Targeted Therapy – Turning Lung Cancer into a “Chronic Disease”

As we all know, lung cancer has become the number one “cancer killer” in the world, with 1.2 million new cases and deaths every 30 seconds. In China, lung cancer is also the cancer with the highest incidence and mortality rate. According to the statistics provided by experts, from 2000 to 2005, there were 120,000 new cases of lung cancer in China, including 70,000 men and 50,000 women. If the number of smokers is not controlled and the environment is not protected, then theoretically, China will reach the peak of lung cancer by 2025: 1 million new patients per year! Therefore, the prevention and treatment of lung cancer has been classified by the state as a research topic for the prevention and treatment of major diseases. The treatment of lung cancer has been unsatisfactory so far, mainly because most of it is not early at the time of diagnosis and 80% of the patients have lost the chance of surgery at the first visit. Most early-stage non-small cell lung cancers are treated surgically according to the standard, and their treatment pattern is relatively fixed, with no major breakthrough in recent years, and the 5-year survival rate of patients can reach about 50%. In contrast, the treatment of locally progressive and advanced non-small cell lung cancer is a more difficult subject. Although most of the current clinical studies focus on the treatment of advanced lung cancer, its 5-year survival rate is still 5-10%. How to prolong the survival period and improve the quality of survival of advanced stage patients is a hot topic nowadays and an important indicator to consider the level of lung cancer treatment. The ability of chemotherapy to significantly prolong the survival and improve the quality of life of advanced lung cancer patients has been confirmed in many clinical studies, and it is also the most important treatment tool in lung cancer clinical treatment. However, the efficiency of first-line chemotherapy for lung cancer is only 30%-40% and the efficiency of second-line chemotherapy is only 10%, and the side effects of chemotherapy such as nausea, vomiting, hair loss and white blood cell reduction make many lung cancer patients afraid of chemotherapy and even unwilling to receive further treatment. For a medical practitioner engaged in lung cancer research, I often feel sad for my incompetence as well. Since the efficacy of chemotherapy alone for advanced NSCLC has reached a plateau, there is an urgent need to conduct new clinical studies and develop new drug treatments to improve patient prognosis. In the past two to three decades, with the deepening understanding of tumorigenesis and its progression, drug therapy for tumors is in a transition period from pure cytotoxic attack to molecularly targeted modulation, and molecularly targeted drugs have become a new “weapon” for cancer treatment. As the name suggests, targeted therapy is a kind of treatment method that targets the diseased area for targeted destruction, just like a missile. Unlike traditional chemotherapy, which is not targeted, chemotherapy drugs can kill not only tumor cells but also normal cells after entering the body, so the side effects are relatively large; unlike targeted therapy, targeted therapy usually takes the substances unique to tumor cells or required for growth as the target. side effects are also rare. Clinical studies of this weapon in lung cancer continue to be reported, and the most intensively studied and clinically applied are small molecule tyrosine kinase inhibitors and monoclonal antibodies. The small molecule tyrosine kinase inhibitors (EGFR-TKIs) that have been approved for non-small cell therapy in recent years – gefitinib (ERSA), erlotinib (Troche) and erlotinib (Kemena) – are one of the lung cancer targeted therapeutics that use epidermal growth factor (EGFR), on which lung cancer tumor cell growth depends, as a target target, and have properties that would block epidermal growth factor ( EGFR) signaling, thus enabling the inhibition of apoptosis tolerance, growth, angiogenesis and tumor metastasis, thus achieving the goal of inhibiting tumor growth. Current studies have demonstrated that in Asian, non-smoking, lung adenocarcinoma patients, the efficacy of EGFR-TKIs can reach 40%-50% and the median survival time of patients can be extended to 1.5 to 2 years. For patients with EGFR mutations detected by tumor tissue, the efficacy is even higher, up to 70-80%, and the disease-free survival time for these patients is 9-14 months, and the median survival time can already exceed 2 years to 27 months. And because of the mild toxicity of these targeted drugs, only some patients taking the drugs will develop acne-like rash and diarrhea, and these side effects will gradually reduce or even disappear with the treatment time. Therefore, patients do not need to be hospitalized, but only need to take one tablet a day at home, which does not affect their normal life at all, thus giving patients who cannot receive chemotherapy or fail chemotherapy a new treatment option. It can be said that the advancement of targeted therapy has enabled some lung cancer patients to live with tumor for a long time, truly turning lung cancer into a “chronic disease”. Although the current cost of targeted therapy is high, since 2007, China Charity Federation has launched the charity drug grant program for ERSA and Tricor. Patients with advanced lung cancer with effective treatment can apply for the charity drug grant after 5-6 months of continuous medication until the disease progresses, which has reduced the economic burden of lung cancer patients and saved countless patients’ lives. As a domestic EGFR-TKIs, Ectinib has started charitable drug donation activities since the beginning of its launch. As a specialized department engaged in lung cancer treatment, Henan Cancer Hospital has undertaken the lung cancer targeted therapy assistance program of China Charity Federation since 2007. Under the guidance of the first batch of charity registered doctors, Ma Zhiyong, the director of Henan Provincial Lung Cancer Treatment Center, nearly one hundred advanced lung cancer patients have been secured charitable donations, enabling many advanced lung cancer patients to survive for a long time and becoming the largest clinical targeted therapy in Henan Province at present. base in Henan Province. With the development of medicine, the treatment methods of lung cancer are progressing and the efficacy is improving, so it is entirely possible to cure lung cancer. “.