Precision Medicine, Integrated Chemotherapy And Immunotherapy – Innovations In Lung Cancer Treatment

Depending on the stage and lung cancer type, the arsenal of treatments includes surgery, chemotherapy, radiation therapy, and the promising field of immunotherapy.

The integration of chemotherapy with immunotherapy tailored to individual genetic profiles represents a groundbreaking avenue in lung cancer treatment. This approach of precision medicine not only enhances treatment efficacy but also minimises adverse effects.

Source : Getty

By Dr Prashant Karajgi

Lung cancer, a global health concern and a leading cause of cancer-related deaths, demands innovative strategies for effective diagnosis and management. According to India’s health ministry data, 14.61 lakh people in the country were diagnosed with cancer in 2022, and eight lakh people succumbed to the disease. Unique challenges posed by cultural practices and environmental factors necessitate inventive solutions. Lung Cancer Awareness Month in November, designated by the World Health Organisation’s (WHO) International Agency for Research on Cancer (IARC), brings focus to the urgency for advancements in addressing this significant health challenge.

The epidemiology of lung cancer in India has shifted from tobacco-associated histologic types to the dominance of adenocarcinoma, reflecting the complex interplay of cultural practices and environmental factors. 

Globally, 1.8 million people succumbed to lung cancer in 2020, surpassing even colorectal cancer. India, with 70,275 cases, faces an imminent crisis, projected to double by 2025. Amidst this scenario, the focus must shift towards innovative approaches that revolutionise both diagnosis and management.

In the evolving landscape of lung cancer treatment, the paradigm is shifting towards a more nuanced and patient-centric approach. Depending on the stage and cancer type, the arsenal of treatments includes surgery, chemotherapy, radiation therapy, and the promising field of immunotherapy.

The insidious nature of lung cancer, often asymptomatic until an advanced stage, contributes to late diagnoses and limited treatment options. The introduction of lung cancer screening holds promise in detecting cases earlier, potentially transforming the current therapeutic landscape. Diagnostic tools such as low-dose computed tomography (LDCT) scans and molecular biomarker testing, including the analysis of genetic mutations and tumour markers, play pivotal roles in early detection. These advanced screening methods not only facilitate timely diagnosis but also contribute to tailoring personalised treatment plans. Consequently, the prevailing mix of surgery, radiation therapy, and chemotherapy may witness a paradigm shift towards less invasive and more patient-friendly methods.

Techniques such as key-hole surgery, stereotactic radiation therapy, and local ablation are gaining prominence in this evolving landscape. These approaches, often in combination, offer less invasive alternatives that prioritise patient comfort and recovery. Intra-procedural imaging emerges as a critical component, ensuring the safe and efficient conduct of interventions.

This shift towards advanced radiation therapy techniques aligns with the broader trend in lung cancer management, emphasising a more nuanced and patient-centric approach. Intra-procedural imaging plays a critical role in ensuring the safe and efficient conduct of these interventions, allowing medical professionals to monitor and adjust treatment in real time. The integration of these innovative radiation therapy methods into the treatment arsenal represents a significant stride towards optimising therapeutic outcomes, especially considering the insidious nature of lung cancer and the imperative for early detection and intervention.

The integration of systemic chemotherapy with immunotherapy tailored to individual genetic profiles represents a groundbreaking avenue. This personalised approach not only enhances treatment efficacy but also minimises adverse effects, ushering in a new era of precision medicine in lung cancer care.

Investigations into robotic and electromagnetic navigation systems in interventional pulmonology exemplify the relentless pursuit of innovation in treatment methodologies. However, the burgeoning array of treatment options poses a challenge in optimising the treatment mix and sequence for each patient. Achieving this optimisation is crucial to bolster overall survival rates.

In this complex landscape, accessibility to modern treatment options becomes paramount. Ensuring that patients have access to cutting-edge therapies is a fundamental aspect of enhancing overall survival. As advancements continue to unfold, the challenge lies in not only developing innovative treatments but also in making them accessible to a broader population. The collaborative efforts of the medical community, policymakers, and the public are indispensable to ensure that modern, effective, and patient-friendly treatments become not just a possibility but a reality for all those affected by lung cancer.

(The author is a radiologist).

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