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Non-Small-Cell Lung Cancer

Most people who have lung cancer have NSCLC. Although it's serious, treatment can sometimes stop it from getting worse. There are things you can do to help you feel better, too.

People who smoke or who breathe a lot of smoke are most likely to get NSCLC. Many of them are over 65.

There are four kinds of NSCLC tumors:

Adenocarcinoma starts in cells in your air sacs that make mucus and other substances, often in the outer parts of your lungs. It's the most common kind of lung cancer among both smokers and nonsmokers and people under 45. It often grows more slowly than other lung cancers.

Squamous cell (epidermoid) carcinoma starts in cells that line the inner airways of the lungs. About a quarter of lung cancers are this kind.

Large cell (undifferentiated) carcinoma grows and spreads more quickly. That can make it tougher to treat. It's about 10% of lung cancers.

Adenosquamous carcinoma is relatively rare and generally develops in the outer part of the lungs. Smoking can increase the risk of its development.

The treatments your doctor suggests will depend on how far your lung cancer has spread.

Doctors aren't sure exactly what causes this disease. Many people who get it have smoked or been around smoke. Other things that make lung cancer more likely are:

It can also run in families.

You may not notice symptoms in the early stages. Or you might mistake them for another illness, such as pneumonia or a collapsed lung.

Like other types of lung cancer, symptoms can include:

If the cancer spreads to other parts of the body, you may have:

First, your doctor will talk with you and ask questions like:

When did you first notice problems?

How have you been feeling?

Are you coughing or wheezing?

Does anything make your symptoms better or worse?

What do you do for a living?

Do you, or did you, smoke?

Has anyone in your family had lung cancer?

They'll also give you a physical exam. You will need tests, too.

Imaging tests help your doctor find tumors inside your lungs. They can also show whether the cancer has spread.

X-rays use low doses of radiation to make images of structures inside your body.

MRI, or magnetic resonance imaging, shows blood flow, organs, and structures.

Ultrasound creates a picture by bouncing sound waves off tissues inside you.

PET scans use a radioactive compound or tracer that collects where your cells are very active.

CT scans are powerful X-rays that make detailed pictures of the tissue and the blood vessels in the lung.

Sputum cytology is a lab test that checks the mucus you cough up for cancer cells.

Fine-needle aspiration biopsy takes cells from an abnormal growth or the fluid in your lungs.

Your doctor may want to look inside your lungs and chest using a thin, flexible tube with a light and tiny camera. They may also take samples of tissue, including from nearby lymph nodes, to check for cancer cells. They can do this a few different ways:

Bronchoscopy goes through your nose or mouth and into your lungs.

Endobronchial ultrasound uses bronchoscopy with an ultrasound placed at the tip of the tube to look at lymph nodes and other structures.

Endoscopic ultrasound is like the endobronchial ultrasound, but your doctor puts the endoscope down your throat into the esophagus.

Thoracoscopy uses a few small cuts along your side to look at the outside of your lung and the tissue around it.

Mediastinoscopy makes a small cut just above your breastbone, in the space between your lungs.

Based on what your doctor finds, they'll assign a stage, describing where the cancer is. That will help your medical team figure out the best treatment for you. You'll want to know what each stage means:

Occult stage: "Occult" means "hidden." Cancer cells are in lung fluid or sputum, but the doctor can't find where the cancer is in your lungs.

Stage 0: Cancer cells are in the lining of your airways.

Stage I: A small tumor is in only one lung. The cancer hasn't spread to lymph nodes.

Stage II: A larger tumor is in one lung, or the cancer has spread to nearby lymph nodes.

Stage III: Cancer in one lung has spread to farther lymph nodes or into nearby structures.

Stage IV: Cancer has spread to both lungs, to fluid around the lungs, or to other parts of the body, such as the brain and liver.

Finding out that you have cancer is overwhelming. You may want to start by asking your doctor:

How serious is my lung cancer?

Has it spread, where to, and what does that mean?

What are my cancer treatment options? How well do they work?

What are the side effects?

What other treatments might I need to feel OK?

Will I have to stop working while having treatment?

