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Lung Cancer in 2025: Hope, Innovation, and the Road Ahead



Lung Cancer in 2025: Hope, Innovation, and the Road Ahead

Taha Al-Juhaishi, MD
Associate Chief Medical Officer for Cancer Services – OU Health
Assistant Professor of Medicine
University of Oklahoma Health Sciences Center - Stephenson Cancer Center

 

Lung cancer remains a challenging disease, despite significant progress in prevention, early detection, and new treatment strategies for both early and advanced stages of the illness. In the United States, lung cancer is the second most common cancer among both men and women, following prostate and breast cancer, respectively. However, it is the leading cause of cancer mortality, accounting for 20-30% of all annual cancer deaths.1,2  While smoking remains the biggest risk factor, it is important to emphasize that many non-smokers can still develop the disease, especially women and some young adults.

Lung cancer can be subdivided into several forms, primarily categorized into two major types: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). SCLC is less common, more strongly associated with smoking, and tends to be very aggressive even in its early stages. In contrast, NSCLC constitutes a large group of disease subtypes that exhibit significant histological and genetic differences, leading to varied biological behavior and responses to available therapies. Furthermore, the anatomic size and distribution of the disease can be used to inform its staging, which historically ranges from I to IV, with stage I being a small, localized tumor and stage IV indicating metastatic disease, where the cancer has spread to other organs like bones and the brain.3

One of the biggest advancements in the management of lung cancer has been the development of screening tests using low-dose lung CT imaging. Detecting lung tumors while they are still small and potentially not causing any symptoms can enhance a patient’s chance for prolonged survival and even a cure, especially in early-stage cases that can be completely resected by surgery or treated with radiation.4 On the other hand, the majority of patients diagnosed with advanced or metastatic disease die from their cancer, with many succumbing within one year of diagnosis. Nevertheless, advancements in the field of oncology and our understanding of cancer biology have led to a revolution in drug development over the last 5-10 years. We now have many new therapies that work by targeting specific genetic mutations in the disease or unleash the patient’s own immune system to kill the cancer. Both of these strategies continue to decrease lung cancer mortality. For the first time, we now have long term survivors living five or more years with metastatic lung cancer, especially among those who respond to a class of immunotherapies called checkpoint inhibitors.3

The future of lung cancer treatment will continue to focus on prevention through smoking cessation and healthier lifestyles, early detection with screening tests, and relentless advancement in drug development aimed at helping patients live longer, healthier lives. One current groundbreaking development in the field of oncology is cellular and gene therapies, such as chimeric antigen receptor T-cell therapies (CAR-T) and tumor-infiltrating lymphocytes (TIL),5 both of which have been approved by the FDA for use in other cancers like lymphoma, multiple myeloma, and melanoma.6 While cancer is a very complex and genetically heterogeneous disease, we now have many tools at our disposal that we can continue to develop to support our patients. Therefore, promoting medical research, particularly clinical trials, should be a collective global goal to expedite progress and save lives.

 

References:

  1. Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin. 2023; 73:17.
  2. Howlader N, Forjaz G, Mooradian MJ, et al. The Effect of Advances in Lung-Cancer Treatment on Population Mortality. N Engl J Med. 2020; 383:640.
  3. Meyer ML, et al. Lung cancer research and treatment: global perspectives and strategic calls to action. Annals of Oncology. 2023; 35(12): 1088-1104.
  4. Jonas DE, Reuland DS, Reddy SM, Nagle M, et al. Screening for lung cancer with low‑dose computed tomography: Updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2021; 325(5): 971–987. https://doi.org/10.1001/jama.2020.2641  
  5. Katiyar V, Chesney J, Kloecker G. Cellular Therapy for Lung Cancer: Focusing on Chimeric Antigen Receptor T (CAR T) Cells and Tumor‑Infiltrating Lymphocyte (TIL) Therapy. Cancers. 2023; 15(14): 3733. https://doi.org/10.3390/cancers15143733 
  6. Al-Juhaishi T, Ahmed S, et al. CAR‑T in B‑Cell lymphomas: The Past, Present, and Future. Leukemia & Lymphoma / Clinical Lymphoma, Myeloma & Leukemia. 2022; https://doi.org/10.1016/j.clml.2021.10.003 (Epub Oct 15, 2021;PMID 34782260)