Life After Lung Cancer

Niall practicing Taekwondo

Niall practicing Taekwondo

By Niall Reynolds, Ireland

It was 2007, I was 41 years old and training for my black belt in Taekwondo when I found out I had lung cancer. After spending weeks trying to get rid of a cough, I went to my doctor. A few weeks later I had a chest x-ray followed by a CT scan which confirmed I had lung cancer, a disease I could never have imagined dealing with, especially at my age. Treatment began quickly with a lower lobectomy on my right lung followed by four months of chemotherapy.

I was determined to continue to live my life, even throughout treatment. The way I did this was not to plan for anything beyond three months. We took vacations, but only booked them a month or two in advance. As time went on, I could extend that time to six months and then a year. I love to travel and since my diagnosis have been to most places I’ve wanted to see, such as Hawaii, the Grand Canyon, Paris and London.

I frequently used the Lung Cancer Alliance website and community for information and support throughout my journey. It was a massive help! After my operation and chemotherapy, I felt like I was sent home to deal with what had been left (e.g. chest pain, drug side effects, etc.). The website offered me the reassurance and information I needed, while the lung cancer community provided me with a platform of support and hope.

Although we never met each other in person (some people being an ocean away from my home in Ireland), I felt a bond with the lung cancer survivors I connected with online. There was a sense that we were all going through this together, on different scales with good and bad outlooks, but all supporting each other through it. One lady told me her goal was to see Ireland before she died, which she did. She loved it and loved the music. I sent her a CD of Irish music, which she loved and played many times before she died.

My advice to those newly diagnosed is to take it one day at a time, until you can take it one week at a time, and so on. Be good to yourself and do what makes you happy. Make time for family and try not to get bogged down by too much “cancer talk.” Make a point to live with awareness, noticing and loving every moment, rather than getting caught up in the “rat race.” Try not to hold grudges or get bothered by silly annoyances; it is a waste of precious time. If you received help, let those people know how much you appreciate that help.

Be sure to thank and have patience with your caregiver(s). Whether that person is your spouse, partner, family member or friend, they hate that you are sick and some would rather take the illness from you than see you suffer. They are the true heroes in my book.

Finally, give back if you can; sharing your experience can make a world of a difference for someone newly diagnosed. It is likely you will benefit just as much as the people you help.

Since my operation I have gone on to get my second and third black belts in Taekwondo, started my own Taekwondo school with a few other friends and completed numerous cycling tours for a local cancer charity which I have now joined the board.  I also teach self-defence to women once a week. There is life after lung cancer, enjoy it!

20 Years to Celebrate and Educate!

By Selma Rosen

Selma, a lung cancer advocate and 20 year survivor.

Selma, a lung cancer advocate and 20 year survivor.

Every year is a celebration for me, but this year in particular. This year marks the 20 year anniversary of my lung cancer diagnosis. It was a fluke my son’s eagle eye saw a lump on my throat that brought me to the doctor, which landed me in a CT scan, and later resulted in the discovery of a nodule on my right lung.

I was incredibly lucky to have found my lung cancer at an early and treatable stage 20 years ago. Following my diagnosis, I made it my mission to ensure others were given the same opportunity I had. Just a few months before my diagnosis, I had bronchitis for which I had two chest x-rays; both were negative. Realizing what a difference a CT scan can make and the life-saving benefits that accompany it, fueled me to take action and raise awareness.

Between 2001 and 2014, I led the Lung Cancer Society of Long Island, where I spent most of my time educating the community about early detection and raising awareness for the stigma associated with the disease, or how I like to call it “blaming the victim mentality.” I was invited to speak at the World Conference on Lung Cancer and worked with I-ELCAP to ensure CT screening became the gold standard for early detection. Knowledge is power and if we can educate those at high risk, as well as the general public, we can make a difference and save lives.

