprehensive education program featured during Lung Cancer Advocacy Week.

Despite being the third most diagnosed malignancy, lung cancer remains the leading cause of cancer mortality in the United States, exceeding the combined deaths from breast, colorectal and prostate cancer.

“Early detection of lung cancer improves a patient’s chances of surviving by 20 percent. It’s the most impactful thing we can do,” Dr. Bostock said. “It’s a simple message: Get a low-dose CT scan.”

Tobacco remains the leading risk factor for lung cancer. The U.S. Preventive Services Task Force recommends annual low-dose CT lung cancer screenings for people who:

• Are between 50 and 80 years old, and
• Have a 20 pack-year or more smoking history (such as smoking one pack a day for 20 years or two packs a day for 10 years), and
• Currently smoke or have quit within the past 15 years

Dr. Bostock suggests that patients speak to their primary care physicians about screening even if they smoke less.

Advances in minimally invasive thoracic surgery

When clinical presentation and imaging findings suggest lung cancer, surgeons will do a biopsy to confirm the diagnosis. “Using a local anesthetic, we can guide a needle into the chest and grab a small piece of the tumor,” Dr. Bostock said, “or we can do a robotic bronchoscopy under general anesthesia, introducing a video camera through the windpipe to the tumor and taking a small segment of tissue.”

Just as biopsy techniques have changed, so too have surgical approaches. Gone are the days when removing a lung tumor required large incisions and lengthy recoveries. Robotic surgery uses small ports while providing superior visualization and enhanced dexterity.

“About 80 percent of our patients go home the day after their procedure,” Dr. Bostock said. “The benefits include reduced postoperative pain, an accelerated recovery, fewer complications and better outcomes when compared with traditional surgery.”

The growth of precision oncology

While robotic platforms have revolutionized surgical intervention, precision medicine based on comprehensive molecular profiling to guide treatment selection has fundamentally altered the management of non-small cell lung cancer.

“What has changed survival is our ability to study the tumor and to understand its molecular makeup,” Dr. Eiseler said. Now we are able to match patients to specific therapies based on their tumor’s unique characteristics.”

The development of first-generation EGFR tyrosin kinase inhibitors in 2003 represented a seminal advance. These agents selectively inhibit mutant EGFR signaling that drives proliferation of the cancer cells. “Testing for the EGFR mutation became the standard of care and really marked the beginning of personalized medicine,” she noted.

ALK inhibitors emerged in 2007 for the fewer than 5 percent of lung cancer patients with an ALK mutation, typically characterized by therapeutic resistance. More recently, the 2021 approval of KRAS G12C inhibitors represented a breakthrough in addressing a mutation once thought impossible to target.

The newest class of drugs — antibody drug conjugates (ADCs) — seek out and target cancer cells, releasing their toxic payload within the cell itself. Medications such as Enherlu, Datroway and Emrelis are dramatically improving overall survival rates for specific mutation types, Dr. Eiseler said.

Clinical investigation at Miami Cancer Institute

The Institute is leading and participating in several clinical trials that are advancing lung cancer therapeutics:

• The COPERNICUS trial is testing a bispecific antibody targeting both EGFR and MET mutations, administered via a subcutaneous injection rather than intravenous infusion.
• The SUNRAY-01 and SUNRAY-02 (opening soon) trials are investigating combination targeted therapy plus immunotherapy to enhance survival outcomes.
• INTerpath-002 is a potentially groundbreaking Phase 3 randomized, personalized neoantigen vaccine trial. This study is evaluating whether a vaccine, developed from a person’s own tumor, combined with pembrolizumab, can prevent disease recurrence in patients who have had surgery to remove Stage II-IIIB non-small cell lung cancer followed by chemotherapy.

“We are continuing to work to bring scientific advances to our patients that result in better quality of life and improved outcomes,” Dr. Bostock said.

“We have made great strides in recent years, and the future holds tremendous promise,” Dr. Eiseler added.

The bottom line, they say, is that advances in cancer care have made it possible for lung cancer patients to live longer than ever. But early detection is still key. For information, or to schedule a patient for a lung cancer screening, go to lung cancer screenings or call 833-596-2473.