“With lung cancer, directed treatment and biological therapy have progressed a great deal”

Lung cancer has the highest fatality rate of any cancer. Some 1,000 people die of lung cancer every day in Europe. This figure is higher than those dying of breast, colon and prostate cancer all together. Smoking has done a great deal of harm, and although levels have fallen, it continues to do so. The fact is that before smoking became a widespread habit, lung cancer was very uncommon. There is still plenty of work to do in terms of raising awareness among the population that smoking is lethal.

“Lung cancer is diagnosed late, but directed treatment and biological treatment have made a great progress,” states Dr Enric Carcereny, Assistència Sanitària oncologist, specialist in lung cancer and Vice-President of the Spanish Lung Cancer Group.

Dr Carcereny “compares” normal cells with the lights in a room which, when they are not needed, are switched off. The tumour cells are the ones that are always turned on. “We can now identify the switches of the tumour cells. And we can also identify the alterations in the tissue and the serum,” explains Dr Carcereny. Another major advance in curing lung cancer is immunotherapy, which has proved highly effective in treatment through the use of the immuno-histochemistry of the biomarker PD-L1 (Programmed cell death ligand 1). “In order to grow the tumour camouflages itself, and certain immunological treatments strip away the camouflage.

The patient’s own immune system can then eliminate the tumour,” Dr Enric Carcereny explains. “Molecular studies with technologies such as PCR (Polymerase Chain Reaction), fluorescent in situ hybridization (FISH) and genetic sequencing can be used to focus the treatment on specific genetic alterations, what are known as target therapies, or more recently personalised or precision therapy. In fact, all therapies are in a way personalised, but current studies that detect molecular alterations are in particularly so, since they focus specifically on the malignant cells with the alteration that dictates their aggressive behaviour,” says Dr Xavier Puig, Assistència Sanitària pathologist and Medical Director of BIOPAT. “In the case of lung cancer, which requires the study of numerous possible therapy targets in each patient, normally with very small volume samples,” adds Dr Xavier Puig, “then new platforms capable of sequencing a great many genes in one single analysis are particularly useful, achieving very high sensitivity above all in samples with a very low concentration of tumour DNA or RNA. This technology, known as mass or next-generation sequencing, has been used at BIOPAT for two years now, and is part of the clinical routine at Barcelona Hospital and Grup Assistència”. In fact, BIOPAT was one of the first laboratories in the country to deploy these new technological resources in the field of oncological care.