Bacteria samples are being collected from the lungs of cancer patients to explore new ways of early detection and treatment.
Lung cancer claims 9000 lives in Australia each year and about one in three cases are non-smokers.
Immunotherapy has shown significant potential in treating lung cancer but the response among patients is extremely variable.
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"We really need to find out ways we can work out who is going to respond because, like all cancer treatments, immunotherapy has side-effects," Dr Anna McLean, RPA Hospital's Respiratory Physician and study investigator at the Woolcock Institute of Medical Research, said.
Researchers say germs lurking in the lungs of patients could hold the key to identifying which patients will respond well to life-saving treatment.
"The way in which these bugs in the lungs interact with our immune system might affect who responds to immunotherapy in particular or chemotherapy," Dr McLean said.
When DNA analysis of the lung's microbiome is done and distinct patterns emerge, there is also the potential for less toxic treatments to be introduced.
"It is possible that microbiomes found to be associated with unfavourable outcomes could be manipulated with antibiotics, probiotics or via completely new techniques to significantly improve patient outcomes," she said.
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About 150 patient samples are being collected by Woolcock researchers as part of the project.
When patients have their cancer staged and undergo a lymph node biopsy, respiratory doctors wash and brush the lining of the airway at the cancer site to obtain a microbiome sample.
Saliva and stool samples are also taken throughout the patient's treatment journey, with preliminary results expected later this year.
The study follows new evidence in recent years, with the advent of new generation DNA sequencing, that our lungs host microscopic bugs rather than being sterile.
"It's really a new area of research and a different tangent to the other genetic markers," Dr McLean said.
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Angeline Low from Sydney's lower north shore has lung cancer and is responding well to a new treatment that targets the genetic mutation of her tumour.
She endured bouts of coughing for three years before her cancer was discovered during a routine health check when her heart specialist ordered a CT scan.
"I was diagnosed accidentally," she said.
"You see, it's a very insidious disease."
"It's silent, you just don't know and I tell my friends coughing is not normal, please do something about it."
Angeline said early diagnosis and ongoing research are vital.
"It is great to analyse whatever is in our lungs, because they still don't know what causes the lung cancer, people like me don't smoke," she said.
