Overview
Lung cancer treatment has been transformed over the past decade by targeted therapy and immunotherapy — moving from a disease with a median survival of less than one year to one where long-term survival is increasingly achievable for selected patients. At the forefront of this transformation is a Shanghai-based oncologist whose clinical trials have directly led to the approval of 13 new drugs and whose immunotherapy protocols have achieved a five-year survival rate of 31.2% for advanced lung cancer — a landmark result that was once considered impossible.
China Medical Concierge Shanghai (CMCS) connects international patients with Shanghai's top lung cancer specialists, providing end-to-end support from remote consultation through to post-treatment follow-up.
Understanding Lung Cancer
What Is Lung Cancer?
Lung cancer is the most common cancer and the leading cause of cancer death worldwide. Non-small cell lung cancer (NSCLC) accounts for approximately 85% of cases and includes three main subtypes: adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. Small cell lung cancer (SCLC) accounts for approximately 15% of cases and is characterized by rapid growth and early metastasis.
In Asia, lung cancer in non-smokers — particularly women — is significantly more common than in Western populations, and is frequently driven by targetable oncogenic mutations such as EGFR, ALK, ROS1, and MET.
Common Symptoms
- Persistent cough or change in a chronic cough
- Coughing up blood (haemoptysis)
- Chest pain or shortness of breath
- Hoarseness
- Unexplained weight loss and fatigue
- Recurrent respiratory infections (pneumonia or bronchitis)
- New onset of wheezing
Risk Factors
- Smoking (the leading cause; accounts for ~85% of lung cancer cases)
- Secondhand smoke exposure
- Radon gas exposure
- Occupational exposures (asbestos, arsenic, chromium, nickel)
- Air pollution
- Family history of lung cancer
- Prior lung disease (COPD, pulmonary fibrosis)
Diagnosis & Molecular Profiling
Accurate molecular profiling is essential for all NSCLC patients — it determines eligibility for targeted therapy and immunotherapy, and directly guides treatment selection.
- CT scan (chest/abdomen/pelvis) — staging and extent of disease
- PET-CT — whole-body staging and detection of occult metastasis
- Brain MRI — brain metastasis assessment (essential for all stage III-IV NSCLC)
- Bronchoscopy / CT-guided biopsy — tissue diagnosis
- Comprehensive molecular profiling — EGFR, ALK, ROS1, MET, KRAS G12C, BRAF, RET, NTRK, HER2, PD-L1, MSI/MMR, TMB — essential for all NSCLC patients
- Liquid biopsy (ctDNA) — for patients where tissue biopsy is not feasible, or for monitoring treatment response and resistance
Treatment: Targeted Therapy & Immunotherapy
Targeted Therapy for Driver Mutation-Positive NSCLC
For patients with NSCLC harboring a targetable driver mutation, targeted therapy is the standard first-line treatment — offering superior efficacy and tolerability compared to chemotherapy:
- EGFR-mutant NSCLC — osimertinib (3rd generation EGFR TKI) is the current standard; amivantamab + lazertinib for osimertinib-resistant disease
- ALK-rearranged NSCLC — alectinib or lorlatinib (3rd generation ALK TKI)
- ROS1-rearranged NSCLC — crizotinib, entrectinib, or lorlatinib
- MET exon 14 skipping — tepotinib or capmatinib
- KRAS G12C-mutant NSCLC — sotorasib or adagrasib
- BRAF V600E-mutant NSCLC — dabrafenib + trametinib
- RET-rearranged NSCLC — selpercatinib or pralsetinib
- NTRK fusion-positive NSCLC — larotrectinib or entrectinib
- HER2-mutant NSCLC — trastuzumab deruxtecan (T-DXd)
Immunotherapy for NSCLC
Immune checkpoint inhibitors (ICIs) targeting PD-1/PD-L1 have transformed the treatment of NSCLC without targetable driver mutations:
- High PD-L1 expression (≥50%) — pembrolizumab monotherapy or pembrolizumab + chemotherapy
- Any PD-L1 expression — pembrolizumab + chemotherapy (KEYNOTE-189/407)
- Locally advanced unresectable NSCLC — concurrent chemoradiotherapy followed by durvalumab consolidation (PACIFIC regimen)
- Adjuvant immunotherapy — atezolizumab or pembrolizumab after resection for stage IB-IIIA NSCLC
The 31.2% Five-Year Survival Landmark
Through optimized immunotherapy protocols and patient selection strategies developed by Prof. Zhou Caicun's team, advanced lung cancer patients treated with immunotherapy have achieved a five-year overall survival rate of 31.2% — a result that fundamentally redefines what is possible for patients with stage IV lung cancer. This outcome, once considered unattainable, reflects both the power of modern immunotherapy and the expertise required to deploy it optimally.