Being a 20 year lung cancer survivor is not all fun and games. There are a number of side effects that have lingered on from my surgery that I deal with every day.  I have scar tissue on my right lung that leaves me susceptible to pneumonia, which I find myself in the hospital for often. I also have difficulty moving the upper ride side of my body, especially repetitive motion, without experiencing pain. But I am alive!

My lung cancer diagnosis set me on a path to help others and raise awareness for early detection of the disease. I was lucky enough to accidentally find my cancer at a treatable stage. Now more and more people can do the same and I will continue to fight on their behalf.

 

To find out if you are at risk for lung cancer visit www.atriskforlungcancer.org. Looking to get a CT scan? Find a Screening Center of Excellence near you.

If you are a long-term lung cancer survivor and need help managing side effects, click here. You can also call our HelpLine, 1-800-298-2436, to speak with one of our support staff.

 

Meet Our Newest Board Members!

Michelle Mason and Lisa Poulin

Michelle Mason and Lisa Poulin

 

We are so thrilled to welcome Michelle Mason and Lisa Poulin as the two newest members to our Board of Directors. Lisa is a Principal at Deloitte CRG in Transactions and Business Analytics and Michelle is the President and CEO of the Association Forum of Chicagoland.  We sat down with them to find out what the lung cancer movement means to them and how they hope to make a difference.

Why did you decide to join LCA’s Board of Directors? 

MICHELLE: LCA gives a voice to those who are impacted by the silent disease – lung cancer.  Their empathic and personalized approach provides access to research, resources and a community of support in a dignified manner.  LCA’s broad reach and accomplishments are changing the lung cancer dialogue and delivering results.  It is because of this level of commitment that I choose to serve on the Board.

LISA: It is an opportunity to give back. Working on the board of an organization that helps people meet the challenges of serious health issues is meaningful work. I am part of something bigger than I am and that makes a difference.

What is your connection to lung cancer?

MICHELLE: I know several who have passed away from the disease.

LISA: Both of my aunts on my mother’s side of the family died of lung cancer and my grandfather suffered a long time with emphysema. Clearly it’s an illness that has impacted my family.

What would you like to achieve through your work with LCA? Is there a particular aspect of the cause you are most interested in (e.g., stigma, screening, support, etc.)?

MICHELLE: I simply want to help LCA accomplish its mission – saving lives and advancing research by empowering those living with or at risk for lung cancer.  I believe all aspect are equally important.

LISA: I just joined so I am trying to figure out where I can make an impact.  Not clear yet as all aspects are important.  I did not join with a selected purpose in mind and am developing a focus the more I learn.

What has been your favorite part of joining the team thus far?

MICHELLE: Joining a community of people committed to helping and supporting those impacted by the disease.

LISA: Getting to know the board members and the organization’s accomplishments.  So exciting to be part of such a solid and positive organization.  Love the energy and passion of all the board and staff.

 

Stories of Sisters. Stories of Strength.

Sandra, her mother,  Rosalind, Carolyn and Nicole.

Sandra’s mother Phyllis Horton (top left), her oldest sister Carolyn Robinson (top right), her sister Rosalind Turner (bottom left), her niece and Carolyn’s oldest daughter Nicole Burnett (bottom middle) and Carolyn’s youngest daughter, Carolyn Greene (bottom right).

Sunday, August 2nd was National Sister’s Day, a day to show your appreciation for your sisters. In honor of the holiday, we found a family in our community that is full of sisters, strength, love, inspiration and hope.

SANDRA
My name is Sandra Walker; lung cancer has impacted my life tremendously. My mother, a non-smoker, died in April 2005 from lung cancer, so in 2013 when I was told that my two older sisters and my niece had been diagnosed with the same disease all within a six month span, I was devastated.  They all appeared to be in good health prior to their diagnoses.

CAROLYN
My name is Carolyn Robinson. I am Sandra’s oldest sister. I am a lung cancer survivor. I lost my sister and oldest daughter to lung cancer in 2013, as I too battled this terrible disease. Just years before this, my youngest daughter was diagnosed with breast cancer. She fights and continues to fight. Her survivorship is an inspiration to me and our entire family.

