Lung cancer is the leading cause of cancer death in the world. The high occurrence and death rate of this disease kills about 1.6 million people each year. It is therefore known as the top enemy for health professionals.
A recent study published in the journal Nature overviewed the progress of fighting lung cancer in the past 20 years and find out the two most advanced treatments for non-small cell lung cancer (NSCLC). The study was conducted by the scientists from Yale University.
Two treatments of NSCLC
NSCLC is the most common type of lung cancer, accounting for about 85% of lung cancer. Lung adenocarcinoma, lung squamous cell carcinoma and large cell lung cancer are subtypes of non-small cell lung cancer. The traditional treatments of NSCLC include surgery, radiotherapy and chemotherapy. With the progress of scientific research, a new method has emerged.
“Over the past two decades, the advent of both molecular targeted therapy and immunotherapy has made huge contributions to overcome NSCLC,” said Roy S. Herbst, a professor of medicine and pharmacology at Yale University.
Molecular targeted therapy
The wide use of molecular targeted therapy makes it more known by ordinary people. Drugs or other substances are designed to target specific molecules involved in the growth and spread of cancer cells. Blocking these molecules may kill cancer cells or may keep cancer cells from growing or spreading. Molecularly targeted therapy may cause less harm to normal cells and may have fewer side effects than other types of cancer treatments.
Since 2004 when U.S. Food and Drug Administration approved the first targeted drug for the treatment of non-small cell lung cancer, about one-fourth of patients with non-small cell lung cancer use various targeted drugs for treatment now. The commonly used drugs for treating lung cancer include Iressa, Tarceva and Camille, all of which are targeted against EGFR mutation in lung cancer.
In 2015, another milestone emerged in the treatment of NSCLC: the FDA approved the first immune checkpoint inhibitor for the treatment of advanced NSCLC, the PD-1 inhibitor Opdivo. Tumor cells can paralyze the immune cells T cells and avoid the attack from T cells by binding themselves to T cells. The immunotherapy is to inhibit the binding of PD-1 protein of T cells to the partner protein PD-L1 of tumor cells so that the tumor cells fail to paralyze T cells and are attacked by T cells.
So far, immune checkpoint inhibitors have received a positive response among about one in five patients with NSCLC. In general, patients with high PD-L1 levels are more suitable for this immunotherapy.
Both treatments are effective but flawed
Although both methods are currently the most advanced treatment for lung cancer, both methods face a common problem – tumor resistance. The drug resistance reduces the efficacy of anticancer drugs. In fact, cancer drug resistance is a common problem in various cancer treatments, including chemotherapy.
Two suggestions that curb tumor drug resistance
In the paper, Dr. Herbst put forwarded two suggestions that help solve the problem of tumor resistance in molecular targeted therapy and immunotherapy. One is to develop new targeted drugs and immunotherapy drugs, such as the development of new cancer molecular targets or the new immunotherapy targeted at other parts of the immune system. Another is the combination of immunotherapy with chemotherapy, molecular targeted therapy, anti-angiogenesis drugs or other forms of cancer treatments.
In the field of combination therapy, ginsenosides present an increasing potential. Ginsenosides combined with molecularly targeted drugs, chemotherapy drugs and radiotherapy have played an important role in reversing tumor drug resistance.
Scientists have found that ginsenosides can significantly reverse tumor cell resistance by increasing the permeability of tumor cell membranes and reducing the drug pumps in tumor cells. Meanwhile, ginsenosides can also inhibit tumor angiogenesis and play a significant role in inhibiting cancer metastasis.
Prof.Herbst concluded: “We have seen unprecedented progress in the treatment of non-small cell lung cancer, but it remains a very intractable cancer and we can only help 30% to 35% of patients at present. Innovative research is further needed and There is a long way to go before we finally conquer it.”