New drugs to aid lung cancer fight, says doctor

New drugs delivered to patients in aerosol form are set to "greatly improve the prospects of controlling early lung cancer". The medication is administered in the same way that inhalers are used by for the treatment of asthma, according to Dr James Mulshine of the US National Cancer Institute. Delayed detection of lung cancer contributes to a mortality rate of 87 per cent within five years for patients with the disease, which this year will account for an estimated 160,000 deaths in the US, greater than the sum of all deaths from colon, breast and genital cancer. A similar trend exists in Ireland.

But early detection techniques and the use of drugs known as retinoids - synthetic derivatives of Vitamin A - represents a promising new direction, Dr Mulshine told the eighth World Conference on Lung Cancer in University College Dublin yesterday.

Lung-cancer treatment has frequently been dominated by "a palliative approach" rather than an emphasis on cure and returning patients to a normal lifestyle, including going back to work. Emerging early detection techniques meant a change of emphasis was possible. "With early detection and management, these are achievable goals," Dr Mulshine said.

New detection methods centre on the identification of "biomarkers" indicating cancer well in advance of clinical indications of the disease. At the latter point the condition is frequently so advanced that it is incurable. Most makers can be found in the sputum. Rapidly evolving technology is able to detect small molecular changes, such as in a gene, which confirms the cancer.

Up to 40 companies throughout the world were devising diagnostic devices that would soon enable early detection of cancer among hundreds of millions of people at risk. Once early detection was possible on a population basis, effective intervention would be necessary.

Previously, the use of retinoids - which have a critical role in controlling cell division in the airways of the body - was effective in reducing upper aero-digestive tract cancers, but there were a lot of side-effects. These were associated with the way it was administered. Using aerosols was "a very efficient delivery strategy".

The next step was clinical trials to fully evaluate the technique. "We think that in 10 years' time there will be an array of drugs for use by this method."

The conference, attended by more than 2,400 lung-cancer specialists, heard details of a highly specific and sensitive test which detects the disease two years in advance of a clinical form of the cancer manifesting itself. The process has been developed by a team headed by Prof Melvyn Tockman of NCI.