With the gift of life I have been given, I hold onto my other two daughters, sisters, nieces, granddaughter and great-grands and give them lots of love. I try and focus my efforts on helping other cancer patients and survivors. Helping others makes me feel closer to those I have lost.

CRYSTAL
My name is Crystal Horton and I am the youngest sister and the baby of the family. My role was that of the caregiver. Professionally, I am a nurse, so caregiving comes naturally to me. When my mother was sick, I took her to all her appointments and provided care.

I found that being a nurse, and the only medical professional in the family, brought both benefits, as well as difficulties. My medical knowledge made me feel purposeful in doctor’s appointments, acting as a medium between the doctors and my family members. The experiences I have endured have given me a strength I never knew I had. I fight and live every day for those family members that are no longer here.

SANDRA
After living through these incredibly difficult losses, our family has become even closer and are careful not to take one another for granted. What gives me strength throughout difficult times are the memories.

My sister Carolyn, now a two year survivor, is not only my biggest supporter, but also motivates and inspires me. She has endured losing both her sister and daughter, all while fighting lung cancer herself.

I wanted to help others in my position, so I became involved with the Lung Cancer Alliance and this year joined the planning community of Lung Love Walk Atlanta. What an amazing experience to come together with other’s touched by the disease. Additionally, I make sure to get a CT scan every year in October in honor of my sister Rosalind who passed away the same month in 2013. I pledge to do everything in my power to bring awareness to this illness.

 

If you or a loved one is battling lung cancer and have questions or need to speak with someone, please call our HelpLine at 1-800-298-2436 or email support@lungcanceralliance.org.

For opportunities to get involved in the fight against lung cancer, click here!

As We Get Smarter, So Do Clinical Trials

Jennifer King, Lung Cancer Alliance Director of Research and Science

Jennifer King, Lung Cancer Alliance Director of Research and Science

By Jennifer King, Lung Cancer Alliance Director of Science and Research

The information we have today about lung cancer – about diagnosis, staging, treatment and survivorship – is because we learned from the journeys of patients before you.  As a patient, an important way that you can be involved in research is to join a clinical trial. It may not just help you but could help others in the future, as well.

Today, I want to explain how clinical trials have been changing to help even more people. Now that we understand cancer better, researchers can use this knowledge to design smarter clinical trials that benefit more people and reach answers more quickly.  One type of new design is called an “umbrella” trial, because the trial covers multiple smaller trials underneath it (think of the smaller sub-studies as the spokes of the umbrella).  Patients with one specific type of disease enroll on the trial, but they are then assigned to one of several smaller studies (sub-studies) under the umbrella that is most appropriate for them.

A good example is the Lung-MAP trial for advanced squamous cell carcinoma, a type of non-small cell lung cancer.  If you have advanced squamous cell carcinoma, you may be able to join this trial, which will check your tumor tissue for certain gene changes that may be helping your cancer to grow and spread.  Depending on your personal results, you get assigned to the sub-study that is most likely to benefit you.  This is a win-win. You have a better chance of responding to the new drug being tested and researchers get more people with the exact tumor characteristics that they are looking for to enroll in each part of the trial.

The researchers running the trial are also able to change the sub-studies over time as we continue to learn more about treating cancer.  I was able to attend the Lung-MAP investigators meeting in June where they were discussing changes to the sub-studies now that Opdivo has been approved.  It was very clear how passionate the group was about making sure the research being done was best for the patients.  (An example discussion point: “Would patients want to go on the trial first or try Opdivo first?”)

Another important umbrella trial in lung cancer to consider is the ALCHEMIST trial for early stage lung cancer that can be treated by surgery.  Similar to LungMAP, there is genetic testing of the tumor. Those with certain changes to the EGFR or ALK genes will receive adjuvant (additional) therapy with drugs targeting these changes to see if these drugs will help keep the cancer from coming back.

