New Statewide Research Initiative Targets Lung Cancer

Peter ShieldsDavid CarboneThe Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute (OSUCCC – James) has launched a statewide clinical research initiative that takes aim at lung cancer, the No. 1 cancer killer among men and women in the United States.

Led by Peter Shields, MD, David Carbone, MD, PhD, and Mary Ellen Wewers, RN, PhD, MPH, the initiative is called Beating Lung Cancer - in Ohio (BLC-IO) and will be supported by a $3 million grant from Pelotonia, an annual grassroots bicycle tour that raises money for cancer research at Ohio State, and additional philanthropy. Recruitment of lung cancer patients for this initiative will take place over three years starting in spring 2017.

The initiative will draw upon a network of more than 50 partner hospitals from communities across Ohio that was established as part of the Ohio Colorectal Cancer Prevention Initiative (OCCPI), a previous statewide research initiative also funded by Pelotonia.

BLC-IO has two aims: to evaluate the impact of Advanced Genomic and Immunotherapy Testing (AGIT) and provide expert clinical decision-making support to the local treating physicians; and to improve smoking-cessation rates among smokers with lung cancer and their family members. Improvements in patient quality of life will be assessed in both study aims.

Planners expect more than 2,500 newly diagnosed, stage 4 non-small cell lung cancer patients to enroll in BLC-IO. Patients will receive free AGIT for more than 300 genes in their cancer specimens.

“Lung cancer is most often diagnosed in a metastatic (stage 4) state; that is why it is critical to get patients on the right treatment right away,” says David Carbone, MD, PhD, director of the Thoracic Oncology Center at the OSUCCC – James and co-principal investigator (PI) of BLC-IO. “We know advanced genomic and immunotherapy testing can help us identify the patients most likely to benefit from a targeted therapy, which is oftentimes a pill and well tolerated, versus traditional chemotherapies not specifically targeted to that patient’s genetic mutations.”

According to Carbone, only about 60 percent of patients in Ohio receive even one or two gene-mutation analyses before beginning therapy. Few patients receive the sevengene testing recommended by the National Comprehensive Cancer Network or testing for PD-L1, another biomarker useful for selecting first-line immunotherapy treatment.

“This initiative will help us give more patients advanced genomic and PD-L1 testing and then determine how that knowledge affects treating oncologists’ clinical decision-making and overall survival for patients with non-small cell lung cancer,” Carbone says. “Knowledge does not have full impact on patients unless it is made available to them through their local provider. Unfortunately, this advanced testing is not covered by any of the major payers in Ohio.”

The second component of BLC-IO will provide all lung cancer patients who are smokers and their family members with smoking-cessation support for up to three years.

“Smoking addiction is a chronic, relapsing disease, and many factors contribute to a person’s success or failure to kick the habit long-term,” says Peter Shields, MD, deputy director of the OSUCCC and co-PI for BLC-IO. “It’s hard to provide strong smoking-cessation support in any oncology practice. We need to do better in supporting patients who smoke, and doing that needs to involve family members who smoke, too.”

BLC-IO researchers will test different models for smoking-cessation support among lung cancer patients and their families, working in collaboration with the patients’ primary care physicians. “For the families,” Shields adds, “we believe there is a strong potential to save many years of life—and millions of dollars associated with cancer treatment later—by helping people reduce their risk for lung and many other cancers through smoking cessation.”

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