#LCSM Chat Topic 04/11/2019: Why research matters for lung cancer

It’s easy to understand the importance of lung cancer education and advocacy.  Of COURSE we should help patients and caregivers learn more about different types of lung cancer, biomarker testing, and treatment options.  Of course we should help them come together, to raise their voices, to make the general public understand the terrible toll lung cancer extracts from individuals and society, to combat stigma and nihilism.

But what about research?  Some people suggest research isn’t as important as education or advocacy. They ask, “But what does research actually do for today’s patients?”

Our April #LCSM Chat will start April 11, 2019 at 8 pm Eastern (5 pm Pacific) and focus on “Why research matters for lung cancer.”  The term “research” covers many topics, from discovering the reasons why patients get lung cancer, to investigating how to detect lung cancer earlier, to identifying and refining drug targets, to developing new treatments for lung cancer patients.  And research itself covers a broad spectrum, from basic science research, to translational research studies on biological materials from lung cancer patients, to clinical studies on patients themselves.

Nothing moves the needle more for lung cancer patients than research.  As an example, let’s consider the story of ALK rearranged lung cancer.  This molecular rearrangement was first described in lung cancer in 2007.  Based upon knowledge of its role in other tumors and based upon laboratory studies of cell lines with ALK rearrangements, an existing drug was hoped to potentially be effective for these patients.  Building on what researchers and oncologists had learned from clinical trials in patients with EGFR mutations, prospective clinical trials were able to narrowly focus on patients specifically with ALK rearrangements and to quickly demonstrate the efficacy of that drug.  It was approved for patients less than four years later.  Today there are many other targeted drugs for ALK rearranged lung cancer patients that work even better.  Additionally, tremendous efforts are being made to understand optimal sequencing of these drugs as well as strategies to overcome treatment resistance.  This has undoubtedly changed the lives and outlooks of thousands of lung cancer patients.  A recent paper reported that at a specialty lung cancer center, the median survival of ALK positive patients was 6.8 years compared to just 9 months for patients without targetable molecular alterations!  Such success would have been hard to imagine just ten years ago.  Fortunately, the ALK story is not unique.  Patients with molecular aberrations in EGFR, ROS1, BRAF, MET, NTRK, and others may experience similar success, thanks in some part to education and advocacy, but particularly driven by research.  And research into immunotherapy (which won the Nobel Prize in Physiology or Medicine in 2018) has now opened the door to patients not lucky enough to have these “driver” mutations.  Clearly research has changed the face of lung cancer and the lives of many patients diagnosed with this terrible cancer.

Please join moderator Brendon Stiles (@BrendonStilesMD) in our April 11 #LCSM Chat for an exploration of lung cancer research.  We will cover the following topics:

  • T1.  Is research just for future patients, or do current patients also benefit?
  • T2. In what areas is more research most needed for lung cancer?
  • T3.  What can researchers do to make their work more accessible to patients and advocates?
  • T4.  What is the @IASLC STARS program and why are programs that train patients and advocates important?
  • T5.  How can patients and advocates get more involved with research?

Please remember to include #LCSM in ALL your tweets so the other chat participants can see them. If you need a refresher, read our primer on participating in the chat. Note that some tweetchat apps (like tchat.io) will not display tweets longer than 140 characters. Hope you’ll join us!

#LCSM Chat Topic 03/07: Biomarker Magicians (or, Why We Love Pathologists)

Diagnosing the type of lung cancer from a tissue or liquid biopsy is absolutely critical to selecting treatment and determining the patient’s prognosis. However, for many lung cancer patients and their families, the role of tumor tissue in their diagnosis is a mystery. What happens to tissue collected in a biopsy? How is it analyzed? What is involved in getting helpful answers from biomarker testing?