Along with these newer umbrella trials that are specific to one cancer, there are also “basket” (also called “bucket”) trials that enroll patients with multiple cancer types. Basket/bucket trials enroll patients from many different cancers but then put them in “baskets” (sub-studies) based on the molecular profile of the tumor, not the type of cancer.  This goes hand in hand with the new, hot topic of precision medicine.

NCI-MATCH is a new basket trial from the National Institutes of Health that is now open across the country, assigning patients to drugs based on DNA sequencing of their tumor.  The American Society of Clinical Oncology is also starting a new clinical study called TAPUR later this year which allows patients to take drugs “off-label” (ie, a patient with lung cancer could take a drug approved for leukemia or melanoma) if the cancer has the type of  genetic change that the drug targets.  In both cases, it’s these precise changes in your cancer, not where it is located that determines the best trial therapy.

The key takeaway is that trial design is changing, for the better.  I was just talking with a pharmaceutical company executive in charge of a clinical trial program about how earlier in his career, a Phase I clinical trial was only to show if a drug was safe (not whether it worked).  Now they expect drugs to be truly helping people even in these early phases, because they are given to the right group of patients.

When evaluating your options for yourself or your loved ones, consider clinical trials and discuss them with your healthcare team.  You may be able to pay it forward and help us learn how to better treat lung cancer for everyone, including yourself. If you need help finding a trial, we have a Lung Cancer Clinical Trial Matching service that can be accessed online or through a phone navigator at 1-800-698-0931.

The following are great resources on the basics of clinical trials and why they are important, including LCA’s Understanding Clinical Trials brochure, the National Cancer Institute website and Cancer.Net’s PRE-ACT video series.

A Permanent Mark of Survivorship

By Francis Spruit, Lung Cancer Alliance Chapter Co-Director, lung cancer survivor

Francis and Roslyn

Francis and Roslyn Spruit at Senator Feinstein’s office during the 2015 National Lung Cancer Summit.

Francis Spruit was diagnosed with lung cancer in 2007 at the age of 48. After the shock of the news, he decided he was not only going to fight the disease, but take on the cause for all those impacted by lung cancer. Francis and his wife, Roslyn, became eager volunteers at Lung Cancer Alliance, taking on the role as Chapter Co-Directors in Northern California and hosting events, recruiting other volunteers and working with policy makers in California and Washington, DC. We sat down with Francis to find out how becoming a survivor has changed his life, for the better.

What is the best part about being a lung cancer survivor?

Living. Somehow my perspective on life became broader in some areas, also more intense and richer. The cancer survivorship journey is (hopefully) long, and at times very challenging. It has taken me to my physical as well as emotional limits. I have experienced fear and uncertainty but also joy and acceptance. It made me realize that you do not survive on your own; I am a survivor because I have a life partner who understands the concepts of living, healing, love and giving.

What would you tell someone newly diagnosed?

Learn about lung cancer. Join Lung Cancer Alliance. Talk to people who have gone through the cancer journey. Lung cancer is a challenging disease but it will bring new people into your life that will make your life richer.

Francis_Tattoo_2

Francis’ tattoo honoring seven years of survivorship.

Why did you get a tattoo of LCA’s lungs?

I wanted to get a tattoo to express my gratitude for surviving lung cancer. I’ve been playing around with the tattoo idea since after my surgery in 2007. Last month when we were in Vegas I decided that the LCA logo would look really cool on my arm. As my wife, Roslyn, puts it “what happens in Vegas comes home with you on your arm.” Thus far I have only had a few people ask me about it, one person actually thought they were angels’ wings. When people ask, I will be very happy to explain and share our story of pain, nausea, physical and emotional stress all the way to surviving and thriving. I’m a very lucky guy in more ways than one.

Why did you decide to get involved in advocacy?

I wanted to contribute to the lung cancer cause. When I joined LCA in 2009 I learned that creating awareness with our representatives on Capitol Hill is of critical importance. Helping them realize that lung cancer deserves a much higher priority when it comes to research funding, allocating key resources and developing policies and legislation. I am able to not only contribute my knowledge of lung cancer statistics, but also provide personal context from my own lung cancer journey. It’s an effective combination!

