This year about 226,000 people in the U.S. will be told by a doctor that they have lung cancer. However, about 390,000 Americans remain alive today after having been diagnosed with this malignancy. Lung cancer includes tumors that begin in tissues lining air passages inside the lungs and bronchi. The bronchi are the 2 branches of the windpipe (trachea) that lead to the lungs. Based on how the cells look under a microscope, lung cancers are divided into 2 main types: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). NSCLC accounts for 85% of these cases.
The main subtypes of NSCLC are squamous cell carcinoma (cancer beginning in thin, flat scaly-looking cells), adenocarcinoma (cancer beginning in cells that make mucus and other substances) and large cell carcinoma (cancer beginning in several types of large cells). The 2 main types of SCLC are small cell carcinoma (oat cell cancer) and combined small cell carcinoma.
Lung cancer (and other tumors) can spread (metastasize) from the place where it started (the primary tumor) in 3 ways. First, it can invade the normal tissue surrounding it. Second, cancer cells can enter the lymph system and travel through lymph vessels to distant parts of the body. Third, the cancer cells can get into the bloodstream and go to other places in the body. In these distant places, the cancer cells cause secondary tumors to grow. The main sites to which lung cancer spreads are the adrenal gland, liver and lungs.
To find out whether the cancer has entered the lymph system, a surgeon removes all or part of a node near the primary tumor and a pathologist looks at it through a microscope to see if cancer cells are present. Several kinds of imaging also can be performed to determine if the cancer has spread. These include MRI, bone scans and endoscopic ultrasound (EUS).
The FDA has approved several targeted therapies to treat patients with NSCLC. These include bevacizumab (Avastin), cetuximab (Erbitux), erlotinib (Tarceva), gefitnib (Iressa) and crizotinib (Xalkori). So far there are no FDA-approved targeted therapies for SCLC.
Despite significant improvements in the treatment of lung cancers, novel therapies and treatment strategies are needed.
Source: National Cancer Institute, 2012
Estimated new cases and deaths from lung cancer (non-small cell and small cell combined) in the United States in 2012:
New cases: 226,160
Deaths: 160,340
Lung cancer is the leading cause of cancer-related mortality in the United States. The 5-year relative survival rate from 1995 to 2001 for patients with lung cancer was 15.7%. The 5-year relative survival rate varies markedly depending on the stage at diagnosis, from 49% to 16% to 2% for patients with local, regional and distant stage disease, respectively.
NSCLC arises from the epithelial cells of the lung, from the central bronchi to the terminal alveoli. The histological type of NSCLC correlates with the site of origin, reflecting the variation in respiratory tract epithelium from the bronchi to the alveoli. Squamous cell carcinoma usually starts near a central bronchus while adenocarcinoma usually originates in peripheral lung tissue.
Tobacco smoking is the strongest risk factor for developing lung cancer, though it should be noted that the majority of patients diagnosed with lung cancer quit smoking years prior to diagnosis or were never-smokers (up to 15% of cases).
The identification of driver oncogene mutations in lung cancer has led to the development of targeted therapy that has vastly broadened treatment options and improved outcomes for subsets of patients with metastatic disease. It is now common practice to determine the genotype of a NSCLC patient early in the course of their diagnosis, to ensure that all possible treatment options are considered.
Source: National Cancer Institute, 2012
CLICK IMAGE FOR MORE INFORMATIONROS1 is a gene that provides the code for making a protein, a receptor tyrosine kinase (RTK), that may activate several signaling pathways involved in the growth and division (proliferation), specialization (differentiation) and survival of cells.
Changes in the ROS1 gene have been associated with non-small cell lung cancer (NSCLC) and a fast-growing type of central nervous system tumor, glioblastoma multiforme. These changes are due to rearrangements of the chromosome where the gene is located.
Source: Genetics Home Reference
ROS1 is a receptor tyrosine kinase (RTK) that activates several signaling pathways involved in proliferation, differentiation and survival of cells.
Changes in the ROS1 gene have been associated with non-small cell lung cancer (NSCLC) and glioblastoma multiforme. These changes are due to rearrangements of the chromosome where the gene is located.
Source: Genetics Home Reference
Genetic alterations that occur in ROS1 involve a portion of (or the whole gene) breaking away from it's other half, or inserting itself in another part of the DNA where it doesn't normally belong. The gene fusion that results is a protein made up of part ROS1, and part of the protein that ROS1 inserted itself into. ROS1 Translocations result in the ROS1 protein being unregulated, as it is in normal cells, creating a constantly active ROS1 that sends growth and proliferation signals all the time, resulting in the development of cancer.
Genetic alterations that occur in ROS1 involve a portion of (or the whole gene) breaking away from it's other half, or inserting itself in another part of the DNA where it doesn't normally belong. The gene fusion that results is a protein made up of part ROS1, and part of the protein that ROS1 inserted itself into. ROS1 Translocations result in the ROS1 protein being unregulated, as it is in normal cells, creating a constantly active ROS1 that sends growth and proliferation signals all the time, resulting in the development of cancer.
Rearrangements of the ROS gene have been found in lung cancers. The tumor cells are unable to regulate these proteins that are part ROS, and part of a different gene.
Testing for ROS mutations is performed at the MGH Center for Integrated Diagnostics. Treatments for all ROS mutated lung cancers are available at the MGH Cancer Center, as are clinical trials testing new and improved treatments for patients.
Rearrangements of the ROS gene have been found in lung cancers. The tumor cells are unable to regulate these proteins that are part ROS, and part of a different gene.
Testing for ROS mutations is performed at the MGH Center for Integrated Diagnostics. Treatments for all ROS mutated lung cancers are available at the MGH Cancer Center, as are clinical trials testing new and improved treatments for patients.
PubMed ID's
22215748,
22919003,
22327623,
22215748