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Non-Small Cell Lung Cancer

A group of lung cancers that are named for the kinds of cells found in the cancer and how the cells look under a microscope. The three main types of non-small cell lung cancer are squamous cell carcinoma, large cell carcinoma, and adenocarcinoma. Non-small cell lung cancer is the most common kind of lung cancer.

PubMed Health Glossary
(Source: NIH - National Cancer Institute)

About Non-Small Cell Lung Cancer

Non-small cell lung cancer is a disease in which malignant (cancer) cells form in the tissues of the lung.

The lungs are a pair of cone-shaped breathing organs in the chest. The lungs bring oxygen into the body as you breathe in. They release carbon dioxide, a waste product of the body's cells, as you breathe out. Each lung has sections called lobes. The left lung has two lobes. The right lung is slightly larger and has three lobes. Two tubes called bronchi lead from the trachea (windpipe) to the right and left lungs. The bronchi are sometimes also involved in lung cancer. Tiny air sacs called alveoli and small tubes called bronchioles make up the inside of the lungs.

A thin membrane called the pleura covers the outside of each lung and lines the inside wall of the chest cavity. This creates a sac called the pleural cavity. The pleural cavity normally contains a small amount of fluid that... Read more about Non-Small Cell Lung Cancer

What works? Research summarized

Evidence reviews

Venous Thromboembolism: Reducing the Risk of Venous Thromboembolism (Deep Vein Thrombosis and Pulmonary Embolism) in Patients Admitted to Hospital

Venous thromboembolism (VTE) is a term used to include the formation of a blood clot (a thrombus) in a vein which may dislodge from its site of origin to travel in the blood, a phenomenon called embolism. A thrombus most commonly occurs in the deep veins of the legs; this is called deep vein thrombosis. A dislodged thrombus that travels to the lungs is known as a pulmonary embolism.

There is no evidence to recommend that patients with non‐small cell lung cancer receive prophylactic radiotherapy to the brain following potentially curative treatment with surgery or radiotherapy

Patients with non‐small cell lung cancer have a significant risk of developing tumour spread (metastases) to the brain after potentially curative treatment. To date, four research trials have been published in full; they included different groups of patients who had different doses of radiotherapy, and different outcomes were measured. None of the trials showed that patients who had received prophylactic radiotherapy to the brain lived longer than those who had not, although fewer of them developed brain metastases. A fifth trial (RTOG 0214) has not yet been published in full and is discussed in the results section.

Surgery may improve survival rates for non‐small cell lung cancer limited to the lung and surrounding affected glands

Surgical resection is currently considered to be the best treatment for some types of lung cancer limited to the lung and surrounding glands with tumour cells (lymph nodes). There is no compelling evidence to show that lung cancer surgery improves survival compared with other types of therapy such as radiotherapy or chemotherapy. Surgery is often performed in combination with removal of lymph nodes draining the lung with the tumour. There is some evidence that complete removal of all lymph nodes may improve survival compared with only removing a limited number of nodes. Individuals with small cancers localised to the lung appear to have an increased risk of local recurrence if treated with a limited resection rather than a more extensive resection of the involved lung. More research is needed to better understand the types of patients that might benefit most from surgery.

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Summaries for consumers

Nivolumab (Opdivo) for advanced non-small cell lung cancer: Nivolumab (Opdivo) for advanced squamous cell lung carcinoma

In 2016, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) looked into whether people with advanced squamous cell lung carcinoma can benefit from treatment with nivolumab. The drug is an option for adult patients who have already had chemotherapy.What was nivolumab compared with?For this group of people, the manufacturer provided one study involving 272 participants. 135 of them were given nivolumab, and 137 received docetaxel. A study comparing nivolumab with BSC was not available. So it is not possible to tell whether nivolumab has any advantages or disadvantages compared with BSC. The following results apply only to the comparison of nivolumab and docetaxel.

Nivolumab (Opdivo) for advanced non-small cell lung cancer: Nivolumab (Opdivo) for advanced adenocarcinoma or large cell lung carcinoma

In 2016, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) looked into whether people with advanced non-small cell lung cancer (NSCLC) that is not a squamous cell carcinoma can benefit from treatment with nivolumab. The drug is an option for adult patients who have already had chemotherapy.What was nivolumab compared with?For this group of people, the manufacturer provided one study involving 582 participants. 292 of them were given nivolumab, and 290 received docetaxel. A study comparing nivolumab with the other supportive treatments pemetrexed, gefitinib, erlotinib, crizotinib or supportive treatment (BSC) was not available. So it is not possible to tell whether nivolumab has any advantages or disadvantages compared with other treatments. The following results only apply to the comparison of nivolumab and docetaxel.

There is no evidence to recommend that patients with non‐small cell lung cancer receive prophylactic radiotherapy to the brain following potentially curative treatment with surgery or radiotherapy

Patients with non‐small cell lung cancer have a significant risk of developing tumour spread (metastases) to the brain after potentially curative treatment. To date, four research trials have been published in full; they included different groups of patients who had different doses of radiotherapy, and different outcomes were measured. None of the trials showed that patients who had received prophylactic radiotherapy to the brain lived longer than those who had not, although fewer of them developed brain metastases. A fifth trial (RTOG 0214) has not yet been published in full and is discussed in the results section.

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Terms to know

Adenocarcinoma
Cancer that begins in glandular (secretory) cells. Glandular cells are found in tissue that lines certain internal organs and makes and releases substances in the body, such as mucus, digestive juices, or other fluids. Most cancers of the breast, pancreas, lung, prostate, and colon are adenocarcinomas.
Body Membrane
A very thin layer of tissue that covers a surface.
Lungs
One of a pair of organs in the chest that supplies the body with oxygen, and removes carbon dioxide from the body.
Pleura
A thin layer of tissue that covers the lungs and lines the interior wall of the chest cavity. It protects and cushions the lungs. This tissue secretes a small amount of fluid that acts as a lubricant, allowing the lungs to move smoothly in the chest cavity while breathing.
Squamous Cell Carcinoma
Cancer that begins in squamous cells. Squamous cells are thin, flat cells that look like fish scales, and are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the lining of the respiratory and digestive tracts.

More about Non-Small Cell Lung Cancer

Photo of an adult

Also called: Non-small cell lung carcinoma, NSCLC

See Also: Small Cell Lung Cancer

Other terms to know: See all 5
Adenocarcinoma, Body Membrane, Lungs

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