Closing in on a Moving Target: New Targeted Therapies Take Aim at Lung Cancer
Everyone hopes and dreams that lung cancer—the #1 cancer killer of both women and men—will soon be a distant memory. The American Lung Association has made defeating lung cancer a strategic imperative of the organization, and is funding promising research, including for the most difficult-to-treat lung cancers.
Jeffrey Engelman, M.D., Ph.D. is a member of the American Lung Association Research Team and a recipient of a 2011 Lung Cancer Discovery Award.
Dr. Engelman chose his career path 15 years ago, clearly recognizing a need for effective treatments for lung cancer. Now he focuses on targeted therapies that attack specific mutations—those changes that occur in lung cancer cells.
"We now know that there are very effective therapies for cancer that have specific genetic mutations," he says. "The problem that we've had is that these cancers don't get cured. They come back sometimes after several years, sometimes after several months, so understanding how the cancer comes back is a major area of interest."
New therapies bring new hope
Two promising areas of research for Dr. Engelman include immunotherapy and targeted therapy. Immunotherapy harnesses the body's own immune system to fight off cancer cells. Targeted therapy identifies what causes a cell to misbehave and attempts to treat the cancer with a drug that addresses this issue. Targeted therapies can be more precise—with less damage to normal cells—and may result in fewer side effects.
Expect to hear more about the rather unexpected role immunotherapy plays against lung cancer, an option whose prospects have "really matured nicely over the last few years," Dr. Engelman says. He's intent on learning how cancer resists these new classes of therapies while on his path to developing more effective, less toxic therapies for cancer patients.
"I'm extremely excited that the pace of advances that have improved patients' lives is growing and growing," he says. "I can't imagine that we won't have even more advances over the next five years."
Building a cancer-fighting arsenal
Overall, the news is very encouraging, he says. "What we've accomplished as a field over the last 10 years is so dramatic. We've come from having no targeted therapies and no immunotherapy, and just having chemotherapy, to now having all these different weapons at our disposal. Our understanding of the biology of cancer is increasing exponentially as is our pace of discovery and bringing therapies to patients."
Many researchers didn't believe that targeting the immune system would be effective, but it is effective in a subset of patients, says Dr. Engelman. "Now we focus a major research effort on immunotherapy here at Mass General, trying it to understand how it can work even better for more patients."
Dr. Engelman has found support from the American Lung Association invaluable. "It helped us build a multidisciplinary team to fight cancer, comprised of clinicians and research scientists, together with pathologists and radiologists," he says. "The award was also instrumental in providing us with the resources to bring this group together so we could move forward."
Quantifiable scientific progress has leant a very real sense of optimism that researchers are going to help lung cancer patients in visible and dramatic ways, says Dr. Engelman. "What's still needed, however, is more funding."
Lending promise for patients and families
Therapies are moving quickly from test tube and Petri dish to real people. "Now laboratory discoveries impact patient care in a very straightforward, clear and dramatic way, and they have a major effect on patient outcomes," he says.
No matter what transpires in the lab, those who ultimately benefit are always top of mind. "We learn directly from our patients, analyzing their biopsies and specimens," he says. "That allows us to actually direct their care based on those discoveries."
One achievement leads to another. "The translation of discoveries in the lab goes back to the clinic and then we take clinical observations back to the lab—and it's all very rapid and seamless," Dr. Engelman says. "There's a very fluid nature to research in lung cancer today, and it is positively impacting our patients."