Lung Cancer: clinical trials & treatment options
A plain-language guide to the major subtypes — non-small cell (adenocarcinoma and squamous) and small cell — the biomarkers that steer treatment, and where clinical trials fit at each stage of care.
Reviewed against public oncology references · see our editorial standards
Educational overview · Data current as of 2026-06-06 · Not a substitute for advice from your care team
Disease overview
What lung cancer is — and why subtype and biomarkers change everything
Lung cancer is not one disease. The type of tumour and its molecular profile determine treatment, prognosis, and which trials are relevant to you.
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Written and fact-checked by the Clinical Trial Compass editorial team
Pending clinical review by a board-certified physician. Read our editorial standards →
Last updated June 6, 2026
Lung cancer begins when cells in the lungs start growing out of control. It is one of the most commonly diagnosed cancers worldwide and, historically, one of the leading causes of cancer death — though outcomes have improved as screening catches more cancers early and as treatment has become far more precise. It occurs in people who have smoked and in people who never have.
What matters most for your plan is not just the size or stage of the tumour, but its type and biology. Doctors first sort lung cancer into non-small cell and small cell. Within non-small cell, molecular testing looks for specific drivers — mutations and other changes that can be matched to a targeted therapy. That result sorts lung cancer into the major groups below, and each can respond to very different treatments.
NSCLC — adenocarcinoma
The most common type of lung cancer, accounting for roughly 4 in 10 cases. It usually starts in the outer regions of the lung and is the subtype most often found in people who have never smoked. It is also the subtype most likely to carry a targetable biomarker — making molecular testing especially important here.
NSCLC — squamous cell
Another major form of non-small cell lung cancer, usually arising in the central airways and more closely tied to a smoking history. Targetable driver mutations are less common than in adenocarcinoma, so treatment more often relies on chemotherapy and immunotherapy, with biomarker testing still worthwhile.
Small cell lung cancer (SCLC)
About 1 in 7 lung cancers. It tends to grow and spread quickly and is strongly linked to smoking. It often responds well to chemotherapy and radiation at first, but can return — which makes it one of the most active areas of trial research, particularly for immunotherapy combinations and new approaches at relapse.
The biomarkers that steer treatment
In non-small cell lung cancer especially, the tumour is tested for molecular markers. A single targetable finding can change the whole plan — and open the door to specific trials. These are worth knowing by name.
A mutation that can drive growth, more common in adenocarcinoma and in never-smokers. Several oral targeted therapies are matched to it.
A gene rearrangement found in a smaller share of NSCLC. Multiple targeted drugs exist, including options that reach the brain.
A rarer rearrangement with its own approved targeted therapies — worth testing for even though it is uncommon.
One of the most common drivers in NSCLC. Long considered 'undruggable', specific KRAS variants now have targeted options, with more in trials.
Not a mutation but a protein level on the tumour. It helps predict how well immunotherapy may work and guides whether it is used alone or with chemotherapy.
Why trials matter here: many of the drugs that are now standard lung cancer care — targeted therapies for EGFR and ALK, immunotherapy for tumours with high PD-L1, newer combinations for small cell disease — reached patients first through clinical trials. For some people, a well-matched trial is a way to access tomorrow's treatment today. For others, the proven standard path is the right call. The point of this guide is to help you have that conversation, not to decide it for you.
Treatment landscape
The typical path — and where trials fit at each step
Treatment moves through these stages, and the exact order and combination depend on your subtype, stage, and biomarkers. Trials exist at every point along the way.
Surgery
For earlier-stage non-small cell lung cancer that hasn't spread, surgery to remove the tumour — and sometimes a lobe of the lung (lobectomy) — can be the main treatment. Nearby lymph nodes are usually sampled to check for spread. Surgery has a smaller role in small cell lung cancer, which is more often widespread at diagnosis.