What happens if the cancer continues to spread?

Have you treated anyone else with this type of lung cancer?

Can I take part in clinical trials? How can I find out about that?

Is there a medical center that takes care of my kind of cancer regularly that I could go to?

Ask a friend or family member to go with you to your appointments for emotional support and to help you understand what the doctor tells you.

You may feel more comfortable getting a second opinion before deciding on your treatment plan.

Doctors treat this kind of lung cancer in two ways: They target the cancer itself, and they try to make you feel better. Their goal is to stay ahead of the symptoms and make you as comfortable as possible.

Your doctor may suggest a combination of treatments, depending on what kind of cancer you have and where it is.

Surgery. If you're in an early stage, your doctor will probably recommend surgery to take out the cancer. You could have a part or all of your lung removed. Other types of surgery destroy cancer cells by freezing them or using a heated probe or needle.

Radiation. It can kill cancer cells that remain after surgery. It also treats certain cancers that your doctor can't get rid of with surgery. The radiation comes either from a high-energy beam aimed at the cancer from outside of your body using a special machine, or from a radioactive substance put inside your body in or near the cancer.

Chemotherapy. Whether you get it as pills or with a needle in a vein or muscle, the drugs travel throughout your body to kill the cancer. Your doctor might put it in your spinal fluid, a specific organ, or a space inside your body to target cancer cells in that area. You could get chemo before surgery to make a tumor smaller, after surgery, or both, or even if you don't have surgery.

Targeted therapy. These drugs and antibodies stop cancer cells from growing and spreading in very specific ways. Because of how they work, they usually harm normal cells less than radiation and chemo.

Laser and photodynamic therapy (PDT). This technique uses a special laser light to "turn on" special drugs that cancer cells have absorbed. This kills them and helps avoid damage to healthy tissue.

Clinical trials. Scientists are studying new ways to treat cancer. Check the National Cancer Institute's web site and ask your doctor if a clinical trial would be a good fit for you, what you should consider, and how to sign up.

Let your doctor know if you have any pain or shortness of breath. There are treatments for that so you can feel better.

As you follow your treatment plan, pay attention to any changes you feel. Tell your doctor how you're doing, both physically and emotionally.

Some days, your appetite may not be great. But you'll need to eat well to keep your strength and energy up. Try to eat several small meals throughout the day instead of a few large ones.

If you have trouble breathing, oxygen from a tank may help. So can practicing relaxation techniques, like meditation, listening to music, or picturing yourself in a peaceful place. Complementary treatments, including gentle massage and aromatherapy, may put you more at ease. Talk to your doctor about what you can do when you're tired, in pain, or breathless.

Finding out that you have cancer is very hard to deal with. You may be afraid, angry, or sad. Strong emotions are normal. A support group or a counselor who works with people who have cancer could help you work through your feelings. Look online or in your community, or ask your doctor for suggestions and about other professionals who can help support you -- perhaps social workers, nurses, clergy, or other doctors.

If it's caught early enough, your cancer may be curable. Even if it's not, your treatment should help you live longer and feel better. Throughout your treatment, you can make choices about what's best for you.

The Lung Cancer Alliance can help you find other people and families near you who have also faced this disease. Their support can make it easier to live with NSCLC.

This Drug Candidate Could Be A Winner For Bristol Myers

Last month, Bristol Myers Squibb (NYSE: BMY) shared that its locally advanced or metastatic non-small cell lung cancer (NSCLC) drug candidate repotrectinib was accepted for priority review by the U.S. Food and Drug Administration (FDA).

CONSTELLATION BRANDS, INC.

Since the FDA expects to reach a decision on repotrectinib by late November of this year, now would be an appropriate time to determine its sales potential. To do so, let's dig into its phase 1/2 clinical trial results and the non-small cell lung cancer drug market.

A potent treatment for a challenging condition

Lung cancer is the leading cause of cancer death in the United States. It's estimated that 127,000 patients succumb to the disease each year. The vast majority (up to 84%) of these cancer cases are the type known as non-small cell lung cancer (NSCLC). The symptoms of lung cancer can include chest pain, a persistent cough, fatigue, and unintentional weight loss.

