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Cancer types

Lung Cancer

Lung cancer is divided into non-small-cell and small-cell groups, with molecular markers that strongly shape which treatment options are discussed.

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EGFRALKROS1KRASMETRET

Not a diagnosis and not final medical advice. Must be reviewed by a doctor.

What is most important to know?

Lung cancer occurs when cells in lung tissue grow uncontrollably. Most cases are grouped into non-small-cell lung cancer and small-cell lung cancer.

These group differences are important because they influence the direction of investigations, the order of therapy, and the types of clinical trials that may be appropriate.

Examination of molecular markers in advanced non-small cell lung cancer is generally part of the initial planning, as the results may change the category of therapy being discussed.

Lung cancer is one of the most frequently diagnosed cancers in the world and is among the largest disease burdens in Indonesia. Specific incidence figures are not shown on this page because the source needs to be cited directly.

Lung cancer is not one disease.

Commonly discussed symptoms

  • Persistent or changing cough.
  • Shortness of breath or chest pain.
  • Coughing up blood.
  • Weight loss for no apparent reason.
  • Hoarseness or recurrent lung infections.
  • Fatigue that does not improve with rest.

These symptoms are not specific. A doctor still needs to assess the cause.

Risk factors

  • History of smoking, including e-cigarettes and smoke exposure.
  • Exposure to asbestos, radon, or carcinogens in the workplace.
  • Family history of lung cancer in some cases.
  • History of chronic lung disease and certain infections.

What shapes the options?

Treatment discussions usually follow this path. The more complete each step is, the more focused the discussion with your doctor becomes.

  1. Diagnosis

    Confirmed through pathology review.

  2. Subtype

    4 subtypes discussed on this page.

  3. Stage

    Staging uses the TNM system (tumor size, lymph node involvement, and distant spread). Small cell lung cancer is also often grouped into limited and extensive stages.

  4. Biomarkers

    Relevant markers: EGFR, ALK, ROS1, KRAS, MET, RET, BRAF, HER2, NTRK, PD-L1.

  5. Treatment history

    Each previous line affects the next option.

  6. Progression?

    If the disease progresses, reassessment and molecular testing are usually discussed.

  7. Next step

    Further evaluation, clinical trials, or a second opinion.

Stage I

Tumour limited to the lung without lymph node involvement.

Stage II

A larger tumour or involvement of lymph nodes near the lung.

Stage III

Tumour involvement of lymph nodes in the chest, often divided into IIIA, IIIB, and IIIC.

Stage IV

Cancer has spread outside the chest cavity or to another organ.

Relevant biomarkers

Molecular testing shapes categories, not decisions

Biomarker results open categories worth discussing. The final choice still considers stage, general condition, treatment history and the doctor's assessment.
Diagram perjalanan EGFR: mutasi, terapi target, progresi, mekanisme resistensi, pemeriksaan ulang, opsi berikutnya

Visual explainer

The EGFR biomarker journey

From an EGFR-positive result and targeted therapy options to what is commonly checked when treatment stops working.

View the EGFR explainer
Ilustrasi reseptor di permukaan sel dengan molekul ligan yang mendekat

  • EGFR

    EGFR is a gene that regulates cell growth signals.

    Next-generation sequencing (NGS) · EGFR PCR

    View biomarker →

  • ALK

    ALK fusion occurs when two genes fuse and produce abnormal growth signals.

    ALK immunohistochemistry · FISH (fluorescence in situ hybridisation)

    View biomarker →

  • ROS1

    ROS1 is a gene that, when fused with other genes, can encourage the growth of cancer cells.

    Next-generation sequencing (NGS) · ALK immunohistochemistry

    View biomarker →

  • KRAS

    KRAS is a gene that regulates growth signals.

    Next-generation sequencing (NGS) · KRAS PCR

    View biomarker →

  • MET

    MET is a gene involved in cell growth signaling.

    Next-generation sequencing (NGS) · FISH (fluorescence in situ hybridisation)

    View biomarker →

  • RET

    RET fusion occurs when the RET gene fuses with another gene.

    Next-generation sequencing (NGS) · FISH (fluorescence in situ hybridisation)

    View biomarker →

  • BRAF

    BRAF is a gene that regulates cell growth signals.

    Next-generation sequencing (NGS) · BRAF PCR

    View biomarker →

  • HER2

    HER2 is a protein on the surface of cells that can promote growth.

    Immunohistochemistry (IHC) · FISH (fluorescence in situ hybridisation)

    View biomarker →

  • NTRK

    NTRK fusion is a change that combines the NTRK gene with another gene.

    Next-generation sequencing (NGS) · Immunohistochemistry (IHC)

    View biomarker →

  • PD-L1

    PD-L1 is a protein that can help cancer cells evade the immune system.