What is your favorite thing about being a lung cancer advocate?

I really like to share my story and see the look of surprise in people’s eyes, and then turn that surprise into empathy and support, or at least understanding. Multiply that by the number of times we get to share our journey and you get a strong sense that we are and will save many lives!

Click here to learn more about becoming a lung cancer advocate and getting involved in the movement!

 

 

Celebrating My Second Independence Day Free of Cancer!

By Jack Martins, US Marine Corp Veteran and lung cancer survivor

Jack

Jack Martins

As the nation prepares to celebrate its 239th birthday, this Marine Corp vet is preparing for a celebration of his own.

Slightly less than two years ago, in November 2013, my wife watched a Health Watch news segment that highlighted the free low dose CT scans being offered to veterans, in honor of Veterans Day, at a nearby hospital, Middlesex Cancer Center in Middletown CT.  Veterans have a higher incidence rate of lung cancer than the general population.

Since I had smoked up to four packs a day for over 50 years she was concerned about the possibility that I might have lung cancer, so she recorded the segment and asked me to watch it.  After learning the risk factors, I realized I would be crazy not to take advantage of this offer.

When I arrived at the cancer center I was greeted by the Nurse Navigator, Gean Brown, and Dr. Raymond Schoomaker, two of the most caring people you could ever meet. After filling out a brief questionnaire, Dr. Schoomaker informed me that I was a prime candidate for a low dose CT scan. After the scan, a quick and easy process, I was told they would be in touch that week with the results.

Two days later I got the phone call no one wants to receive – they had found something on my right lung that didn’t look right. After meeting with a Pulmonologist and getting a Pet CAT Scan to assist in determining the problem, we found out it was cancer.

Jack, his wife Marianne, son, Brian, and daughter, Patty.

Jack, his wife Marianne, son, Brian, and daughter, Patty.

Hearing this news was shocking, but I powered through the process to learn more about how I could fight this. I was put in touch with Dr. John Frederico, , who brought a sense of relief when he told me he was confident he could remove the cancer completely through surgery and have me home the next day.  He proved to be a man of his word! Since January 7, 2014, I have had two additional scans which showed no additional problems!

So as the nation celebrates its independence I am celebrating my second Independence Day free of cancer.

My closing thoughts for anyone reading this is, if you are worried about the possibility of having lung cancer, have a low dose CT scan performed. Even if cancer is found, if you are as lucky as I was, it will be Stage 1A cancer which is easily treatable. If the cancer is more advanced, early treatment can save your life.

Happy July 4th!!!

Visit AtRiskForLungCancer.org to find out if you are at risk for lung cancer. If you are interested in getting a CT scan, click here to find a Screening Center of Excellence near you. For any further questions, please call our HelpLine at 1-800-298-2436 or email support@lungcanceralliance.org.

What Men Need to Know About Lung Cancer

By Keith D. Mortman, M.D., F.A.C.S., F.C.C.P., Associate Professor of Surgery at The George Washington University School of Medicine & Health Sciences and Director, Thoracic Surgery at The George Washington University Hospital

Dr. Keith Mortman

Dr. Keith Mortman

This year, 221,200 people in the United States will be told “You have lung cancer.”  Slightly more than half of these people (roughly 115,000) will be men.  1 out of 13 men will be diagnosed with lung cancer during his lifetime.

The key to a favorable outcome is early diagnosis.  The 5-year survival rate (the percentage of patients alive 5 years after diagnosis) for stage 1A non-small cell lung cancer (the earliest stage of the most common form of lung cancer) is approximately 85-90% for those having surgery at experienced centers.  Understanding your risk factors and discussing these with your physician may lead to an early diagnosis or give you peace of mind that you are lung cancer free.

