Statewide research initiative takes aim at lung cancer

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Experts at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) have launched a statewide initiative that targets lung cancer, which causes more cancer-related deaths than colon, breast and prostate cancers combined.

In Ohio, about 7,000 people are newly diagnosed with stage 4 lung cancer. By the time lung cancer is diagnosed, it has usually progressed to a metastatic (stage 4) state.

The new statewide research initiative is called Beating Lung Cancer In Ohio (BLC-IO). The initiative has two principal objectives and is funded by a $3 million grant from Pelotonia, an annual threeday cycling fundraiser based in Columbus that has raised more than $140 million for cancer research since its inception in 2008.

Advanced gene testing

The first objective is to study the impact of advanced gene testing and expert advice on survival rates and quality of life of lung cancer patients, said Peter Shields, MD, deputy director of the OSUCCC – James, who is leading the study along with David Carbone, MD, PhD, Mary Ellen Wewers, PhD, and Barbara Andersen, PhD.

Recruitment started in March and will continue for three years. The goal is to enroll 2,500 newly diagnosed advanced-stage lung cancer patients for the study, which will draw upon an existing network of more than 50 partner hospitals throughout Ohio that was built as part of the Ohio Colorectal Cancer Prevention Initiative.

Patients enrolled in the study will receive free testing for more than 300 genes in their cancer specimens. Currently, most insurance companies cover testing for only about three or four genes, and many patients do not even receive this, or they receive testing late in their care.

“Knowledge does not have its full impact on patients unless it is made available to them in the community through their local provider. Unfortunately, this advanced testing is currently not covered by any of the major payers in Ohio,” said Carbone, director of the OSUCCC – James Thoracic Oncology Center and co-principal investigator of BLC-IO.

“We need to prove this testing and support is beneficial. We are measuring both survival and quality of life. We really are trying to help our patients in every way so the testing becomes more widely used,” Shields said.

Previously published data suggests that up to 64 percent of lung cancer patients have genetic mutations that can be specifically targeted and treated with Food and Drug Administration-approved therapies or drugs in clinical trial testing.

“We know advanced genomic 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,” Carbone said.

Targeted therapies and immunotherapies, sometimes coupled with chemotherapy, are extending patients’ lives from one to two years. “Over the past two years, seven or eight new drugs have been developed that are doubling survival rates,” Shields said. “That trend is only going to grow.”

All care of patients will remain with their treating oncologists at participating BLC-IO hospitals, who will receive support interpreting patient test results and determining what treatments could be used. As part of the study, OSUCCC – James researchers will provide “decision reports” and direct consultations to patients’ doctors.

“There have been so many great breakthroughs for the treatment of different cancers that cancer care is more complex than ever. This study will directly provide help for our patients and for those in the community,” Shields said.

“We will work with a patient’s treating cancer doctor to decide how they best want to treat their patients, especially when there are many options for different therapies and clinical trials.” he continued. OSUCCC – James researchers also plan to create a weekly genomic tumor board to discuss patient profiles. “Doctors can call in, and together we can explore the patient’s options.”

Smoking cessation

The second objective is to help lung cancer patients and their families quit smoking.

Ohio ranks No. 11 for cancer mortality in the U.S., and more Ohioans report smoking cigarettes — 22 percent — compared to the national average of 18 percent.

“Many lung cancer patients, no matter how much they try, cannot quit. Lung cancer is a stressful time and this makes it even harder,” said Shields. “But, a lung cancer patient who continues to smoke may have more side effects to therapy, the therapy may not work as well and in general patients do not live as long.”

Shields says that BLC-IO will also help patients by providing smoking cessation counseling and work with the treating cancer doctors to help them quit.

About 85 percent of all lung cancers are non-small cell lung cancer, which can affect both smokers and non-smokers. Among lung cancer patients, about two-thirds of them are former smokers, Shields said.

Cessation support will be in the form of phone counseling from the OSUCCC – James, and the treating oncologists will prescribe smoking cessation medications as appropriate.

Improvements in quality of life will be assessed throughout the study and beyond. “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,” Shields said.

Partners in the study include Foundation Medicine, Inc. a cancer gene testing company, the Addario Lung Cancer Foundation and additional philanthropy.

To learn more, visit cancer.osu.edu/beatinglungcancer or call 614-293-5066.