25 Years in Lung Cancer: An Arduous Fight

However, many researchers now believe that traditional chemotherapy agents have reached a therapeutic plateau. And even despite the chemotherapeutic advances, most characterize the late '90s and the early part of the 21st century as a "stagnant" time for advances in treatment.

"We tried a lot of drug combinations, and combining targeted agents," Johnson said, but often to little avail.

Progress was even slower for the small cell type of lung cancer. Crawford said oncologists are still using the same treatments they did 20 years ago for treating this subtype of disease.

Its biology is less well understood, and it becomes chemoresistant very quickly, he added. Patients often don't live long enough to be enrolled in clinical trials, and they certainly don't live long enough to go on to become vocal advocates.

"We haven't made nearly the progress that we have in non-small cell lung cancer," he said.

So what do the advances in treatment mean for patients? Arriving at the clinic in 1984 with early-stage non-small cell lung cancer that could be treated with surgery carried a 40 percent chance of survival, researchers say.

Today, survival in this group stands at about 50 to 60 percent. But the problem, researchers say, is that the vast majority of patients -- about 70 percent -- present with advanced-stage disease. Survival rates for advanced disease have increased by only about 15 percent above 1984's meager 20 percent.

Targeted Therapies, Personalized Treatment

But some researchers say they've started to see a glimmer of hope for patients with advanced disease. Many predict that targeted therapies, which began to be better understood in the middle of this past decade, are the future of lung cancer treatment.

The first targeted therapy in lung cancer was bevacizumab (Avastin), an antiangiogenic agent that prevented the formation of new blood vessels in tumors. The drug showed prolonged survival in advanced non-small cell lung cancer patients.

Erlotinib (Tarceva) and gefitinib (Iressa) also appeared on the market, but it wasn't until about 2004 that researchers began to figure out why these two agents worked particularly well for certain lung cancer patients.

Meanwhile, improved imaging techniques have contributed to advances in surgery, staging, and radiation treatment for lung cancer patients.

Surgical incisions have been getting smaller, partly because surgeons have a better idea of the exact location of the cancer. And it's easier to figure out if a patient is a candidate for surgery because better images lead to better staging.

"The impact of much better imaging techniques has led to changes in how we diagnose and accurately stage lung cancer," Rudin said. "Routine CT and PET scans for the initial evaluation and staging have led to much better assessment of patients for surgical eligibility and for staging multimodality therapy."

The advent of brachytherapy and intensity-modulated radiation therapy (IMRT) in particular have had an impact on treatment.

"Twenty-five years ago, it was essentially point-and-shoot," Rudin said. "There was significant radiation toxicity because it encompassed other structures within the radiation field. We've done a lot of work on refining radiation, improving delivery specifically to the tumor by incorporating advances in imaging."

But one of the most successful advances in the lung cancer battle, they say, has been the campaign against smoking.

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