Lung Cancer ung Cancer by mikeholy

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									Lung Cancer                                                                                                                   Fall 2009




 National Lung Cancer Partnership Hosts Symposium on Stigma of Lung Cancer
                                                                                                             documenting the stigmatization of lung
                                                                                                             cancer and the impact it has on patients.
                                                                                                             Dr. Ostroff theorized the stigmatization of
                                                                                                             lung cancer is a consequence of effective
                                                                                                             antismoking campaigns, and one way to
                                                                                                             lessen stigma is to increase understanding of
                                                                                                             nicotine addiction – to view smoking not as
                                                                                                             a character flaw, but a biological or genetic
                                                                                                             predisposition to nicotine dependence. A
                                                                                                             better understanding of the pressures that
                                                                                                             lead people to start smoking could also help
             Dr. Wayne Steward, Dr. Jaimie Ostroff and Mary Ann Childers lead the roundtable discussion.
                                                                                                             reduce stigma surrounding lung cancer.

 Lung cancer is so tightly associated with                  Wayne Steward, PhD, (University of               Drs. Steward and Ostroff both concluded
 smoking in the minds of the public, patients               California - San Francisco) drew parallels       that it is critical to develop support programs
 with lung cancer can feel stigmatized by                   between the causes and consequences of           that help those affected by lung cancer
 their disease regardless of whether or not                 HIV/AIDS stigma and lung cancer stigma.          manage the self-blame and shame that can
 they have ever smoked. Patients may feel                   Dr. Steward explained the degree of stigma       accompany the disease. All lung cancer
 ashamed or unjustly blamed for their illness.              associated with a disease depends on             patients need to feel that they are not at fault
 Such feelings may increase psychological                   several variables: whether the patient is seen   for having the disease. They still have the right
 and emotional distress, compromise                         as personally responsible for the condition;     to quality health care and should be treated
 patients’ ability to develop social support                whether effective treatments exist for the       with respect.
 networks and even result in failure to seek                condition; and whether the condition or side
 adequate medical care and psychological                    effects are readily apparent to others.          In a roundtable discussion, speakers and
 support services.                                          Dr. Steward also explained that widely           meeting participants stressed the need to
                                                            publicized advances in HIV treatment greatly     unite lung cancer patients regardless of cause
 To address these issues head-on, the                       helped to combat the HIV/AIDS stigma.            of their illness, to empower them with a voice
 National Lung Cancer Partnership sponsored                 He predicted that once well-publicized           for advocacy and to combat the perception of
 De-stigmatizing Lung Cancer – Developing                   advances in lung cancer treatment occur,         lung cancer as a self-inflicted death sentence.
 A Road Map for the Future: A Think-Tank                    the perception that lung cancer is an
 Presentation at the World Conference on                    untreatable, incurable disease will be           Slides and Podcast Online
 Lung Cancer. The goal of this interactive                  countered, thus reducing stigma.                 A podcast of this symposium as well as
 forum, moderated by Mary Ann Childers
 (Res Public Group), was to discuss the issues              Jamie Ostroff, PhD, (Memorial Sloan-             Dr. Steward’s and Dr. Ostroff’s slides are
 contributing to lung cancer stigma and to                  Kettering Cancer Center) reviewed the            available at
 identify strategies to dispel this stigma.                 growing body of scientific evidence               NationalLungCancerPartnership.org .