Risk factors for lung cancer:

  • Current or former cigarette smoker
  • Secondhand exposure to tobacco
  • Occupational exposure (metal workers, painters, cleaners, plumbers and pipe fitters, welders, construction workers)
  • Radon exposure
  • Prior radiation
  • Family history of lung cancer

A study published in 2011 in the New England Journal of Medicine (the National Lung Screening Trial) found that there was a 20% reduction in lung cancer deaths when patients were screened with a low-dose CT scan (compared to a plain chest x-ray).  Since this was a screening examination, it means that patients had no signs or symptoms of lung cancer—they simply had known risk factors.

In addition to being aware of your risk for lung cancer, you should also contact your physician if you exhibit any of the common lung cancer symptoms below.

  • A new, unremitting cough (or a change in a chronic cough)
  • Coughing up blood (hemoptysis)
  • Shortness of breath (dyspnea)
  • New chest pain
  • Recurrent pneumonias
  • Unexplained weight loss
  • Fatigue

Click here to find out if you are at risk for lung cancer. If you would like to talk with someone on the phone, call our HelpLine at 1-800-298-2436. Or meet with a Healthcare Professional in-person at a national Screening Centers of Excellence to find out if a low-dose screening CT scan is right for you.

If you have recently been diagnosed with lung cancer, you have options. Not all treatments are right for every person but learning about the possibilities can help you have an informed discussion with your doctor. Click here to learn about treatment options.

 

 

 

 

 

 

 

Your Children Are Eternity

By Jim Pantelas

Jim, his wife and his three daughters at a butterfly exhibit.

Jim, his wife and his three daughters at a butterfly exhibit.

When I was 26 years old my father died as the result of lung cancer. His case was so advanced that he died 7 days after his actual diagnosis. Fast-forward several years later to my own diagnosis and so much had changed, but all too much seemed the same.

The day I was diagnosed with lung cancer my wife Cathy was 6 months pregnant. We had the PET and CAT scans, knew the size of the tumor and we were assured that we were dealing with an early stage cancer, and that I could have a very good outcome. I went into the operating room with a Stage 1B cancer only to come out of that room minus 75% of my right lung and staged at 3B with stage 4 lymph node involvement.

With the change in the understanding of how my cancer had spread came the need to re-think how aggressive we might want to be in my post-operative treatments. I was offered, and I accepted a trial treatment regimen that included daily radiation and weekly chemo treatments. Four weeks after my surgery those treatments began, and they continued over the next several months. But it wasn’t those treatments that filled our world.

In the weeks between my operation and my daughter’s birth all of the “deals” we made were that I be allowed to live long enough to see her born. And life remained fairly hectic. Cathy’s baby shower went off while I was confined to my recliner, and while I couldn’t climb the stairs or help, family members came over and finished the nursery, friends took care of the yard work, and neighbors dropped off food.

Three weeks after starting my post-operative therapies, and on a day in which small mountains were moved to allow me to have my chemo treatment early, my wife gave birth to our daughter Stella and she was so very beautiful!

An old adage says that your last death happens when your name is spoken for the last time. For me Stella’s birth in some weird way made my physical death more palatable. She was here, and she would be able to live on when I could not. So I wrote her notes – things I’d want her to get on birthdays, Valentines or Christmas, and I reached out to friends to welcome them to share stories with her if I could not.

At 21 days old Stella had a brain bleed. She was in the NICU at Mott Children’s Hospital for over 30 days. We spent my birthday, Christmas and New Years there. Every day I would leave Mott to go to my radiation or chemo treatments at the hospital across town, but a piece of me never left. And we stopped thinking about my cancer. All of our thoughts, hopes and prayers were for Stella.

Stella’s brain bleed caused what her neurologist called “a significant injury.” And my cancer went into an NED state. I found myself thankful for some of the gifts my lung cancer had given me. I was unable to work, so I could spend all day, every day with Stella. I hadn’t died the way my father had – my cancer had given me the time to get my affairs in order, and given Stella’s injury and subsequent disabilities getting those things done was and remains vital. And I was there with my wife so we could go through this together. None of that would have been possible if I’d died in a bus accident, in a fall in the bathtub, or if I’d been taken by a heart attack. And, most of all, I’d have never known the pure joy of being Stella’s dad.

