While a diagnosis of lung cancer years ago didn’t come with a wealth of treatment options, the outlook has brightened. Jonathan Thompson, MD, medical oncologist, explains that surgery, radiation therapy, medical therapies and clinical trials offer innovative options and hope. When standard treatment is no longer effective, people with certain types of lung cancer may turn to immunotherapies — groundbreaking treatments that train the immune system to eliminate cancer cells.
What are important and developing treatments for lung cancer?
Dr. Thompson: Interventional pulmonology expertise, coupled with advanced diagnostics and treatment with state-of-the-art technology, is an advantage for accurate treatment planning. Minimally invasive robotic surgery is available for people who can have surgery. Different ways of combining radiation therapy with drug agents are being explored. We’re seeing rapid development in targeted therapies, as well as with cellular therapies like immunotherapy, which uses a person’s own immune system to fight their cancer. Genetic evaluation to direct targeted therapy is another key component guiding treatment decisions.
Tell us more about “targeted therapy” and how a person’s genes make a difference in the way they’re treated for lung cancer.
Dr. Thompson: Tissue biopsies have been the gold standard for telling us if a person’s lung cancer is linked to a gene mutation. Now, as much as possible, we do that evaluation with a liquid biopsy. These blood tests pinpoint unique factors in a person’s lung cancer. If we find genetic mutations, we use targeted therapies — drugs that go after a person’s specific mutation — rather than treating with a broader-based chemotherapy drug.
Are immunotherapies or targeted therapies better than chemotherapy?
Dr. Thompson: Chemotherapy is still an effective treatment and may be combined with other treatment such as immunotherapy. However, for some patients, immunotherapy or targeted therapies can be used without chemotherapy and can control cancer for much longer than chemotherapy. We determine which people are most likely to benefit from these treatments by looking at the genetic and protein makeup of a person’s cancer. Most of our clinical trials aim to improve outcomes
Are clinical trials a “last-ditch” effort when other lung cancer treatments don’t work?
Dr. Thompson: That is a misconception. Clinical trials can help lung cancer patients at any time in treatment. Trials offer options that may work better when added to standard treatment or after a recurrence. We have the largest portfolio of lung cancer clinical trials in eastern Wisconsin — some unique to our Cancer Network. We review each patient’s situation to match them with a clinical trial if it will benefit them.
What are some examples of your team’s ongoing research?
Dr. Thompson: In an early-phase national trial, we’re giving bemcentinib, a protein inhibitor, with pembrolizumab, an immunotherapy drug, to people with advanced lung cancer to test the safety and effectiveness of the combination. Initial results have been good. One of our patients has had the longest positive response in the U.S. on that trial.
In another national trial, we’re testing surgery to remove the lung tumor, followed by a cellular therapy called tumor-infiltrating lymphocytes (TIL). After surgery, we gather cancer-fighting T cells from the tumor, amplify their power in the lab and infuse the cells back into the patient. This is followed by the immunotherapy drug pembrolizumab. We’re also testing TIL as a single therapy.
Because our experts focus on lung and other cancers in the chest, research new treatments and publish results of clinical trials, we stay current on every advance affecting lung cancer patients. Through clinical trials, patients have access to new options that may not be widely available. Learn more about lung cancer clinical trials.
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I would like to know the NCT number on this trial, please: "In another national trial, we’re testing surgery to remove the lung tumor, followed by a cellular therapy called tumor-infiltrating lymphocytes (TIL). After surgery, we gather cancer-fighting T cells from the tumor, amplify their power in the lab and infuse the cells back into the patient. This is followed by the immunotherapy drug pembrolizumab. We’re also testing TIL as a single therapy."
Hi Roger -
The clinical trial referred to in that paragraph is NCT03645928, and more information can be found here: https://www.froedtert.com/clinical-trials/cancer/phase-2-multicenter-st….
This is a highly informative interview. It provides, in great detail, a well-reasoned analysis of advances in lung cancer treatments. It is indicative of the high quality of doctors at Froedtert.