Cancer of the Lung

Lung cancer is a highly incident disease, and the major cause of cancer death worldwide. Trends in lung cancer incidence and mortality follow an epidemiological link to the history of tobacco consumption, although a recent increase of cases in never smokers has been observed. Throughout this chapter, readers will have the chance to appreciate the major changes and advances that took place in the presentation, diagnosis, and treatment of lung cancer in the past decades. The pathology and staging classification of lung cancer has evolved over time, as has the knowledge on its genomic landscape. The discovery of driver mutations such as EGFR and ALK has revolutionized the field of targeted therapy. Molecular testing has become a standard in non-squamous NSCLC, and results are now essential to link patients to better-suited therapies. The greater understanding of cancer immunology also impacted lung cancer therapy. Immune checkpoint inhibitors are now a routine in most lung cancer cases, including metastatic and locally advanced NSCLC. The advance in imaging diagnostics and intervention allowed better detection (including screening programs), staging (mainly due to PET-CT), and treatment. Minimally invasive techniques are commonly used to help diagnose and stage lung cancer. Daily examples include CT-guided biopsies, EBUS, EUS, video-assisted and robotic surgery. Modern radiation devices have enabled the application of highly precise doses to localized nodules, adding new treatment opportunities to different disease stages. Altogether, lung cancer control requires multidisciplinary care and continuous research effort.