Where trials fit: Trials here study less-invasive surgery, and 'perioperative' strategies — giving targeted therapy or immunotherapy before or after surgery to lower the chance the cancer comes back.
Chemotherapy & radiation
Chemotherapy, often paired with radiation, is a backbone of treatment for cancers that can't be removed surgically and for small cell lung cancer. Radiation can also be aimed precisely at a single tumour (stereotactic radiation) for some early-stage patients who can't have surgery.
Where trials fit: Trials test new drug combinations, more precise radiation schedules, and ways to add immunotherapy to chemoradiation to extend how long the cancer stays controlled.
Targeted therapy & immunotherapy
This is where biomarkers matter most. If the tumour carries a driver like EGFR, ALK, ROS1, or certain KRAS variants, a matched oral targeted therapy may be the right first step. Where no driver is found, or PD-L1 is high, immunotherapy — alone or with chemotherapy — is often central. Treatment is increasingly chosen to fit the tumour's molecular profile.
Where trials fit: The largest share of lung cancer trials live here — new targeted agents for known and emerging drivers, next-generation immunotherapy combinations, antibody-drug conjugates, and strategies to overcome resistance after a first treatment stops working.
This is a simplified map, not a treatment plan. Advanced (metastatic) lung cancer follows a path focused on long-term control rather than cure, and has its own active trial landscape. Your oncologist will tailor the sequence to your subtype, stage, and biomarker results.
What to ask your doctor
Lung-cancer-specific questions worth raising
Bring these to your next appointment. The answers shape your treatment, your prognosis, and which trials you may be a fit for.
What subtype of lung cancer do I have?
Ask whether it is non-small cell (and if so, adenocarcinoma or squamous) or small cell. The subtype shapes nearly every treatment and trial decision that follows.
Has my tumour had full biomarker (molecular) testing?
Ask specifically about EGFR, ALK, ROS1, KRAS, and other drivers, plus PD-L1. Comprehensive testing can reveal a targetable mutation — and missing it could mean missing a matched therapy or trial.
What stage is my cancer, and has it spread?
Stage drives whether surgery is on the table and which trials you may fit. Ask whether lymph nodes or other organs are involved, and how that was determined.
Should I get a tissue or liquid (blood) biopsy for testing?
If there isn't enough tissue, a blood-based test can sometimes find biomarkers. Ask which approach fits your case and how long results will take, since timing can affect treatment choices.
Is immunotherapy, targeted therapy, or chemotherapy the right first step for me?
The answer depends on your subtype, biomarkers, and PD-L1 level. Ask why the recommended first treatment fits your specific results, and what the alternatives are.
Is now a good moment to consider a trial, or later?
Trial timing matters. Some trials enrol before surgery, some alongside first treatment, some only after a therapy stops working. Ask where a trial could fit without compromising proven care.
If a trial comes up, it is reasonable to ask: “Is this worth discussing for someone with my exact subtype, stage, and biomarkers?” A well-matched trial is worth exploring — but eligibility is decided by the study team, never by a website. You may meet some major criteria; confirm the rest with the trial coordinator.
Active clinical trials
See what's recruiting now
We pull recruiting lung cancer trials from the public ClinicalTrials.gov registry, with NCT IDs and last-updated dates, so you can review them with your care team.
See recruiting lung cancer trials
Browse currently recruiting studies, filtered by phase and status, each linked to its source listing on ClinicalTrials.gov.
View trials
Find your trial match
Answer four quick questions about your diagnosis and we'll surface trials worth discussing with your doctor — no account, no cost, no pharma sponsorship.
Start the eligibility checkEducational only — not medical advice.This guide is a general overview and may not reflect your individual situation. It does not diagnose, recommend treatment, or determine trial eligibility. Always make treatment decisions with your oncologist and care team. Trial eligibility is confirmed by each study's coordinator, not by Clinical Trial Compass. Statistics are approximate and drawn from public oncology references; data current as of 2026-06-06.