Examples of NCI research to lessen the burden of lung cancer and other tobacco-related diseases include the following:
Etiology: Population studies uncover the biologic, genetic, epidemiologic, environmental, social, and behavioral factors that interact with cigarette smoking and other tobacco exposures to cause cancer. NCI-supported case-control studies (which compare people who have a condition with people who do not) explore the genetics of lung cancer development, smoking persistence, and patient survival. Research on the link between the changes in the lung microenvironment caused by inflammation will help inform the process of cancer development and may inform our understanding of lung cancer in smokers, former smokers, and non-smokers.
Prevention: The Lung Cancer Biomarkers and Chemoprevention Consortium (LCBCC) conducts clinical trials and studies to identify blood-based biomarkers that can be used to assess response to chemoprevention agents.
A scanning electron microscopic
image of a cancer cell and its
processes on a cellular surface
Early Detection: The National Lung Screening Trial (NLST) and the Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trials are following large groups of participants to compare the effectiveness of spiral-computed tomography (CT) against standard chest X-rays in reducing lung cancer mortality and to test the effectiveness of regular chest X-rays for lung cancer detection.
Treatment: NCI's lung cancer clinical trials are studying new treatment approaches to inhibit factors that stimulate growth of lung tumors. NCI's Imaging and Lung Cancer teams are planning research to advance the use of advanced imaging, such as FDG-PET (positron emission tomography), an imaging technique that produces a three-dimensional image of functional processes in the body, to detect a patient's response to a targeted therapy. Work to translate findings from this and other research into interventions to reduce the burden of tobacco-related cancers affords a potentially major opportunity to improve the health of people across the globe. For example, a drug called erlotinib (Tarceva®) is one of the "targeted drugs" that more specifically attack cancer cells, sparing normal cells. Erlotinib targets a protein called the epidermal growth factor receptor (EGFR). A protein that helps cells divide, EGFR is found at abnormally high levels on the surface of many types of cancer cells, including many cases of non-small cell lung cancer. By interfering with EGFR, erlotinib may keep tumors from growing. NCI is working to identify those patients for whom the drug, now approved by the FDA, offers the best outcome.