As lung cancer continues to claim tens of thousands of lives each year, our researchers remain focused on treatment innovation and prevention efforts that can improve outcomes for today’s patients while reducing cases in the future.
The nation’s leading cause of cancer-related deaths in the United States (approximately 165,000 per year), lung cancer is the second most commonly diagnosed form of the disease; around 266,000 new American cases were expected in 2018. Of those cases, 80 to 90 percent will be linked to smoking, according to the Centers for Disease Control.
Despite these daunting numbers, progress in lung cancer care is underway, with researchers hard at work developing new therapies while doctors promote screening and healthy habits to prevent people from becoming patients.
Early detection—which can reduce the mortality rate by 20 percent, according to national studies—is the goal of the OSUCCC – James Lung Cancer Screening Clinic, which performs screenings for at-risk patients.
At-risk patients are men and women, ages 55 to 77, who have smoked at least two packs per day for 15 years, or one pack per day for 30 years, as well as ex-smokers with similar smoking histories who have quit within the past 15 years.
“There are so many benefits to catching it early,” says Michael Wert, MD, director of the OSUCCC – James’ Lung Cancer Screening Clinic and a member of the Division of Pulmonary, Critical Care and Sleep Medicine at Ohio State.
Many healthcare plans cover these screenings. For those that don’t, and for people without health coverage, the OSUCCC – James has a program to help offset the costs.
“Our goal is to make lung cancer screenings as well-known as mammograms and colonoscopies,” Wert says. “Screenings are so important—they save lives.”
Beating Lung Cancer in Ohio
The Beating Lung Cancer in Ohio (BLC-IO) initiative is a cutting-edge program aimed at saving and extending lives in the Buckeye State through prevention and clinical trials.
“About 2,300 lung cancer patients in Ohio will be part of this program,” says Peter Shields, MD, deputy director of the OSUCCC and a lead investigator of the BLC-IO.
All the patients in BLC-IO have Stage 4 lung cancer—a status that, among the general population, comes with a median life expectancy of four to six months. That span rises to 10 to 12 months for patients enrolled in clinical trials.
“About 25 to 30 percent of these patients could have a genetic mutation that can be treated by a drug already approved by the FDA, or they could be enrolled in a clinical trial,” Shields says. “This will add two or three years to their lives, and by then, new drugs and clinical trials could extend their lives even longer.”
A smoking cessation program for the patients with Stage 4 lung cancer also will be part of BLC-IO.
“Smoking is the number-one risk factor for lung cancer,” Wert says.
There were few active therapies for lung cancer when David Carbone, MD, PhD, began his medical career in the mid ’80s, says the now-director of the James Thoracic Oncology Center. “There was some chemotherapy available, but back then it wasn’t even offered to most lung cancer patients because the survival prolongation was so short and the side effects so severe.”
Now, thanks in large part to researchers like Carbone, there are more and more chemotherapy options for lung cancer patients that target specific mutations. The next step is immunotherapy, a process that reinvigorates the body’s immune system to help it detect and kill cancer cells.
“It was found that an important immunologic checkpoint was PD-L1,” Carbone says. “It acts like a force field around the cancer cell. If you have a drug that blocks PD-L1, a checkpoint inhibitor, it allows the immune system to see and kill cancer.”
Around 25-30 percent of Carbone’s lung cancer patients have tumors with a high expression of PD-L1. “The response [to treatment] is 45-50 percent in the patients with the highest PD-L1 markers, which means shrinkage or total elimination of the tumors.”