As is the case with any type of cancer, early detection is key to an optimal health outcome. Unfortunately, the disease is often diagnosed once it has already spread to some extent and has become more difficult to treat. Because lung cancer typically flies under the radar, just 23% of all patients diagnosed with lung cancer survive five years or longer.

When a cancer has spread to nearby tissue or lymph nodes, this is referred to as a locally advanced cancer. And when cancer has reached vital organs like the brain or liver, this is called metastatic cancer.

It's hard to find a silver lining in such a difficult-to-treat disease like locally advanced or metastatic NSCLC. But if there is any good news for patients, it is that treatments are progressing. Acquired in Bristol Myers' deal for Turning Point Therapeutics that was closed last August, repotrectinib is one therapy that could soon find itself in the arsenal of oncologists and patients.

More than 400 patients with a type of genetic rearrangement in their tumor cells called ROS1 positive were enrolled in a phase 1/2 clinical trial to receive repotrectrinib. It was observed that among patients who had not previously been treated with a drug in the same class as repotrectrinib, the objective response rate was 79%. That means an overwhelming majority of ROS1 positive patients with NSCLC had at least a 30% reduction in the size of their tumor after treatment.

Even patients who had been treated with a drug from the same class and chemotherapy or two different drugs in the same class achieved objective response rates ranging from 28% to 42%. For such a tricky condition to treat, these are particularly encouraging results.

The sales potential is incremental

Repotrectrinib could be a lifesaving treatment for countless patients. So what could that mean for Bristol Myers' from a financial perspective?

It is estimated that approximately 238,000 Americans are diagnosed with lung cancer each year. Taking the five-year survival rate into consideration, this could conservatively mean twice as many patients (roughly 500,000) who potentially need treatment. And 1% to 2% of locally advanced or metastatic NSCLC cases fit into the ROS1 positive category. That means the addressable patient share of repotrectinib is 5,000 to 10,000 annually, so we'll split that down the middle at 7,500.

Since Pfizer's xalkori and Roche's rozlytrek are already approved by the FDA, repotrectinib will face plenty of competition. But because no one drug is completely effective for all patients, I anticipate that repotrectinib can still carve out a 25% patient share -- or nearly 2,000 patients. Assuming a $100,000 annual net price per patient, this equates to $200 million in annual sales potential for Bristol Myers.

This isn't a huge revenue boost compared to the $46.7 billion in revenue that analysts are expecting from the pharmaceutical giant in 2023. But alongside the dozens of other compounds that Bristol Myers has in its pipeline, the drugmaker's future is bright.

A deeply underappreciated stock

Having dipped 9% so far in 2023, Bristol Myers' stock has gone from cheap to even cheaper. Its forward price-to-earnings ratio of 8 is well below the drug manufacturers' industry average of 13.2. Given that Bristol Myers' pipeline looks sufficient to withstand eventual patent expirations of key drugs like Eliquis and Opdivo, shares of the stock could be a buy for value investors.

Everything To Know About Lung Cancer: Symptoms, Diagnosis, And Treatment

By Lauren Kirkbride of Healthy Gem

Slide 1 of 21: The average person has a one in 15 chance of getting lung cancer. It is the second most prevalent cancer in the US, and nearly 149,000 Americans die of it every year, says the Prevent Cancer Foundation. But how much do you know about this deadly disease? Lung cancer spreads to other organs more often than other diseases. Some people believe that lung cancer only results from smoke, but that isn't true. Common symptoms, such as a chronic cough and fatigue, are often ignored. Read on to learn everything about lung cancer--symptoms, diagnosis, and treatment.

The average person has a one in 15 chance of getting lung cancer. It is the second most prevalent cancer in the US, and nearly 149,000 Americans die of it every year, says the Prevent Cancer Foundation. But how much do you know about this deadly disease?

Lung cancer spreads to other organs more often than other diseases. Some people believe that lung cancer only results from smoke, but that isn't true. Common symptoms, such as a chronic cough and fatigue, are often ignored. Read on to learn everything about lung cancer--symptoms, diagnosis, and treatment.

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