Incidence & Mortality

Lung cancer is the leading cause of cancer death for both men and women worldwide. In 2012, there were more than 1.8 million lung cancer diagnoses causing 1.6 million deaths worldwide (Goldstraw et al., 2011). With the current high and ever-increasing rate of smoking in many Asian and developing countries, the incidence of lung cancer and consequent deaths from this disease is anticipated to increase over the next decades. In Asia, it is noteworthy that a significant proportion of people who develop lung cancer are lifelong non-smokers (Thun et al., 2008; Toh et al., 2006). The mortality rate of lung cancer is high compared with other cancers because only about 15% of lung cancer cases are diagnosed at an early stage allowing curative treatment (Liam, Pang, Leow, Poosparajah, & Menon, 2006; Wang et al., 2013).

In the United States, 5-year survival figures range from 52% to 24% to 4% for local, loco-regional and distant disease, respectively (Howlader et al., 2015). However, meta-analytic studies suggest that the survival of Asian lung cancer patients is better than that of their Caucasian counterparts (Soo et al., 2011). The reasons behind a more favourable prognosis of Asian lung cancer patients might be explained by the relatively high prevalence of epidermal growth factor receptor (EGFR) mutations predicting altered biology and more favourable response to EGFR tyrosine kinase inhibitors (Liam, Wahid, Rajadurai, Cheah, & Ng, 2013; Zhou & Christiani, 2011).

Lung Cancer Screening & Treatment

Over the last decades, lung cancer has been the leading cause of cancer-related mortality in the world, with almost 1 in 5 deaths attributable to it (Cancer, 2014). Non-small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancers, with this encompassing the pathologically distinct adenocarcinoma, squamous cell carcinoma and large cell carcinoma sub-types. NSCLC is associated with good prognosis if diagnosed at an early stage, when surgery is most effective (Ettinger et al., 2010); however, for advanced disease, 5 year survival rates remain low, despite developments in chemotherapy (Klastersky & Paesmans, 2001) This highlights the need for alternative treatment approaches for patients with unresectable or metastatic tumours.

Targeted therapies are systemic treatments that work by specifically blocking certain aspects of signaling pathways associated with tumour growth and suppression. The first of these to be put into clinical practice were small molecule inhibitors of the epidermal growth factor receptor (EGFR). This is expressed in a high proportion of tumours, and is involved in cell proliferation and apoptosis signaling. The identification of the echinoderm microtubule-associated protein-like 4 (EML-4)–anaplastic lymphoma kinase (ALK) fusion oncogene in 2007 provided a further target for molecular therapy (Soda et al., 2007).

Advances in our knowledge of cancer biology, in particular in its genetic basis, are continually providing further targets for systemic therapies. Furthermore, increasingly, genetic screening of patients is allowing for identification of subgroups that will benefit most from a particular drug (Cagle & Allen, 2012). Over the last decade there have been significant advances in the treatment of advanced NSCLC. There is now a variety of drugs available on the market that has been demonstrated to improve survival when administered as first-line, second-line or combination therapies. The identification of genetic alterations that predict response to some drugs has provided an effective means of selecting the most appropriate treatment for individual patients.

At International Cancer Specialists (ICS), we relentlessly strive to provide our patients compassionate and competent care. Led by qualified and experienced oncology clinicians and healthcare managers, as well as a multidisciplinary team of medical specialist partners (all of whom are UK or/and US Board-Certified), ICS stands ready to deliver cutting-edge patient-centered care in a welcoming environment.

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