The specialized doctors responsible for answering these questions are pathologists.  They identify any lung cancer cells in the biopsied tissue, and guide the patient’s biomarker testing. Unfortunately, pathologists do not typically speak with patients, so patients and families–and even  some doctors–often do not have a clear understanding of  the role pathologists play in their diagnosis and treatment.   Learning more about the pathologist’s role can help patients and families cut through the hype about biomarker testing and provide a better understanding of the patient’s specific disease.

Please join moderator and pathologist Dr. Timothy Craig Allen (@TimAllenMDJD) at 8 PM Eastern Time on Thursday, March 7, 2019, for a discussion about the pathologist’s role in lung cancer, a subject potentially affecting all lung cancer patients and doctors.  We will cover the following topics:

  • T1: What role does a pathologist play in diagnosing lung cancer?   How is a molecular pathologist different from a pathologist?
  • T2: What happens to tumor tissue after a biopsy?
  • T3: How does a pathologist know if a cell is cancerous? How can they tell what type of lung cancer it is (e.g., small cell vs adenocarcinoma)?
  • T4: How does a molecular pathologist decide what biomarker tests to do?
  • T5: If you have talked to your pathologist, what did you learn? If you haven’t, what would you like to learn?

Please remember to include #LCSM in ALL your tweets so the other chat participants can see them. If you need a refresher, read our primer on participating in the chat. Note that some tweetchat apps (like tchat.io) will not display tweets longer than 140 characters. Hope you’ll join us!

#LCSM Chat Topic 2019-02-07: Is it worth the drive?

Unfortunately, you just got diagnosed with cancer.  You and your family are desperately trying to figure out where to go and which doctor to see.  But how far are you willing to go?  Can you be more confident in your diagnosis, decrease your complications, and improve your chances of survival if you drive a little farther, past your local hospital, to a specialized center that treats a higher volume of cancer patients?  What would it take for you, the patient, to go that extra distance?

Seminal surgical studies have described a “volume outcome” effect, suggesting that cancer patients operated on at high volume centers are less likely to die in the hospital.  Recently, evidence was also published which suggested that stage IV lung cancer patients are more likely to survive when treated at academic versus community centers in the United States.  But how solid are these findings?  Are they clouded by selection bias and statistical flaws, in which the patients who travel for care are actually healthier, more motivated, and with better insurance and prognostic factors?  Although regionalization of complex cancer care (which is already mandated in some countries) may be appealing, we have to take potential patient barriers such as time away from work and family, costs of and ability to travel, insurance restrictions and other socioeconomic factors into account.  Failing to do so, would decrease access to care for patients with limited ability to travel.

Please join moderator Dr. Brendon Stiles (@BrendonStilesMD) at 8PM Thursday night, February 7, 2019, for this important discussion, one which affects almost every cancer patient and doctor.  We will cover the following topics:

  • T1: Do you travel far for cancer care?  If so, why?
  • T2: Is there data supporting the concept that surgery/oncology/radiation oncology results are better at high volume, specialty centers?
  • T3:  What are the downsides of and obstacles to traveling for your cancer care?
  • T4:  How can we best coordinate care between community and high volume regional centers?
  • T5:  Are there resources that exist to help patients educate themselves, get second opinions, or even facilitate travel for cancer care?

Please remember to include #LCSM in ALL your tweets so the other chat participants can see them. If you need a refresher on how to participate, read our primer on participating in the chat . Note that some tweetchat apps (like tchat.io) will not display tweets longer than 140 characters.  We look forward to the discussion.


Here is further reading on the topic:

Survival Comparison in Patients with Stage IV Lung Cancer in Academic versus Community Centers in the United States (Journal of Thoracic Oncology, Dec 2018)

How Far Would You Drive to Increase Your Chances of Cancer Survival? (Op-Med, Feb 2019)

Lung Cancer Surgery Patients May Reap Benefits of Larger, More Centralized Hospitals (Society of Thoracic Surgeons, Jan 2019)

Motivators, Barriers, and Facilitators to Traveling to the Safest Hospitals in the United States for Complex Cancer Surgery (JAMA Network, Nov 2018)


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