Lung cancer: Biology and treatment options

Abstract

Lung cancer remains the leading cause of cancer mortality in men and women in the U.S. and worldwide. About 90% of lung cancer cases are caused by smoking and the use of tobacco products. However, other factors such as radon gas, asbestos, air pollution exposures, and chronic infections can contribute to lung carcinogenesis. In addition, multiple inherited and acquired mechanisms of susceptibility to lung cancer have been proposed. Lung cancer is divided into two broad histologic classes, which grow and spread differently: small-cell lung carcinomas (SCLCs) and non-small cell lung carcinomas (NSCLCs). Treatment options for lung cancer include surgery, radiation therapy, chemotherapy, and targeted therapy. Therapeutic-modalities recommendations depend on several factors, including the type and stage of cancer. Despite the improvements in diagnosis and therapy made during the past 25 years, the prognosis for patients with lung cancer is still unsatisfactory. The responses to current standard therapies are poor except for the most localized cancers. However, a better understanding of the biology pertinent to these challenging malignancies, might lead to the development of more efficacious and perhaps more specific drugs. The purpose of this review is to summarize the recent developments in lung cancer biology and its therapeutic strategies, and discuss the latest treatment advances including therapies currently under clinical investigation.

Keywords: Immunotherapies; Lung cancer; Mesothelioma; Non-Small Cell Lung; Small-cell lung carcinomas; Surgery; Targeted therapies; Therapies; Treatments.

Figure 1

Schematic illustration of the Non-Small Lung Cancer (NSCLC) staging. Of note, Squamous cell lung carcinomas arise in the epithelial cells of main and lobar Bronchi (not shown), whereas Adenocarcinomas originate in the peripheral lung tissue and arise in the epithelial cells of segmental bronchi. For stage IV NSCLC cancers, the incidence of distant metastasis to the extrathoracic organs is depicted. For each organ, the percentages represent the incidence of metastasis for squamous cell lung carcinomas and adenocarcinomas, respectively.