Non-small-cell lung cancer · What is coming

A cheap old tablet to restore appetite

A clone report from blood at every treatment cycle

A coordinated FLASH radiotherapy evidence programme with shared dose-rate standards

A delivery-science moonshot for prevention we already own

A standard platform to get drugs into the brain: focused ultrasound plus shuttle-engineered therapeutics

A standing platform for testing new drugs with radiotherapy

A test to tell true oligometastatic disease from hidden widespread spread

Add a drug when the blood test turns, without stopping the one that works

Add the second drug on day one when the escape route is predictable

AI clears the normal lung screening scans so radiologists read only the suspicious ones

AI malignancy scores to end repeat scans and biopsies for benign lung nodules

Automatic palliative care referral triggered by diagnosis, not by decline

Autonomous closed-loop adaptive therapy driven by blood tests and evolutionary models

Bank three spatially separate tumour blocks from every resection

Biopsy the one lesion that is growing while the others shrink

Block the complement signal that recruits tumour-protecting cells

Blunt the inflammation that wakes sleeping cancer cells

Borrow from past control arms to shrink the control group in phase 3

Brain metastases included by default in every solid-tumour trial

Build a human model of the barrier that guards the brain fluid

Burden-weighted portfolio targets for every major cancer funder

Capture diet, fibre and antibiotic exposure in every immunotherapy pivotal trial

Catch wasting early with a smart scale and a step counter

CD8 PET to stop or switch immunotherapy early

Combine the new anti-wasting antibody with exercise and protein

Competing sponsors share one control arm in the same indication

Confirm low-dose olanzapine for appetite and weight in advanced cancer worldwide

Confirm or refute the harm of antioxidant supplements during chemotherapy

Confirm ultra-low-dose immunotherapy so it can be afforded where most patients live

ctDNA-guided dose holidays for lung cancer targeted therapy

Dedicated cohorts for patients with performance status 2 in first-line trials

Detect tumours changing cell type from RNA in the blood

Evaluate clean-air policies using lung cancer in never-smokers

Every lung screening visit includes stop-smoking medicine, opt-out

Every routine CT scan checked by AI for early cancer signs, with a tracked follow-up pathway

Extended-interval immunotherapy: give checkpoint inhibitors every 8-12 weeks once stable

Get the one approved appetite drug licensed beyond a single country

Give immunotherapy in the morning

Intercept cancer at the field stage

Kill drug-tolerant persisters through ferroptosis

Look for the resistant sub-population before the first dose

Lung screening eligibility by risk score, not pack-years, including high-risk never-smokers

Make bespoke mouse cancer models in weeks with in vivo gene editing

Make cigarettes non-addictive by capping their nicotine

Mandatory radon testing when homes are sold, with subsidised mitigation

Map metabolic dependencies in the patient, not the dish

Microbiome transplant as a routine immunotherapy adjunct

Molecular indolence classifiers bundled with every screening programme

Pathologists order genomic profiling automatically at diagnosis of advanced cancer

Pause a failed drug so the tumour becomes sensitive to it again

Pre-surgery platform trials that test combinations on pathological response in months

Prevention trials aimed only at brain metastasis

Protect hearing from cisplatin in adults as we now do in children

Protect the gut flora of patients about to start immunotherapy

Put cytisine, a cheap plant-based quit-smoking pill, on every essential medicines list

Randomise a cheap antihistamine alongside immunotherapy

Randomised trials of stopping immunotherapy after one year versus continuing

Re-test the metastasis, not the old primary, before every change of treatment

Select cachexia trial patients by the hormone driving their wasting

Select patients for cell therapy by whether their tumour holds reactive T cells

Slow the tumour's mutation engine with APOBEC inhibitors during targeted therapy

Smoke-free generation laws with a built-in evaluation across countries

Social impact bonds for cancer prevention, repaid from avoided treatment costs

Standing reflex biomarker panels per tumour type, run without an oncologist's order

Switch drugs at maximum response, not at relapse

Take lung screening scanners to supermarket car parks in the poorest areas

Test a high-fibre diet as an immunotherapy adjunct

Test alternating drug schedules against giving both drugs at once

Test intermittent dosing of targeted drugs to delay resistance, with honest priors

Test protein and resistance training during immunotherapy

Treat brain metastases as a disease with its own trials programme

Treat cachexia as a disease: GDF-15 blockade plus anabolic and nutrition bundles

Treat cachexia before it starts

Treat immunotherapy side-effects without wiping out the response

TROP2 PET to choose and sequence TROP2 ADCs

Turn a brake back on: drugs that reactivate the PP2A phosphatase

Unmask hidden antigens with a short epigenetic course before immunotherapy

Use a blood test at six weeks to decide whether to keep going

Use a hypoxia scan to pick patients for adenosine-pathway drugs

Use LET, RBE and alpha/beta to decide when protons beat IMRT

Use the brain's own transport door to carry antibody drugs across

Use tumour DNA in blood to decide when to pause treatment in metastatic cancer

Video palliative care as an equivalent default option for patients far from a team

Watch the immune system's response in the blood three weeks in

What is comingNon-small-cell lung cancer

What is coming

In development

Drugs in phase 3 · 67

Drugs in phase 2 · 46

Drugs in phase 1 · 1

Drugs at an unstated stage · 2

Technologies being tested · 29

Trials under way · 510

Trials reported · 82

Combinations being explored · 11

Ideas not yet in a trial · 84

Open problems and what is being done

What changed