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The Acceleration in Progress of Lung Cancer Treatment

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Published on March 23, 2016

How much progress has been made in the field of lung cancer?  Can patients expect increased treatment options?  Patient Power Founder Andrew Schorr interviews Dr. George Simon, Thoracic/Head & Neck Oncology Professor at MD Anderson Cancer Center, discussing the dramatic changes occurring in lung cancer research.  Listen as Dr. Simon describes how the field is accelerating, or as Dr. Simon puts it, “Getting 2020 treatment in 2016.”

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LUNGevity Foundation The University of Texas MD Anderson Cancer Center

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Patient Empowerment Network The University of Texas MD Anderson Cancer Center

Transcript | The Acceleration in Progress of Lung Cancer Treatment

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.        

Andrew Schorr:

Hello and welcome to Patient Power.  I'm Andrew Schorr.  Fortunately, there is an evolving story in lung cancer.  Some people have been helped greatly, and the hope is that the story can change for more people affected by lung cancer. 

Joining me now is a leading expert in the field who is very much involved in research and, of course, helping patients do better, Dr. George Simon from MD Anderson.  Welcome to Patient Power.  

Dr. Simon:

Thank you.  

Andrew Schorr:

So the story is evolving.  Tell us from your perspective as someone who is dealing with research and seeing patients as well.  

Dr. Simon:

The landscape of lung cancer has dramatically changed in the last 10 years.  Initially, we had the ability to identify molecular markers and patients with non?small cell lung cancer, and many of the targetable molecular aberrations were actually seen in nonsmokers.  So we were able to identify several molecular aberrations and then develop targeted therapies against these molecular aberrations. 

These targeted therapies are incredibly effective if you have that particular molecular aberration.  More importantly, also we now have the ability through next?gen sequencing methods to be able to identify many markers in small amounts of tissue.  So we are able to now look at 50, 60, 70, up to 200 genes sometimes in small amounts of biopsy tissue.  And then after identifying these molecular aberrations, then we are able to target these with special targeted therapies. 

Also importantly, we are now able to make drugs.  These drugs are actually man?made from the ground up.  Previously, many of the drugs that have been made were extracted from nature, from plants, from minerals, but now we actually design drugs to block specific receptors. 

So these two changes are ability to identify molecular markers, our ability to multiplex, that means looking at multiple molecular markers in small amounts of tissue and our ability to make drugs to block these driver molecular aberrations have made dramatic improvements in certain populations of patients who have these molecular aberrations. 

In the last three, four years or so, we have also now learned how to sort of unharness the immune system.  And I use the word unharness because the tumor to protect itself shackles the immune system.  So we sort of take the shackles away from the immune system so that the immune system can then attack the tumor. 

Now, fortunately, many of these immune checkpoint inhibitors actually work well in the garden variety, common lung cancers, which are more commonly seen in people with a past history of tobacco use.  So between these two agents we are now able to help populations of patients who are nonsmokers, but we are also able to help populations of patients who have had prior tobacco use. 

Andrew Schorr:

Now, you have many research trials going on, and this is, as you said, a changing field, accelerating in its change.  It would seem like patients with, let's say, advanced lung cancer now should really inquire about clinical trials and see if there's research that lines up with their situation.  

Dr. Simon:

I would absolutely agree with that.  Clinical—participating in clinical research is in a way trying to get 2020 treatment in 2016.  Many of these drugs are new, they are just out of the labs, and they have been designed—they're essentially designer drugs that have been designed to block a specific molecular aberration. And the only way we can develop proof that these drugs work is by participating in clinical trials. 

And so what is in it for the patient?  So if I have, let's say, an ALK translocation and there is a new drug, very effective drug based on preclinical information that these drugs are very effective, the only way I can actually get this drug is now in a clinical trial, because many of these drugs have to go through an FDA approval process. And integral to the FDA approval process is developing proof that you say it does what it does, what it's supposed to do.  And to develop that proof you have to get cohorts of patients to participate in these clinical trials. 

And like I said, what is in it for the patient?  They get access to these newer compounds, which have a reasonable likelihood of becoming standard of care in 2020. 

Andrew Schorr:

So sometimes somebody has high hopes for a medicine, maybe an experimental medicine, and it doesn't pan out for them. But it seems like you are now increasingly having something else you can try, and that patient may respond to that. 

Dr. Simon:

That's exactly right.  Actually, the last—about a few years ago I tried to sit down and figure out how many drugs are being developed for breast cancer, and I came to realize there are in excess of 300 drugs from 15 different molecular categories that are being developed. 

It's incredibly exciting to see that years of basic research is panning out and which have increased our understanding of the molecular underpinnings of the cancer and have increased our ability to target those pathways and receptors and that have led to these drugs.  And so if one doesn't work, there are several options that could be available to you.  And one of the duties of a doctor basically is to sort of educate you about those possibilities.  

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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