    PD-L1 immunohistochemistry · Tumour tissue biopsy

    View biomarker →

Progression and resistance concepts

  • Progression means the disease gets bigger or appears in new locations despite ongoing therapy.
  • Resistance can occur because tumor cells change so that signals that were previously inhibited become active again through other pathways.
  • In lung cancer with target markers, repeat tissue or blood tests are often considered when progression occurs.
  • Discussions about next steps usually consider the patient's general condition, existing therapies, and clinical trial options.

Treatment options commonly discussed

The actual order and combination are always determined by the team directly examining the patient.

When are clinical trials discussed?

Trial group and treatment history

The studies below are filtered from the public registry. International patient access and site readiness have not been verified.

Clinical trials are usually discussed after standard pathways are mapped, or when biomarker results point to a specifically studied group. There are currently 80 registry records related to Lung cancer, and 33 mention a specific biomarker.

View all 80 studiesCheck my case match

What should be prepared for a second opinion?

Records usually requested

  • Complete pathology report including histology type.
  • Molecular examination report (panel or single) along with methods and laboratories.
  • PD-L1 immunohistochemistry results with clear score types.
  • Recent imaging results (CT, PET-CT, and brain MRI if available).
  • Records of therapy that has been undertaken including dates and responses.

Questions for the oncologist

  • Which group does my lung cancer belong to, and what is the basis for determining this from the pathology report?
  • What marker examinations have been carried out, with what methods, and what are the complete results?
  • Is it necessary to check additional markers before selecting the next plan?
  • What is the goal of the proposed therapy: cure, prolong disease control, or reduce symptoms?
  • How will success be assessed and by what checks?
  • Are there any clinical trials that might match my markers and therapy history?

Does your result show EGFR, ALK or another biomarker?

Not sure about the next step for Lung cancer?

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Deeper references

A reference section for readers who want details on subtypes, drugs, or every study record.

Non-small-cell lung cancer: adenocarcinoma

Draft, not yet medically reviewed

The most common non-small-cell lung cancer subtype and the one most often carrying actionable molecular markers.

Tumors originate from cells that line lung tissue and produce mucus. This group is most often associated with the discovery of markers such as EGFR, ALK, ROS1, KRAS, MET, RET, BRAF, HER2, and NTRK.

Stage note

Staging is measured using the TNM system, and brain imaging is often part of the initial assessment in advanced stages.

Non-small-cell lung cancer: squamous cell carcinoma

Draft, not yet medically reviewed

A non-small-cell lung cancer subtype arising from squamous cells, most often located near the main airways.

These tumors often have a high mutation burden and are less likely to have target markers such as EGFR or ALK than adenocarcinomas. PD-L1 testing and molecular panels remain frequently considered.

Relevant markers

PD-L1PD-L1

Stage note

The size and location of the tumor near the airway can influence the choice of action and choice of surgical route.

Non-small-cell lung cancer: large cell carcinoma

Draft, not yet medically reviewed

A non-small-cell lung cancer subtype that does not clearly show adenocarcinoma or squamous patterns.

This diagnosis is often established after a thorough pathological examination. Additional testing is important to confirm actionable markers and rule out other possible subtypes.

Relevant markers

PD-L1EGFRKRAS

Stage note

Staging assessment still uses the TNM system with full imaging examination.

Small-cell lung cancer (SCLC)

Draft, not yet medically reviewed

A fast-growing lung cancer group usually treated with chemotherapy and immunotherapy rather than surgery, except in very early stages.

SCLC rarely has target markers like adenocarcinoma. Grouping usually uses limited and extensive stage categories instead of detailed TNM in daily practice.

Relevant markers

PD-L1

Stage note

Limited or extensive division influences the treatment plan; Brain imaging examinations are often performed because of the risk of spread.

Frequently asked questions

Short answers to the most common questions; full explanations are in the sections above.

What is the difference between non-small cell and small cell lung cancer?

Most lung cancers are grouped as non-small cell lung cancer (NSCLC) or small cell lung cancer (SCLC). The distinction affects testing, treatment sequence, and which trials may be relevant. SCLC is also often grouped as limited or extensive stage.

Why is molecular marker testing important in lung cancer?

In advanced NSCLC, molecular marker testing is usually part of early planning because results can change which treatment categories are discussed. Histology first establishes the tumor type, and that result guides which molecular tests are sensible.

What tests are usually done?

The page discusses tissue biopsy, immunohistochemistry, molecular panels such as NGS, and CT, PET-CT, or MRI imaging. Histology determines whether the tumor is adenocarcinoma, squamous, large cell, or small cell before markers such as EGFR, ALK, and PD-L1 are assessed.

What does stage mean in lung cancer?

Staging uses the TNM system: tumor size, lymph-node involvement, and distant spread. Stage IV means cancer has spread outside the chest cavity or to another organ. Stage helps frame treatment discussion but does not describe the whole patient condition.

Which documents should be prepared for a lung cancer second opinion?

Prepare the full pathology report including histology, molecular testing report with method and laboratory, PD-L1 immunohistochemistry with score type, recent imaging, and prior-treatment notes with dates and responses. The same checklist appears in the second-opinion section of the page.

Related explainers

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