Exploring Innovative Pathways in Lung Care

Timing is everything in patient care

Cancer is relentless, taking more lives globally than any other disease.¹ Even among the more prevalent types, like lung cancer, approximately 72% of patients with lung cancer are diagnosed with non-localized disease,² potentially limiting intervention options and reducing 5-year survival rates.

For patients diagnosed with cancer, time matters. A delay in any part of the patient pathway can result in a direct impact on prognosis. By aiming to bridge the gap between diagnosis and intervention, we believe we can help care teams shorten the patient journey.

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Going further for answers and rethinking lung cancer care

Every moment counts

The pathway for patients with suspicion of lung cancer can begin in different ways. Today, fewer than 7% of eligible high-risk patients in the U.S. get screened with a low dose CT scan,³ while other suspicious lesions (growths) are often found through an incidental finding.

If a suspicious lesion is detected, patients are triaged for potential biopsy. A recent study found that 46% of patients require two or more biopsies to receive a diagnosis with an average time of 57 days between the first biopsy and diagnosis.⁴ If diagnosis is not possible, it may be suggested that patients enter watchful waiting, where they would receive regularly scheduled imaging to assess if the lesion has grown. Patients may also be scheduled for surgery or oncologic therapy out of caution if there is a high risk of malignancy.

For the patients where a diagnosis comes from a biopsy, they may be referred for surgery, oncology services, or both, depending on the state of the disease. Each of these steps can take time and may result in delays, which may have a direct impact on prognosis.⁵ The variability at each stage of care coordination highlights an opportunity to examine and innovate for unmet needs on the lung care continuum.

Early diagnosis of hard-to-reach nodules

With approximately 70% of all-stage cancerous lung nodules found in the periphery of the lung,⁶ physicians may face challenges using bronchoscopy to biopsy peripheral nodules, including those less than 2 cm.⁷ Of note, small nodules less than 2 cm may represent early-stage disease (Stage IA1- IA2)—and detection of early-stage disease is associated with the highest 5-year survival rate of 92% and 83% respectively.⁸

Biopsy in the periphery may be done percutaneously and while chances of diagnosis are favorable, risks of complications are relatively high, including the risk of pneumothorax requiring chest tube of up to 15%⁹. With both approaches, multiple biopsies may be required to get a definitive diagnosis, which can add up to 90 days⁴ to a patient’s diagnostic journey, and up to an 80% increase in hospital cost.¹⁰

Catching up to the needs of physicians and patients

The introduction of Ion’s technology opens the door to other pathways of care. With Ion, physicians can navigate to and biopsy small nodules in the periphery¹⁰ to help enable quick care decisions. Unlike other navigation bronchoscopy systems, Ion’s fiber optic shape sensor is immune to electromagnetic interference, meaning it can be used in the procedure room alongside metallic items because it is not sensitive to metal objects.¹¹

Considering that robotic-assisted surgery is currently the primary surgical modality used for lung resection¹², biopsy enabled by Ion allows for pathology, staging, and surgical intervention using the da Vinci surgical system, to be performed sequentially in a single operating room.