Lung cancer is one of the deadliest types of cancer in the world – often undetected for a long time, socially stigmatized and emotionally distressing. However, it is precisely with this disease that medical research has made tremendous advances in recent years. These breakthroughs were made possible by targeted investments in oncology – with major involvement from research-based pharmaceutical companies in Switzerland.

From death sentence to hope for time and quality of life

Until the mid-20th century, lung cancer was considered a rare disease. It was only with the high prevalence of smoking that the number of cases skyrocketed – first among men and later, with a time lag, among women¹. Today, lung cancer is one of the most common types of cancer in the world and is also the leading cause of cancer-related death. In Switzerland, around 4,900 people develop the disease every year, most of them in later life².

Until the 1990s, lung cancer was usually only diagnosed at an advanced stage – often with metastatic tumors and a relatively poor prognosis. For a long time, the five-year survival rate was below 10%³. Since then, and thanks to advances in diagnostics and a new generation of targeted and cancer immunotherapies, treatment options have significantly improved. As of 2024, the five-year survival rate for those affected has risen to 30%³.

This change was largely due to the realization that lung cancer is not a homogenous disease. Classification into small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) – the latter accounting for about 85% of cases – now forms the basis for the choice of therapy⁴. Targeted treatment has significantly improved the prognosis for many patients – while at the same time being better tolerated than conventional therapies.

Smoking remains by far the biggest risk factor. Other influences such as air pollution, occupational exposure to carcinogens (e.g. asbestos) and genetic predisposition play a complementary role – particularly in non-smokers and younger patients¹.

Research saves lives: the path to modern therapy

For decades, conventional therapy consisted of surgery, radiotherapy and non-specific chemotherapy, often with significant side effects. The turnaround came with a better molecular understanding of tumor biology. Researchers discovered mutations and growth factors as the cause of cancer and began to develop targeted therapies. Today, targeted therapies (such as EGFR, ALK and ROS1 inhibitors) and immunotherapies that activate the immune system to detect and destroy cancer cells are available⁵. One milestone was the approval of the first checkpoint inhibitors, which can significantly prolong survival in certain patient groups – with significantly better tolerability than conventional cytostatic drugs used in the context of chemotherapy.

Switzerland – an innovation hub in oncology

Although research into lung cancer is global, Switzerland plays a key role. Strong basic research and the networking of all research stakeholders is essential to Switzerland’s success. International studies are conducted in Swiss clinics and pharmaceutical companies from all over Switzerland are directly involved in developing new active substances. Switzerland is one of the leading countries in clinical research in oncology – with a high participation rate in studies and rapid implementation in healthcare⁶. More than 70 oncological drugs are currently being developed for lung cancer – and many of them with Swiss participation⁷. The research aims to make therapies not only more effective, but also more tolerable and targeted.

Universities, hospitals and the industry are working closely together to advance biomarker-based diagnostics and precision medical therapies. One example is the combination of immunotherapy and chemotherapy, which is now considered the standard treatment for advanced non-small cell lung cancer – with good results in selected patient groups⁵.

Rethinking lung cancer: precision instead of standardized treatment

Lung cancer has long been regarded as a disease that is difficult to treat, but this picture is increasingly changing due to modern diagnostics and targeted approaches to treatment. Today, the focus is no longer on the type of disease alone, but on the individual tumor profile. What genetic changes drive the growth? Which immune response can be activated?

This personalized approach – supported by molecular tests – allows targeted therapies with improved efficacy and higher tolerability. What used to be treated uniformly with chemotherapy is now viewed in a nuanced way – and is increasingly being treated successfully.

¹ Goeckenjan G.: Lung cancer – historical development, current status, future prospects – https://www.thieme-connect.com/products/ejournals/pdf/10.1055/s-0030-1255636.pdf
² Federal Statistical Office (FSO): Swiss health statistics
³ Swiss Cancer League: lung cancer statistics 2023 – www.krebsliga.ch
⁴ American Cancer Society: types of lung cancer – www.cancer.org
⁵ Swiss Cancer Research Foundation: Oncology in transition – 2022 annual report
⁶ Interpharma: Research for a healthier future – 2023 report
⁷ Pharmaceutical Research and Manufacturers of America (PhRMA): Medicines in development – oncology 2023