 November is Lung Cancer Awareness Month:                                                                    Inside:
 Support Research, Awareness & Change
 When you think about lung cancer, are you                  families and health care providers to access     Letter from our President:
 angry about how few options there are for                  important information.                           Joan H. Schiller, MD
 screening and treatment? Do you wonder
 why the general public doesn’t seem to care                Fifteen $10 gifts allow us to fund one day of    Advancing Lung Cancer Research:
 enough about this horrible disease?                        critical lung cancer research.                   National Lung Cancer Partnership 2009
                                                                                                             Annual Meeting Summary
 We’re working to change these perceptions,                 Your gift – in any amount – will directly help
 but we need your help! November is Lung                    lung cancer patients and their families.         Stories of Strength:
 Cancer Awareness Month – the perfect time                                                                   Survivor, Melissa Peterson
 to show your support. In this challenging                  We can’t do it without you. And we must          Physician, Anil Potti, MD
 economy, we are not asking much – only                     do it today. Lung cancer patients and their
 $10. What can your gift do?                                families can’t wait.                             Patient Point of Interest:
                                                                                                             Update from ASCO and World Conference on
 One $10 gift allows us to mail educational                 Please donate today – visit                      Lung Cancer
 materials to five patients.                                 NationalLungCancerPartnership.org, or
                                                            mail your tax-deductible donation in the pre-    Upcoming and Past Events
 Five $10 gifts keep our website running for                addressed envelope enclosed.
 a month, enabling 30,000 patients, their                                                                    Research, Awareness and Change
                                                            Thank you for your support!


 222 N. Midvale Blvd. Suite 6 Madison, WI 53705            P. 608.233.7905        F. 608.233.7893                www.NationalLungCancerPartnership.org
Letter from the President
                           Health care             patients have access to the treatments they        Board of Directors:
                           reform. It’s in         need, regardless of who is providing their         President
                           the news, the           health insurance.                                  Joan H. Schiller, MD
                           topic of town hall                                                         University of Texas-Southwestern
                           meetings and a          Sincerely,                                         Medical Center
                           major presidential
                           address and
                           the concern                                                                Vice President
                           of Americans                                                               Kathy S. Albain, MD
                           everywhere.                                                                Cardinal Bernardin Cancer Center
                           Health care                                                                Loyola University Chicago
                           reform is also of       Joan Schiller
 Joan H. Schiller, MD great concern                Chief, Division of Hematology and Oncology         Secretary/Treasurer
                           to those in             Deputy Director, Simmons Comprehensive             Antoinette J. Wozniak, MD
the cancer community because of the                Cancer Center                                      Karmanos Cancer Institute
uncertainty about how it will affect cancer        Andrea L. Simmons Distinguished Chair in           Wayne State University
care delivery.                                     Cancer Research
                                                                                                      Richard N. Barg, JD, MBA
Examples of people’s insurance coverage                                                               University of California, San Francisco
working for them during a cancer diagnosis         New Scientific Executive Committee
and treatment are just as common as                Members
examples of problems. One young lung                                                                  Amy Cipau, MBA
cancer patient shared how her employer             The Partnership’s Scientific Executive              North Carolina Lung Cancer Partnership
had a sick leave bank, so other employees          Committee engages a group of premier               Key Healthcare Partners
were able to donate their unused sick              doctors and researchers to develop a
time to her. She never lost a paycheck or          common agenda for research progress in             Sarita Dubey, MD
health insurance coverage during the nine          lung cancer. We are grateful to these world-       University of California, San Francisco
months she had to be out of work to receive        renowned individuals for giving their time to
treatment for her cancer. A different patient      help ensure the Partnership’s programs are
                                                   of the highest quality, are based in scientific     Deborah A. Fuderer
couldn’t join a clinical trial because her
insurance company deemed the treatment             evidence, and are of the greatest benefit to
                                                   the lung cancer patients of today, tomorrow        Jennifer Garst, MD
“experimental,” even though the insurance                                                             Duke University Medical Center
company would have only paid for the               and beyond.
standard treatment portion of the trial. Her       The Partnership is pleased to welcome five
