The Cancer Treatment Within You
How blood, urine and gene mutations may unlock secrets to lung cancer treatment options.
Did you know that lung cancer is the leading cause of cancer-related deaths in the U.S.? Recognizing Lung Cancer Awareness Month, we interviewed two experts at Sutter about the cutting-edge discoveries helping improve care for patients with the disease.
Read more for perspectives from Deepti Behl, M.D., medical oncologist, Medical Director of the Sutter Institute for Medical Research (SIMR) in Sacramento, and Benson Chen, M.D., FCPP, a pulmonologist and critical care medicine specialist at Sutter’s California Pacific Medical Center (CPMC).
What are the biggest challenges in treating lung cancer and how are Sutter researchers making strides to improve care for people with the disease?
Dr. Behl: When lung cancer spreads to other areas of the body, it is considered “metastatic.” Sutter patients with metastatic lung cancer get routine genetic testing to help us ensure those who are eligible for targeted therapies—drugs that interact with the cancer’s specific genes or proteins—receive treatment matched to their unique type of cancer and their genetics.
The results of cancer genetic testing may take two to three weeks to become available, but many patients with advanced-stage lung cancer need treatment as soon as possible. At Sutter, we are exploring ways to obtain those results faster with strategies such as liquid biopsy testing, where blood or urine is analyzed for disease markers or “clues” that can help us determine the best treatment option for each patient.
Sutter has also implemented Clinical Pathways (formerly called Via Oncology Pathways)—a tool that shows oncologists the latest published evidence and best practices of physicians nationwide, helping to standardize care and connect cancer patients to clinical trials.
Dr. Chen: Early-stage lung cancers are curable in 60% of people with the disease. But most are caught late, making lung cancer the leading cause of death by any cancer. I direct CPMC’s lung cancer screening program, a resource to help detect the disease in people older than 55 years who are long-time smokers or former smokers. Twenty locations throughout the Sutter Health network offer screenings using a special CT scan that has less than half the typical radiation exposure compared with traditional CT scans.
What are some of the most exciting research discoveries today that may help improve care for people with lung cancer now and in the future?
Dr. Behl: Lung cancer researchers at Sutter and others nationwide are identifying new genetic markers of lung cancer, and applying those findings to make drug-based treatment more personalized than in decades past. For example, approximately 25% of people with lung cancer have a mutation of a gene called KRAS long thought to be untreatable. But at one of the world’s leading cancer research meetings this year, novel findings were presented that suggest an investigational new drug may target a type of KRAS mutation called G12C.
Dr. Chen: Liquid biopsy tests to help us detect genetic mutations in cancerous tissue would allow us to offer targeted therapies and potentially determine whether findings from lung cancer screening are indeed cancerous, or benign. In the future, if liquid biopsy technology advances like we hope, we may be able to avoid the use of radiation-based screening technology and use blood tests instead.
How are cancer researchers at Sutter applying the latest insights in research, to develop new treatments?
Dr. Behl: Sutter researchers lead lung cancer clinical trials that may lead to medical breakthroughs.
A few examples of these include:
NCI-MATCH, a precision medicine cancer treatment clinical trial. In this trial, patients receive treatment based on the genetic changes found in their tumors through genetic testing and other tests.
TAPUR™, a national clinical trial determining the safety and effectiveness of approved, targeted anticancer drugs in patients with advanced cancers who do not respond to standard treatment or for whom standard treatments are unavailable.
Lung-MAP, a national clinical trial available for patients with advanced cancers whose tumor has continued to grow despite treatment with standard therapy.
LUNAR, a study for patients with advanced-stage lung cancer that has not responded to initial treatment. The study is sponsored by NovoCure Ltd. In this study, patients who have progressed following platinum-based therapy receive treatment with alternating electric fields in combination with docetaxel or checkpoint inhibitor immunotherapy. The energy is delivered by a portable, battery-operated device that sends electric fields to the region around the cancerous tumor.
At Sutter, we take pride in offering the most evidence-based, innovative, and personalized treatments for every patient. Our clinical trials bring the latest that medical science has to offer to our patients, right where they live.