So as we come up on Father’s Day I think of my dad, but mostly I think about the gift of being able to be a dad. Stella is now 9 years old, and she has two glorious, bright, and very funny younger sisters, Grace, 7 and Leda 5, and I’m grateful for every extra day I’ve been given to be their dad, Cathy’s husband and, I hope, a better man.

Your Cancer, Your Treatment

By Jennifer King, Director of Science and Research at Lung Cancer Alliance

"General Views"

“Illumination and Innovation” Presentation at ASCO

Last week, I blogged about some of the research presented at the 2015 ASCO Meeting – particularly the promise of immuno-oncology.  Today, I’m going to focus on another topic that is a very hot right now: precision medicine.  President Obama announced a new Precision Medicine Initiative during the state of the union address. The government is defining precision medicine as “an emerging approach for disease prevention and treatment that takes into account people’s individual variations in genes, environment, and lifestyle.”

Precision medicine, formerly called personalized medicine, is exploding in lung cancer as well as many other cancers. There are countless targeted therapies, drugs that work on specific genetic variations (changes/mutations), in company drug pipelines.  For most clinical trials of these drugs, you are first tested to see if your tumor has the right biomarker (the variation) – before you can go on the drug.

Many new advances in targeted therapies were presented last week at the ASCO meeting. Note that in all of the studies referenced below, the patients had advanced/metastatic lung cancer.

There are already multiple drugs available for treating lung cancer with EGFR and ALK changes, but many people develop resistance to these therapies. This resistance is typically because the tumor develops another variation/mutation that prevents the drug from working. Drugs are now being developed to target these resistance mutations.

Data on some new EGFR targeted therapies were presented at the meeting.  Rociletinib worked in close to half of the patients who had a known EGFR resistance mutation.  Notably, this was true whether the EGFR test was done from a regular tissue biopsy or from a “liquid biopsy” (a blood test). AZD9291 had good results in an early trial as a first-line EGFR inhibitor and a Phase III trial comparing it to first-line Tarceva or Iressa (gefitinib) is now underway.

ASCO2_2

Poster Presentations at ASCO

For patients with ALK changes in their lung cancers, there are also new drugs in development. Data was presented on alectinib showing that roughly half of patients who were already resistant to crizotinib responded to alectinib (and if you include those who had ‘stable’ tumors that were not growing, it was ~80% of patients who benefitted from the drug).

Importantly, more than half the patients in the trial had lung cancer that had metastasized to the brain and the drug also worked on many of the tumors in the brain.  A Phase III trial is now ongoing comparing alectinib to crizotinib, as well as an expanded access study for patients whose cancer is resistant to crizotinib. Another new ALK inhibitor, brigatinib, that may also work on brain metastases is in a Phase II clinical trial.

Increasingly, targeted therapies are being used for a much smaller population of patients. There are many gene changes that are only present in less than 5% of lung cancer patients, but drugs may still be quite effective for the patients that do have these changes.  Some examples that had promising results presented at the meeting were a combination of Tafinlar (dabrafenib) and Mekinist (trametinib) for patients with mutations in a gene called BRAF (common in melanoma) and Cometriq (cabozantinib) for patients with changes in RET, and likely  also MET and ROS1.

The important things to remember here are not the specific drugs names and studies.  There are a few key take-aways:

  • Every lung cancer is different and treatment decisions need to be made precisely for you, your cancer and your lifestyle and values
  • There are many new drugs coming soon and they each will likely only work for a small percentage of people. It is more important than ever to have conversations with your care team about what the options are and what tests are needed to determine the best treatment path for you.

Also, I want to point out that none of this important research could have been done without patients enrolling on clinical trials.  Clinical trials are very important and definitely a path to consider.  My next blog will be about some of the new trials out there and how clinical trials are now being designed in smarter, more effective ways.