Through discoveries in the lab, investigator-initiated trials and leading-edge surgical treatments, researchers and clinicians at The University of Kansas Cancer Center are revolutionizing the lung cancer landscape. According to Chao Huang, MD, associate professor, director of Thoracic Oncology, the health needs of the cancer center’s catchment area have long guided these efforts.
“In Kansas, lung cancer kills more people annually than pancreatic, colon and breast cancers combined,” Huang explained. “Missouri has some of the highest lung cancer rates in the nation — 73 cases per 100,000 people — significantly higher than the national rate of 59.6. These statistics drive us to do more.”
Over the last five years, the cancer center has offered about 45 lung cancer clinical trials and accrued nearly 200 participants. Such efforts taking place at the cancer center and other National Cancer Institute (NCI)-designated centers nationally are making a meaningful impact. Over the past 10 years, the five-year survival rate has increased from about 17% in 2009 to 21.7% in 2019, a 26% improvement.
A 2020 report published in CA: A Cancer Journal for Clinicians delivered additional good news. From 2016 to 2017, the United States saw its largest-ever single-year drop in overall cancer deaths. Authors of the report largely credit this 2.2% drop to advances in lung cancer treatment. If lung cancer is omitted from the statistic, the overall cancer death rate decrease is 1.4%. Nirmal Veeramachaneni, MD, associate professor, Department of Cardiovascular and Thoracic Surgery, noted that profound changes in lung cancer detection, diagnosis and treatment over the last decade contribute to the improved survival rate.
“From screening alone, we have been able to demonstrate a more than 20% reduction in lung cancer-specific mortality,” Veeramachaneni said. “Advances in immune-based and targeted therapies have also improved survival rates, and additional research is building a deeper understanding of its applications.”
Comprehensive efforts
In the quest for Comprehensive designation — the NCI’s most elite level of distinction — cancer center scientists and oncologists must demonstrate they are pointing their efforts at the cancers most affecting our catchment area communities.
“Lung cancer clearly affects people in our catchment area disproportionately, and the cancer center has made a significant investment in this priority,” Veeramachaneni said.
Huang added that scientists and clinicians are constantly working to improve lung cancer outcomes through clinical trials. He focuses on testing new immunotherapies, as well as studying why some patients don’t respond as well to it. Currently he is looking at a combination therapy to enhance the activity of T-cells in patients with solid tumors.
“Thanks to advances in immunotherapy, I have seen patients with metastatic lung cancer who are living three or four years, which we haven’t seen before. It’s a significant change in the way we treat patients,” Huang said. “We are studying additional ways immunotherapy can be used to treat lung cancer and leveraging our outreach network, the Masonic Cancer Alliance, to offer these clinical trials across the state.”
Associate professor Jun Zhang, MD, PhD, and assistant professor Kathan Mehta, MD, MPH, both examine an element of the human body not typically associated with lung cancer — the microbiome — and its role in immunotherapy response.
“Each of us carries billions of microorganisms, collectively referred to as microbiota,” Zhang explained. “Researchers are increasingly connecting the microbiome to different aspects of our health and body. Every time we breathe, our lungs take in bacteria and viruses. Do the microorganisms in our respiratory tract influence response to lung cancer therapy?”
Mehta analyzes large datasets to see how antibiotics affect outcomes of those receiving immune checkpoint inhibitors, a type of drug that blocks certain proteins made by some types of immune system cells. Those findings may serve as the basis for a future clinical trial.
Prevention is another key element of Comprehensive designation. Smoking contributes to about 80% of lung cancer deaths. Launched 13 years ago, The University of Kansas Health System’s comprehensive bedside tobacco cessation program, UKanQuit, has helped more than 18,000 people quit tobacco. UKanQuit has also supported significant research efforts, serving as a platform for several large NIH-funded clinical trials to discover the best way to engage smokers in cessation services before they leave the hospital.
These efforts and more are helping to fundamentally transform the experience of cancer.
“The lung is a beautiful organ. It inspires me,” Zhang said. “I came to The University of Kansas Cancer Center because I was looking for lifelong collaborators with the same interests and mindset. We are all committed to helping those living in the cancer center’s catchment area.”
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