12 ways we’ve influenced progress in lung cancer 

1 – Uncovering faulty genes in lung cancer 

Our scientists have been pivotal to discovering some of the genetic faults that can lead to the development of lung cancer, helping to improve our understanding of the disease.   

Two separate teams we funded in the early 1980s found cancer-causing mutations in the EGFR and NRAS genes. These genes are both involved in complex signalling pathways that control how our cells grow and divide. When these genes are faulty, this can result in cells growing out of control, which can lead to cancer. Today, 57 countries worldwide now test for EGFR mutations to help guide treatment. 

But thanks to these discoveries by our scientists, we now have ways to help stop that.   

Drugs that block EGFR activity in cancer cells, like erlotinib and gefitinib, are now used to treat non-small cell lung cancer (NSCLC). Because they target the mechanism that actually drives specific cancers, they don’t cause as many side effects in healthy cells – a problem with older chemotherapies.   

Years of research have shown that over a quarter of all cancer cases are driven by mutations to RAS proteins. Drugs designed to alter RAS activity are some of the best ways to treat them. For example, sotorasib is a KRAS inhibitor that can be used to treat NSCLC with a specific KRAS gene mutation.  

3 – Investing in the lung cancer research community   

Despite lung cancer being the most common cause of cancer death in the UK, until recently there was limited lung cancer-specific research taking place across the country. That’s why our 2014 research strategy made lung cancer a priority.  

Since then, we’ve increased our research spend in the area, committing over £10m to fund TRACERx – our flagship lung cancer research study. Many of the developments on this list have come thanks to TRACERx, and in 2022 we announced TRACERx EVO, which we hope will continue to accelerate progress against lung cancer for years to come.  

We also launched our Lung Cancer Centre of Excellence in 2014, bringing together world-leading researchers from the University of Manchester and University College London to create a collaborative environment where lung cancer research can flourish. We’ve recently celebrated 10 years of the centre of excellence, which in the last decade has helped create more than 15 computational tools, underpinned over 20 academic clinical trials and developed a living biobank of lung cancer models.  

We have also invested in numerous other projects, including the National Lung Matrix Trial – our pioneering collaboration with pharmaceutical companies and the NHS to test the idea that genetic changes in people’s cancers could be used to match them to treatments.    

5 – Campaigning for tobacco control 

Smoking is the biggest cause of cancer, causing around 160 cases every day in the UK, so reducing smoking rates is key in preventing lung cancer cases.  

Over the years, our supporters have helped us to successfully campaign for smokefree workplaces, the covering up of tobacco displays and removal of tobacco vending machines in shops, and plain cigarette packaging. 

In 2022, we launched our Smokefree UK campaign calling on the UK Government to take action by raising the age of sale of tobacco and providing more funding to help people quit smoking. Our policy calls were backed by almost 14,000 supporters, more than 50 MPs, councillors and Lords, and over 20 other organisations.  

So, we were pleased when, at the 2023 Conservative Party Conference, former Prime Minister Rishi Sunak launched landmark legislation to raise the age of sale of tobacco, as well as commit to providing increased funding for services and measures to help people quit smoking.  

This legislation, however, came to a disappointing halt in May 2024, when the UK general election was called. That’s why during the election, we called on the next UK Government – regardless of political party elected – to reintroduce the legislation. 

Thanks to the efforts of campaigners, we were thrilled to see the new UK Government commit to reintroducing legislation to raise the age of sale of tobacco in their first King’s speech.  

Now we want to see this legislation passed and implemented in all four nations of the UK.  

We’ll continue to campaign to ensure that plans to raise the age of sale of tobacco become a reality. And you can help too, add your name to join our Smokefree UK campaign. Together, we can help end cancers caused by smoking. 

7 – Laying the foundations for radiotherapy 

Radiotherapy is the use of high energy x-rays to destroy cancer cells and is commonly used to treat lung cancer.   

For more than a century, we’ve supported doctors, physicists and radiologists to establish the principles of radiotherapy and its application to the clinic. Our researchers helped to build understanding on how to measure radiotherapy doses and how cells respond to radiation. This work has been crucial to radiotherapy becoming a mainstream cancer treatment.    

And things are still improving. In 2017 we got the results from our CONVERT trial, which looked at finding the best way to give radiotherapy to people with small cell lung cancer. The trial team found that having radiotherapy once a day worked as well as having it twice a day when you have it alongside chemotherapy. This means patients and doctors can choose together which treatment suits them best.   

To keep driving radiotherapy research forward, in 2019 we announced RadNet, our multimillion-pound plan to establish a network of national centres of excellence in radiation oncology and radiobiology. We hope that this will help to stimulate research in three key areas: discovery, translation and clinical use, to keep making radiotherapy more effective and kinder for people with cancer. 

9 – Tracking the evolution of lung cancer

Last year, a raft of papers published from our flagship TRACERx study revealed more of the secrets of how lung cancer can evolve, spread and resist treatment.   

As a tumour grows, its DNA continues to mutate, and new clusters of cells genetically different from the rest of the tumour can start to form.  These clusters are called subclones, and as a tumour grows, more subclones are likely to develop.   

TRACERx researchers have found that by looking at these subclones, it’s possible to predict how likely a cancer is to return and whether it might spread (metastasise).  

Testing for these subclones usually involves doctors taking a small sample of tissue directly from the tumour, which can be uncomfortable and time consuming.   

But TRACERx researchers are working on that problem too. Another one of their recent papers showed that it might be possible to use blood samples to measure the proportion of different subclones in a tumour, which can be used to predict whether the cancer might spread.

11 – Linking working with asbestos to mesothelioma

In the early 1900s, there was a boom in the use of a material called asbestos, which is made up of thousands of tiny fibres, in construction.  

But these tiny fibres can easily break away and, if inhaled, can cause damage to cells in the lungs. It can also damage the lining of the lungs which can cause the cancer mesothelioma.  

In 1966 a study by the British Occupational Hygiene Society (BOSH) suggested a ‘safe’ level of asbestos exposure, but over a decade later, research led by Professor Julian Peto, and funded by our predecessor, pointed out that there was no evidence for a safe level.   

This study, along with other research, led to stricter regulations, and in 1985 the use of blue and brown asbestos (the types of asbestos strongly linked to mesothelioma) were banned.  

Fast forward over 30 years, we’re still investing in mesothelioma research. Mesothelioma may not develop until 15 to 60 years after someone has been exposed to asbestos, so even though asbestos isn’t used anymore, new knowledge from research is still very important.    

For example, in 2021 the CONFIRM trial, which we funded, showed that the immunotherapy drug nivolumab increased survival and made the disease more stable for patients with relapsed mesothelioma.