Lung cancer can stay hidden for over 20 years, researchers say

9 Oct 2014

According to a new study, lung cancers can stay hidden for over 20 years before suddenly "turning on" and revealing themselves as an aggressive form of the disease. The research included people who never smoked, used to smoke, or currently smoke.

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Researchers studied lung cancers from seven patients overall. They found that after the first genetic mistakes that cause the cancer, it can exist undetected for many years until new, additional, faults trigger rapid growth of the disease. During this expansion there is a surge of different genetic faults appearing in separate areas of the tumor. Each distinct section evolves down different paths, meaning that every part of the tumor is genetically unique.

2 in 3 lung cancer patients diagnosed with advanced form of the disease

This research (jointly funded by Cancer Research UK and the Rosetrees Trust) highlights the need for better ways to detect the disease earlier.  2 in 3 patients are diagnosed with advanced forms of the disease when treatments are less likely to be successful. By revealing that lung cancers can lie dormant for many years the researchers hope this study will help improve early detection of the disease.

Cancer Research UK: "we hope we can start to predict lung cancer's next steps"

Study author Professor Charles Swanton, at Cancer Research UK’s London Research Institute and the UCL Cancer Institute, said: “Survival from lung cancer remains devastatingly low with many new targeted treatments making a limited impact on the disease. By understanding how it develops we’ve opened up the disease’s evolutionary rule book in the hope that we can start to predict its next steps.”

*The role of smoking

The study also highlighted the role of smoking in the development of lung cancer. Many of the early genetic faults are caused by smoking. But as the disease evolved these became less important with the majority of faults now caused by a new process generating mutations within the tumor controlled by a protein called APOBEC.

The wide variety of faults found within lung cancers explains why targeted treatments have had limited success. Attacking a particular genetic mistake identified by a biopsy in lung cancer will only be effective against those parts of the tumor with that fault, leaving other areas to thrive and take over.

Renewed focus to beat lung cancer at the Cancer Research UK

Building on this research will be a key priority for the recently established Cancer Research UK Lung Cancer Centre of Excellence at Manchester and UCL. The Centre is a key part of Cancer Research UK’s renewed focus to beat lung cancer; bringing together a unique range of internationally renowned scientists and clinicians to create an environment that catalyzes imaginative and innovative lung cancer research.

Professor Nic Jones, Cancer Research UK’s chief scientist, said: “This fascinating research highlights the need to find better ways to detect lung cancer earlier when it’s still following just one evolutionary path. If we can nip the disease in the bud and treat it before it has started travelling down different evolutionary routes we could make a real difference in helping more people survive the disease.

“Building on this work Cancer Research UK is funding a study called TRACERx which is studying hundreds of patients' lung cancers as they evolve over time to find out exactly how lung cancers mutate, adapt and become resistant to treatments ”

 

Source: Cancer Research UK

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