Scientists discover how lung cancer spreads in its later stages

Researchers at UCL and UCLH, working with colleagues at the Francis Crick Institute, have discovered how lung cancer spreads in the final stages of the disease, a finding that could help doctors treat advanced lung cancer more effectively. 

The study, published in the journal Nature, analysed more than 500 tissue samples from 24 patients who died from advanced lung cancer. It found that tumours which had spread to other parts of the body were themselves seeding new tumours, driving the cancer further. In over half of cases studied, this chain of spread was observed. 

When lung cancer spreads (a process called metastasis) the tumours that form elsewhere in the body look very different from the original tumour. They carry many more genetic mutations and chromosomal changes, which help the cancer survive, spread and resist treatment. Understanding this process is a crucial step towards finding ways to slow or stop it. 

The study drew on two Cancer Research UK-funded programmes: TRACERx, which follows patients from diagnosis and tracks how their cancer changes over time, and PEACE, which analyses tumour samples donated after death with the informed consent of patients and their families. 

UCLH consultant Professor Mariam Jamal-Hanjani, Chief Investigator of the PEACE study, said:

"There is a particular need to understand what cancer looks like at its advanced stages, where treatments are often less likely to be successful. The only way we can fully understand the impact of cancer across a lifetime is by analysing tumour samples after people have died." 

UCLH consultant Professor Charles Swanton, Chief Investigator of TRACERx, added:

"Many cancers can have poor survival because they have enormous potential to adapt and evolve and, by doing so, resist different forms of treatment. By understanding how cancer affects the body over the long term, we can make better predictions about where it will go next and which treatments are likely to work best." 

The next phase of TRACERx, called TRACERx EVO, is already under way. Backed by £14.9 million in Cancer Research UK funding, it will look in greater detail at how metastases occur in PEACE, with the aim of developing better treatments for late-stage lung cancer. 

This research was funded by Cancer Research UK. The paper, "Evolutionary characterisation of lung cancer metastasis", is published in Nature.