Page 19 - Christiana Care Focus August 2018

“In taking an integrated and sustainable approach toward lung cancer, Christiana Care will need the help of many in this room and leaders throughout the state,” said Eric Kmiec, Ph.D., director of the Gene Editing Institute, Christiana Care.
Among those already supporting the symposium and the proposal to harness innovative approaches to lung cancer are the U.S. National Institutes of Health, the Helen F. Graham Cancer Center & Research Institute, and the Delaware IDeA Network of Biomedical Research Excellence (INBRE), which is an effort to strengthen basic and translational biomedical research capability in Delaware.
“Every two and a half minutes in the United States, someone is di- agnosed with lung cancer, but this disease has not been on enough people’s radar,” said Albert A. Rizzo, M.D., FACP, FACCP, chief of Pulmonary and Critical Care Medicine, Christiana Care, and key medical adviser for the American Lung Association. “The American Lung Association is enthusiastically on board with this effort, as we know that the best way forward is through collaboration.”
Early detection is key
The lung cancer initiative is similar to Christiana Care’s decade- long collaboration with the Delaware Cancer Consortium to
raise awareness around colorectal cancer, a statewide effort that was successful in reducing deaths while increasing colorectal screenings and erasing disparities in treatment. But in some ways lung cancer is more of a challenge, in that the disease is hard to identify in its early stages, which is why lung cancer remains the leading cause of cancer death in the world.
In fact, the five-year survival rate for lung cancer patients in the United States is less than 20 percent — a statistic that has not changed significantly in decades, according to the National
TInstitutes of Health.
he initiative is a good fit for the Christiana Care, which is focused on innovation for optimal health, said Nicholas J. Petrelli, M.D., FACS, Bank of America endowed medical director, Helen F. Graham Cancer Center & Research
Institute. In Delaware, the incidence of lung cancer per 100,000 people is 71.4, which is higher than the United States as a whole, at 57.3 per 100,000, said Dr. Petrelli.
One area for improvement is screening. Recent data shows that low-dose CT scans are the most reliable way of identifying lung cancer early. But most Delawareans are not aware of the guidelines for requesting a CT scan.
“We have about 32,000 people in Delaware who are probably eligible for lung cancer screenings, and we only are screening about 6 percent of the people who should be screened. Delaware can do better,” said Heather Bittner Fagan, M.D., MPH, FAAFP, a family physician and researcher who works in primary care and the community to improve cancer screening.
Dr. Rizzo agrees. “If we can improve when we find cancer — moving it from a stage 4 disease to stage 1 — we can significantly improve survival,” he said. “Early detection is an important way to fight this cancer.”
“In Delaware, the incidence of lung cancer ... is higher than the United States as a whole.”
Nicholas J. Petrelli, M.D., FACS
| Cancer Care
Seated: Scott Siegel, Ph.D., MHCDS.; Gregory A. Masters, M.D.; Eric Kmiec, Ph.D.; Heather Bittner Fagan, M.D., MPH, FAAFP; Standing: Daniel Rodriguez, Ph.D.; Albert A. Rizzo, M.D., FACP, FACCP.
Cancer treatment overview
In giving an overview of lung cancer treatments, Gregory A. Masters, M.D., principal investigator with the U.S. National Cancer Institute Community Oncology Research Program at the Graham Cancer Center, said in the past several years the understanding of lAungcancerhasbecomemoredetailedandnuanced.
nd as lung cancer is better defined, there are more clinical trials available for patients and new ways to approach treatment, including the targeting of gene mutations.
“Part of the ongoing effort is to put together the best clinical trials to learn more about what we are dealing with, as we help our patients,” said Dr. Masters.
A targeted therapy involving epidermal growth factor receptor (EGFR) is promising, said Dr. Masters. In a well-functioning cell, EGFR allows cells to properly grow and divide. But in patients with non-small-cell lung cancer there can be mutations to EGFR. Targeted therapy can interfere with EGFR and prevent tumors fromgrowing. CONTINUED
FOCUS • AUGUST 2018 17