Targeting Lung Cancer

Dr. Dean Edell: Lung cancer is the leading cause of cancer death among both men and women in the U.S.; in fact, more people die of lung cancer than breast, colon, and prostate cancer combined. Today targeted treatment options are aimed at saving more lives. Male Speaker: I had no idea I had lung cancer. Dr. Dean Edell: Don Costanich doesn't take a single breath for granted. He is one of the 170,000 people diagnosed this year with lung cancer, and Don knows 160,000 will die. Daniel Nader: That would be equivalent to a 747 jet crashing everyday, that would be the same number of people over the course of a year that would die of lung cancer. Female Speaker: Are you having any nausea today? Dr. Dean Edell: In an attempt to beat those terrible odds, patients face painful surgery, plus radiation, and chemotherapy, that often sickens them. Anil Potti: When you identify who to treat, then you identify what you treat with. Dr. Dean Edell: In the past it was a matter of trail and error, but now doctors are looking at ways to match the most effective treatment to the individual patient. Anil Potti: It's this whole concept of being able to walk into a patient's room and say, I am not just a doctor who treats lung cancer, I am here to treat your lung cancer. Dr. Dean Edell: Doctors at Duke University Medical Center have created a test that can tell one patient's cancer from another. Anil Potti: It's in someways a fingerprint. Dr. Dean Edell: The Lung Metagene Predictor scans tumor tissue and looks at the pattern of gene activity to determine if chemotherapy will work for that patient, and if so, which chemo drug might be the most effective. Anil Potti: If the genes show a particular pattern, then they are more likely to be sensitive to a particular form of chemotherapy as opposed to another form of chemotherapy. Dr. Dean Edell: It can also identify which early stage patients will benefit from chemo. Anil Potti: Patients who currently would not receive chemotherapy, but then using a genomic test are now candidates for chemotherapy. Dr. Dean Edell: Al Claver went through the genomic test and received customized chemotherapy. Male Speaker: The last two scans that they have done on me are shown negative. Dr. Dean Edell: There is also research looking at intratumoral chemotherapy, in other words, chemotherapy placed within the tumor. Male Speaker: The dose cloud is shown in blue. Dr. Dean Edell: Doctors at Istanbul, Turkey studied this method as a way to shrink cancerous tumors that obstruct bronchial tubes. Male Speaker: These two dots are the catheters. Dr. Dean Edell: Now researchers in the United States are looking at its effectiveness when combined with a radiation treatment called Brachytherapy. Daniel Nader: Brachytherapy has been around for many years. Dr. Dean Edell: During Brachytherapy, a catheter is inserted into the tumor and radiation is delivered through the catheter. In this study patients are given a dose of intratumoral chemotherapy before the radiation is delivered. Daniel Nader: It's felt that by injecting these tumors with chemotherapy, we may make that tumor that's inside the lung more vulnerable to the localized radiation therapy that they are getting with Brachytherapy. Dr. Dean Edell: Preliminary results presented at a recent meeting of the American College of Chest Physicians show a significant reduction in Tumor mass. Male Speaker: Before I could hardly breathe, now I have got 99% of my breathing back. Daniel Nader: We are hoping that the outcomes will be sufficient enough so that other centers can consider this form of therapy to treat these very complex patients. Dr. Dean Edell: Of course, the best way to fight lung cancer would be to detect it sooner. Male Speaker: It's a dense area in her right upper lobe. Dr. Dean Edell: Cornell University researchers looked at low dose CT screenings for 30,000 high-risk people, and found that the scans are an effective screening tool. Claudia Henschke: Those smallest, most curable lung cancers, 85% of them were missed on the chest x-ray. Dr. Dean Edell: In this study, lung cancer was diagnosed in nearly 500 people, 80% were in the earlier stage. Jason Chien: I think the findings are important or they need to be interpreted with caution. Dr. Dean Edell: Why? Because CT scans, even low dose scans, do expose patients to radiation. Plus, a patient may be put through the risk of surgery only to find that a growth discovered by the scan is not cancer after all. Jason Chien: The only way to know that for certain is to have a second arm for comparison. Dr. Dean Edell: In other words, the study did not include a group of patients who did not get screened. While doctors debate CT scans, people living with lung cancer continue to fight for survival. Male Speaker: My hope is that I will be cancer free. I consider myself very, very lucky. Dr. Dean Edell: Smoking causes nearly 90% of lung cancer cases, but exposure to radon and asbestos also put you at risk, and according to the CDC, family history and genetics could also play a role.