Lung cancer research

Lung cancer is the third most common cancer in the UK. Approximately 46,400 people are diagnosed each year. More than 4 out of 10 people diagnosed with lung cancer in the UK are aged 75 and older. More than 8 out of 10 lung cancers are caused by smoking.

Clinical research increases patient’s options, but requires a multidisciplinary team keen to go the extra mile to provide them. In Merseyside lung cancer is one of the most common cancers, but we are lucky to have a world leading thoracic oncology diagnostic/molecular pathology service, lung cancer scientists of international recognition affiliated to the University of Liverpool, and a top-notch surgical service provided at Liverpool Heart and Chest. The Clatterbridge Cancer Centre sits comfortably within this network, and we are developing our clinical research programme to:

  1. Expand the molecular profile of our patient’s cancers so that we can learn more about our particular patient population and what novel treatment options are more likely to help them. In this regard, we have a CRUK study called SMP2 that gives us a broad genetic profile of the patient’s cancer. This may offer patients with unusual molecular anomalies entry into a second study called MATRIX, a so called “basket study” that offers a large number of targeted treatment options.
  2. Offer our large patient population the opportunity to enrol into clinical studies that test current standard treatments with promising novel treatments
  3. Identify areas of need, such as patients with rare tumours, patients that have had surgery and who have cancer treatment to increase their chances of cure, or those that have received several treatments to control their cancer already and are keen and fit enough to explore newer experimental options

The formal classification of lung cancer is changing thanks to new biological insights. Old clinicians knew that cancers that may look similar under the microscope may have very different speeds of growth and have broadly diverse responses to the same treatment. We can now identify lung cancer better with the support of the diagnostic and molecular pathology laboratory, and aim to improve it through the UK SMP2 study (see above).

In broad terms, lung cancer can be divided between Small Cell Lung Cancer and Non-small cell lung cancer.

Small cell lung cancer

Small Cell Lung Cancer (SCLC) originates from cells in the lung of neuroendocrine origin and is commonly related to smoking habit. They tend to be rapidly growing tumours that press on the central structures of the chest such as the windpipe, the gullet or major blood vessels. They spread rapidly, hence most patients present with advanced disease. These patients commonly have rapid weight loss and tiredness. Unfortunately, immune therapy has not shown significant effectiveness in this patient population to date, and novel approaches to achieve disease control are constantly brought forward by scientists world-wide.

Non-small cell lung cancer

Non-Small Cell Lung Cancer (NSCLC) originates from endothelial cells, the cells that line the inside of the lungs. These cells are adenoid cells with mobile little hair-like structures that behave like an automatic mini-mop, constantly cleaning the lungs. If these same cells have been exposed to constant injuries, be it smoking, contamination or infections, they may have changed into squamous, more resilient cells. Those who have given up smoking may have noticed that they cough more as their cells go back into their original adenoid form.

These NSCLC tumours are more diverse than previously thought. To date we have identified three major genetic anomalies that drive the growth of the cancer and can be controlled for long periods of time using tablet targeted treatments. These called “driving mutations” are more common in patients that have never smoked, and are rare cancers. Targeted treatments knock out the “driver mutation” with a high level of effectiveness, achieving disease control in most patients, at the expense of some toxicity.

Soon, we hope to open a national study led by Clatterbridge clinicians working closely with the Liverpool Heart and Chest surgeons, where we will identify patients that have this lung cancers at a stage when they can be cured with surgery, give them a very potent inhibitor, shrink the cancers and take them out afterwards, hoping that we may increase the cure rates of surgery.

Mesothelioma