What Do Genetics Have to Do With Lung Cancer Risk? Researchers Are Working to Find Out

Lung cancer research is moving quickly, from a better understanding of genetic risk to new targeted treatments for mutations once considered “undruggable.” But Dr. Caitlin Nichols, director of scientific affairs at the Susan Wojcicki Foundation, says one of the most important pieces of progress is making sure patients have a voice in that research.

Nichols spoke with CURE at the Lung Cancer Initiative (LCI) conference about the importance of listening to patients, the goals of the Lung Cancer Connect study and why she is hopeful about the future of lung cancer research.

Why Listening to Patients Can Improve Lung Cancer Care

For Nichols, conversations with patients are one of the most valuable parts of attending meetings like LCI.

“Every time I'm at a meeting like this and have an opportunity to speak with patients, I learn something that I didn't know before,” she says.

Patients can provide insight into experiences that may not always be captured by clinical research, including treatment side effects and how cancer affects daily life.

“It’s not just about having better treatments that will prolong life,” Nichols says. “It’s about, are my treatments tolerable? Am I able to eat how I would normally eat? Do I have skin problems as a result of my treatment?”

Understanding those priorities can help researchers and clinicians think beyond whether a treatment works and consider how that treatment affects a person's quality of life.

“We’re not just giving them good treatments for their cancer, but giving them good quality of life along with that as well,” she says.

What Is the Lung Cancer Connect Study?

Nichols also helps lead the Lung Cancer Connect study, a collaboration involving the 23andMe Research Institute, the Lung Cancer Initiative and more than 20 lung cancer advocacy organizations.

The research aims to better understand how genetics and environmental factors may work together to influence lung cancer risk. Researchers are also interested in learning more about how lung cancer may evolve or progress over time.

“There’s a lot that we still need to learn about how genetics and the environment interact,” Nichols says.

Large numbers of participants are important to this type of research because researchers are often looking for small genetic differences that, individually, may have a limited effect but could collectively help explain differences in lung cancer risk.

People interested in learning more about the study can visit 23andMe’s Lung Cancer Connect study page to determine whether they are eligible to participate.

Does Having a Higher Genetic Risk Mean Someone Will Develop Lung Cancer?

Not necessarily.

Nichols emphasizes that an increased risk — whether related to genetics or other factors — does not mean a person is guaranteed to develop lung cancer.

Instead, understanding risk could eventually help researchers determine who may benefit from different screening approaches or provide additional information about how people can manage their health.

As research continues, that understanding may change.

“The more data we have, the more that we’ll be able to understand,” Nichols says. “It could be five years from now, well, things may change and we may learn more. It’s always evolving.”

She encourages patients and families to follow research through reputable organizations and to continue contributing to research when opportunities are available.

Why Patient Voices Matter in Lung Cancer Research

Nichols believes one of the biggest opportunities in cancer research is helping patients and caregivers better understand the science behind new discoveries — and then empowering them to communicate that knowledge to others.

Programs that provide patients with scientific and advocacy training can be especially valuable, she says.

Patients bring something researchers and clinicians cannot replicate: lived experience.

“They really have a superpower of this lived experience,” Nichols says.

That experience can help bridge the gap between researchers, clinicians and the people ultimately affected by the research.

The goal, Nichols says, is to help patients understand what scientists are studying while also helping researchers and clinicians better understand which questions matter most to the patient community.

Why Nichols Is Hopeful About the Future of Lung Cancer Treatment

One of the developments that gives Nichols the most hope is how quickly the field has changed.

She points to KRAS, a gene that was once considered an “undruggable” target.

“I remember in my dissertation defense, I had a slide about undruggable targets,” Nichols says. “One of them was the gene KRAS.”

Today, there are approved therapies that target certain KRAS alterations in lung cancer and other cancers.

“Seven years later, it is no longer an undruggable target,” she says. “We have approved drugs against KRAS, which is really amazing.”

For Nichols, that progress shows how quickly cancer research can move when scientists, patients, advocates and policymakers work together.

She also sees hope in the growing role of patients and caregivers as advocates — not only for their own care but for research funding, policy changes and efforts to reduce the stigma surrounding lung cancer.

“It’s just really wonderful to be here in a community that’s empowering advocates to bring their voice,” Nichols says. “That can just push us toward more and better research and treatments in the future.”

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