Combination Strategies & Resistance Management
For patients who develop resistance to targeted therapy or immunotherapy, Prof. Zhou's team has extensive experience in:
- Liquid biopsy-guided resistance mechanism identification
- Sequential targeted therapy strategies
- Combination immunotherapy approaches
- Clinical trial access for novel agents
Why Choose Shanghai for Lung Cancer Treatment?
- Global clinical trial leadership — Shanghai oncologists have led trials that resulted in 13 new drug approvals, giving patients access to the most innovative treatments
- 31.2% five-year survival with immunotherapy — outcomes that set the global benchmark for advanced lung cancer
- Comprehensive molecular profiling — full genomic testing to identify every targetable mutation
- Access to novel agents — clinical trials and early access programs for cutting-edge therapies
- Cost-effective world-class care — significantly lower cost than equivalent treatment in the US, UK, or Singapore
Featured Specialist: Prof. Zhou Caicun — Oriental Hospital, Tongji University
Prof. Zhou Caicun (周彩存) is one of the world's foremost lung cancer oncologists, based at Oriental Hospital, Tongji University in Shanghai. He holds the position of President-Elect of the International Association for the Study of Lung Cancer (IASLC) — the world's premier lung cancer organization — making him one of the most internationally recognized Chinese oncologists in any field.
Global Clinical Trial Leadership
Prof. Zhou has led or co-led over 60 clinical trials in lung cancer — a body of work that has directly contributed to the regulatory approval of 13 new drugs for lung cancer treatment. This extraordinary track record of translating research into approved therapies means that patients under Prof. Zhou's care have access to the most innovative, evidence-based treatment options available anywhere in the world.
Landmark Survival Outcomes: 31.2% Five-Year Survival
Through the development and optimization of immunotherapy protocols for advanced lung cancer, Prof. Zhou's team has achieved a five-year overall survival rate of 31.2% for advanced lung cancer patients treated with immunotherapy — a result that represents one of the most significant advances in lung cancer outcomes in the modern era.
IASLC President-Elect
Prof. Zhou's election as President-Elect of the IASLC — the world's leading lung cancer scientific organization, with members in over 100 countries — reflects his standing as a global leader in lung cancer research and clinical practice. This role places him at the center of international lung cancer guideline development and scientific innovation.
Clinical Expertise
- Targeted therapy for driver mutation-positive NSCLC — EGFR, ALK, ROS1, MET, KRAS, RET, NTRK, HER2, BRAF
- Immunotherapy for NSCLC — PD-1/PD-L1 inhibitors, combination strategies, resistance management
- Comprehensive molecular profiling and treatment selection
- Clinical trial access — novel agents and combination strategies
- Advanced and metastatic lung cancer management — including brain metastases
- Small cell lung cancer (SCLC) — systemic treatment and immunotherapy
For international patients, Prof. Zhou's team offers remote pre-consultation review of CT scans, PET-CT, brain MRI, pathology, and molecular profiling results, enabling a precise treatment recommendation to be developed before arrival in Shanghai.
How CMCS Supports Your Journey
CMCS is not a hospital — we are your dedicated medical concierge, providing a trusted bridge between international patients and Shanghai's finest cancer specialists.
Our services include:
- ✅ Direct appointment coordination with Prof. Zhou Caicun and the Oriental Hospital lung cancer team
- ✅ CT, PET-CT, brain MRI, pathology, and molecular profiling translation and pre-consultation review
- ✅ Second opinion facilitation — especially for patients with complex or treatment-resistant lung cancer
- ✅ Clinical trial eligibility assessment
- ✅ Hospital admission and treatment scheduling support
- ✅ Accommodation and logistics coordination in Shanghai
- ✅ Post-treatment follow-up and remote check-in support
Contact CMCS
If you or a loved one has been diagnosed with lung cancer and would like to explore treatment options in Shanghai, our team is ready to help.
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CMCS — China Medical Concierge Shanghai. Connecting international patients with Shanghai's finest specialists.
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