Backgrounder
Non-Small Cell Lung Cancer Fact Sheet
What is Lung Cancer? Lung cancer is characterised by the growth of abnormal cells inside the lung. There are two main forms of lung cancer: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). These two types are treated in different ways. NSCLC is the most common form of lung cancer, accounting for approximately 80 percent of all cases.1 However, most symptoms do not manifest until the disease has progressed, making lung cancer difficult to treat.
Prevalence • According to the World Health Organization (WHO), lung cancer is the leading cause of cancer-related death in both men and women,2 responsible for 17.6 percent of all cancer deaths3 • • Worldwide, there are more than 1.2 million new cases of lung and bronchial cancer diagnosed each year2 Lung cancer is the single biggest cancer killer in Europe, claiming 341,800 lives in 2004 – that is, 936 deaths every day3
Risk Factors Risk factors include: • • Smoking – this is associated with 80 to 90 percent of lung cancer cases1 Passive smoking – there is a 20 percent increase in the likelihood of developing lung cancer in spouses of smokers,4 and it is estimated that passive smoking causes about 25 percent of NSCLC in non-smokers.1 Exposure to smoke at work also increases risk of lung cancer2,4 • • Symptoms • • • • • • Shortness of breath2 and / or wheezing2 Chronic cough2 and / or repeated bouts of bronchitis7 Hoarseness of voice2 Coughing up blood6 Weight loss and loss of appetite with no known reason2 Chest pain2 A family history of lung cancer5 Exposure to asbestos and radon gas2
Treatment options and prognosis • The three standard treatments for lung cancer are surgery, radiotherapy and chemotherapy. One or more of these therapies may be used depending on the type of cancer, the stage of the disease and the age of the patient • Localised cancers (that is, cancer that has not spread to any surrounding tissue) detected at an early stage may be successfully treated using surgery and radiation. Up to 70 percent of patients survive for at least five years after diagnosis if treated at this stage, with a proportion of these patients being cured1 • However, the majority of NSCLC cases are diagnosed at an advanced stage1 when the cancer has already spread to another part of the body. In spite of the use of chemotherapy as the first-line treatment option, less than five percent of advanced NSCLC patients survive for five years and most die within six months1 New therapies Avastin® (bevacuzimab) is the first monoclonal antibody in a first-line setting to be shown to prolong the life of patients with advanced NSCLC. Avastin targets angiogenesis, the growth of new blood vessels within and around a tumour, starving the tumour of the blood supply that is critical to its growth and spread throughout the body.
2
In May 2005, phase III trial results demonstrated that the addition of Avastin to standard chemotherapy extended median overall survival by 23 percent from 10.2 months to 12.5 months in patients with previously untreated advanced NSCLC.8 A dossier for the approval of Avastin in metastatic NSCLC will be submitted to the European authorities later this year.
References 1. Wilking N and Jonsson B. A Pan-European comparison regarding patient access to cancer drugs. Karolinska Institute in collaboration with Stockholm School of Economics, Stockholm, Sweden, 2005 2. Stewart BW and Kleihues P. World Cancer Report. IARC Press, Lyon, pp.183-87, 2003 3. Boyle P and Ferlay J. Cancer incidence and mortality in Europe, 2004. Annal Oncol:16;481-488, 2005 4. Dobson R. Exposure to spouse’s smoking increases risk of lung cancer by over 20%. BMJ 10: 328(7431):70. Jan, 2004 5. Amos CI, Xu W, Spitz MR. Is there a genetic basis for lung cancer susceptibility? Recent results in Cancer Research 151:3-12. 1999 6. Hamilton W, Peters TJ, Round A, Sharp D. What are the clinical features of lung cancer before the diagnosis is made? A population based case-control study. Thorax, 2005 7. Al-Wadei HA, Takahasi T, Schuller HM. PKA-dependent growth stimulation of cells derived from human pulmonary adenocarcinoma and small airway epithelium by dexamethasone. European Journal of Cancer 41(17):2745-53. Nov, 2005 8. Sandler AB, Gray R et al. Randomized phase II/III trial of paclitaxel (P) plus carboplatin (C) with or without bevacizumab (NSC # 704865) in patients with advanced non-squamous non-small cell lung cancer (NSCLC): an Eastern Cooperative Oncology Group (ECOG) trial – E4599. Journal of Clinical Oncology 23. June Supplement: 2s (Abstract LBA4). 2005
3