5 Updates on Lung Cancer Mortality, Risk, and Treatment

Accounting for about 1 in 4 cancer deaths, lung cancer is the leading cause of cancer death in the United States. The National Cancer Institute estimates that there will be an estimated 234,030 new cases and an estimated 154,050 deaths in 2018. As November marks Lung Cancer Awareness Month, here are 5 things to know about the disease.

1. Mortality rates are dropping

Tobacco control efforts implemented since the 1960s have led to significant reductions in smoking-related diseases and deaths, including lung cancer, and these efforts will continue to reduce lung cancer rates into the next half-century, according to study findings. Under the assumption of continued decreases in smoking, age-adjusted lung cancer mortality is projected to drop by 79% between 2015 and 2065 and the annual number of lung cancer deaths is projected to decrease by 63%.

However, there is still room for improvement, with 4.4 million lung cancer deaths projected to occur by 2065, with about 20 million adults age 30 to 84 continuing to smoke in 2065.

2. Gaps in mortality rates

Analyzing both smoking and lung cancer data, a team of researchers found that lung cancer deaths are 28% lower in California than in the rest of the country and the gap is widening each year by almost a percentage point.

Between 1985 and 2013, lung cancer mortality in the state dropped from an annual rate of 108 per 100,000 people to 62.6 per 100,000 people. According to the researchers, the decline is 33% faster than it has been in the rest of the country. The researchers credit the rapid decline to California’s effective approach in discouraging young people from starting to smoke. The state was also the first to set up a comprehensive statewide tobacco control program formed by the California Department of Public Health.

3. New treatment option for metastatic squamous NSCLC

Earlier this week, the FDA gave the nod to pembrolizumab (Keytruda) in combination with carboplatin and either paclitaxel or nab-paclitaxel for the first-line treatment of metastatic nonsquamous non—small cell lung cancer. The approval followed data coming out of the KEYNOTE-407 trial, which found that treatment with the combination significantly improved overall survival and reduced the risk of death by 36% compared with chemotherapy alone.

The approval marks the first anti—PD-1 treatment regimen for the first-line treatment of squamous NSCLC regardless of tumor PD-L1 expression.

4. Increased lung cancer risk with common blood pressure medication

Treatment with a common blood pressure medication may increases the risk of lung cancer, according to a new study. In a cohort of more than 900,000 patients newly treated with antihypertensive drugs between January 1, 1995, and December 31, 2015, there were 7952 incident lung cancer events. Overall, treatment with angiotension converting enzyme inhibitors was associated with an increased risk of lung cancer compared with treatment with angiotension receptor blockers (1.6 vs 1.2 per 1000 person years).

Risk increased with longer duration of use, with an association evident after 5 years of use and peaking after more than 10 years of use.

5. Benefits of exercise in advanced lung cancer

Research presented at the ESMO 2018 Congress in Munich, Germany, brought to light the benefits of exercise among patients with advanced lung cancer. A study of 227 patients with advanced or metastatic lung cancer found that among those who did regular aerobic and muscle strengthening exercises, their symptom scores improved by approximately 10% during chemotherapy.

However, most people with lung cancer are unaware of the benefits of exercise, research presented at the conference found. More than half (54%) of patients with advanced disease who completed an exercise questionnaire were unaware of the benefits and only 22% achieved healthy activity levels.