Reasons for Optimism in Lung Cancer

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Lung cancer can be a frightening diagnosis. However, new treatment approaches and promising research trends have made the outlook for patients a little more optimistic, says David Jackman, MD, an oncologist in the Lowe Center for Thoracic Oncology at Dana-Farber Cancer Institute.

Targeted therapies
A decade ago, researchers at Dana-Farber and elsewhere identified a series of gene mutations in the cancer cells of some lung cancer patients that caused them to respond differently to certain oral chemotherapies. Since then, researchers continue to find additional gene alterations that drive lung cancer and develop more effective drug therapies for them.

David Jackman outlines three areas of advancement in lung cancer treatment.

Tarceva (erlotinib), for example, targets tumors with mutations in the EGFR, while Xalkori (crizotinib) attacks tumors with a DNA rearrangement in the ALK gene. Now, lung cancer patients and their treating physicians are often having conversations that involve the word “years.”

“We’re excited that we’re finding a mutation that is either known, or hypothesized, to be targetable in over half of patients with lung adenocarcinoma,” says Jackman. “At present, there are newer agents in clinical trials that are attempting to attack these and other altered proteins in lung cancer.”

Immunotherapy
For decades, researchers have attempted to harness the body’s immune system to fight off lung cancer. A major advance came in 2000, when Dana-Farber scientists described the interaction between PD-1, a protein on the surface of T cells of the immune system, and PD-L1, a protein on the surface of some cancer cells. Interaction between these two proteins normally allows cancer cells to hide themselves from the immune system. Within the last few years, Dana-Farber physician-scientists have helped develop drugs that block this interaction, leaving lung cancer cells vulnerable to attack by the immune system.

“These studies are still very early in their development,” Jackman notes. “It may be years before we can determine whether there is sufficient efficacy and safety to warrant their approval. But we are excited about their potential.”

Precision surgery and radiation
For localized lung tumors, surgery can be an effective treatment, and in many cases, a cure. Surgical oncologists continue to develop minimally invasive thoracic surgery techniques for removing tumors that hope to get patients cured and back on their feet faster than before. Similarly, in radiation therapy, more precise aiming of the X-ray beams allows radiation oncologists to maximize the effect of radiation on cancerous tissues while minimizing the impact on surrounding, healthy tissues.

10 comments

  1. richaqrd oconnor says:

    Absolutely wonderful news ! Glad to hear that all of the scary things going on in the medical industry ( drugs , research etc . ) produce some results …

  2. Jack Canavan says:

    My wife battled lung cancer @ DF since May of 2012. She passed away on July 19, 2013.
    Where were the “Precision Surgery” & “Radiation” then?

    • Dana-Farber says:

      We are very sorry to hear about the death of your wife from lung cancer. Please know that we have a bereavement program which others have found helpful, especially in the early months. You can reach this program by calling 617-632-2490 or emailing bereavement_program@dfci.harvard.edu.
      The advances made in diagnosing and treating lung cancer during the past decade, as well as the direction and pace of research today, give us reason to be optimistic. While many people have benefitted, it is clear that there is so much more research to do in order to improve the outcome for all lung cancer patients and their families.

  3. Doreen Genna says:

    Mr. Canavan, I can truly understand where you’re coming from. As those left behind, we will always have those questions. My son, Jonathan, passed away 10 years ago (at the age of 25) from non-small cell lung cancer. I often wonder if things would have been different if he were diagnosed now. But, it just wasn’t his path in life to follow.

    I can only thank Dana-Farber/Brigham&Women’s Hospitals for all that they did to treat my son. His oncologist, Pasi Janne, was a godsend. The other medical staff as well.

    Please, please, please, continue with your work to treat this horrible disease. I don’t want to think that Jonathan’s illness and death were in vain.

  4. Kathy Cuddy says:

    To help support research for targeted therapies for lung cancer, please join us as we WALK together towards a world where no one dies of lung cancer.

    LUNGevity Foundation’s

    BREATHE DEEP BOSTON 5K WALK
    Saturday, November 2, 2013
    DCR’s Carson Beach
    http://www.lungevity.org/boston

  5. Debi Thompson says:

    Dr. Jackman was our doctor for Dennis’ treatment for lung cancer. He and Dr. Elizabeth did everything they could and I have never experienced such wonderful treatment and responsiveness in my life. Sadly Dennis lost his battle, but the skill of these doctors made him believe they would do their very best every day for him. I know he was grateful and I will be so for eternity. If there is a place where they will find a cure it will be Dana and staff like Dr. Jackman. God bless you all!

  6. Patti Bolduc says:

    My mom has been on Tarceva for 72 weeks. Her last CT scan of the lung is showing new nodules. Is there any benefit of continuing the Tarceva or would chemo be a better option.
    I realize this is a very broad question as there are many variables. She does have NSCLC, adenocarcinoma.
    Thank you

  7. Dana-Farber says:

    Thanks for the comment and I’m sorry to hear of your Mom. Questions like the one you ask are very important ones to bring up with your Mom’s oncologist. Unfortunately, we can’t give out specific medical advice over email (or via this blog). Our Contact Us page on our website (http://www.dana-farber.org/contact-us.aspx) has some general contact information. Also, our Lung Cancer Treatment Center does offer second opinions, and the contact information for that is here: http://www.dana-farber.org/Adult-Care/Treatment-and-Support/Non-Small-Cell-Lung-Cancer/How-We-Diagnose-Non-Small-Cell-Lung-Cancer.aspx

    You’ll also find some links on that page for additional information. I hope that’s helpful and we wish the best to you and your Mom.

    –Michael Buller
    Insight editor

  8. Doreen says:

    April 2013 I was diagnosised with large cell lung cancer. Did 3 rounds of chemo but had to stop due to bad side effects. My right lung had 2 lobster removed and two lymphnodes removed. 10 days later I had a heart attack, stint put in. The 28 days later my lymphnode on my neck swelled on both sides….feels choked in.rer I don’t fit the targeted new things and pretty much tossed aside and placed on hospices. Can anything more be done?

    • Dana-Farber says:

      Hi Doreen:
      I’m sorry to hear about your diagnosis. Unfortunately, we can’t diagnose or offer medical advice over the blog. I’m sure you’re already talking with your doctor about your options. If you’d like to get a second opinion, you can call the Lung Cancer Program at Dana-Farber at 877-442-3324 or use this form
      https://www.dana-farber.org/apps/request-an-appointment.aspx
      I hope that’s helpful and wish you the best,
      Michael

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