physician called the insurance company’s                                                              Nancy Gatschet
                                                   new members to our Scientific Executive             Pennsylvania Lung Cancer Partnership
denial ironic because if she had participated      Committee:
in the trial, she would have received her
regular treatment, a very expensive drug, for                                                         Pasi Jänne, MD, PhD
                                                   Andrea Bezjak, MDCM, MSc
free.                                              University of Toronto and Princess Margaret        Dana-Farber Cancer Institute,
                                                   Hospital                                           Harvard Medical School
One of the most challenging issues in              Dr. Bezjak’s interests are in radiotherapy and
the health care reform debate is the cost          applications of new technologies in radiation      Lorraine C. Pastore, MBA
of imaging and cancer therapies. These             planning for thoracic tumors.                      Reagent USA
costs could deter doctors from ordering
tests that could detect or rule out a cancer       Yolonda Colson, MD, PhD                            Kelly Young, RN, MSN, ANP-C, AOCN
diagnosis in people who may not fit the             Brigham and Women’s Hospital, Harvard              Duke University Medical Center
profile of someone at risk. Such costs              Medical School
could also prevent a doctor from prescribing       Dr. Colson’s research interests include
a potentially beneficial drug if he or she          developing new technologies for delivering         Staff:
believes the patient may not be able to pay        chemotherapy drugs directly to tumors.             Regina Vidaver, PhD
for it. It is important that scientific evidence,                                                      Executive Director
not cost, be used to determine health care         James Jett, MD
needs and treatment.                               Mayo Clinic                                        Kenda Schwarz
                                                   Dr. Jett is an expert in clinical trials for the   Director of Development & Outreach
Many of the newest therapies are so                early detection of lung cancer and treatment
expensive because of the small number of           of advanced lung cancer and mesothelioma.          Alice Yuroff, PhD
people using the treatments, the high cost of      He is also the Editor-in-Chief of the Journal of   Programs Manager
developing the drugs and the lack of generic       Thoracic Oncology.
alternatives. These costs are difficult for our                                                        Jackie Ford
health care system to bear. However, these         Anil Potti, MD
                                                   Duke University                                    Development Manager
drugs have the potential to dramatically
improve some lung cancer patients’ lives. It       Dr. Potti’s research investigates genomic
would be very difficult to accept a system          testing strategies to improve the treatment of     Tracy Fischer, MSc
                                                   people with lung cancer.                           Communications Manager
in which patients don’t have access to
beneficial drugs because of cost. Fears of          Ann Schwartz, PhD, MPH
such a system have added to the debates                                                               Julie Chrisler
                                                   Karmanos Cancer Institute, Wayne State
surrounding health care reform.                    University                                         Office Manager
                                                   Dr. Schwartz studies the genetics underlying
There are several versions of health care          lung cancer risk, including how risks differ       Kim Bautz
reform legislation making their way through        between men and women and people from              Development Administrative Assistant
Congress, and we don’t know which one will         different racial backgrounds.
come out “on top.” What is clear, though, is                                                          Graphic Design & Layout:
that we need to stay informed, as consumers                                                           Heather Hagerty
and as advocates, to ensure that lung cancer


National Lung Cancer Partnership - Fall 2009                                                                                                > Page 2
Advancing Lung Cancer Research
National Lung Cancer Partnership 2009 Annual Meeting
                                                        Dr. Sequist is also planning studies to test          aprepitant (Emend®) is combined with other
                                                        whether the microfluidic chips can be used for         standard anti-vomiting drugs, 75-85% of
                                                        lung cancer screening and early detection.            patients receiving chemotherapy experience
                                                                                                              complete control of vomiting. These three-
                                                        Targeting for a cure: radiation therapy for           drug treatments appear especially effective for
                                                        lung cancer                                           women.
                                                        Walter Curran, MD, (Emory University)                 In another encouraging study, women were
                                                        reviewed technological advances that deliver          treated with a different three-drug combination
                                                        higher doses of radiation targeted at a tumor         (dexamthasone, aprepitant and palonosetron
                                                        to minimize damage to surrounding healthy             [Aloxi®], a newer serotonin receptor inhibitor).
  National Lung Cancer Partnership research grant       tissue.                                               Ninety-five percent of patients receiving this
  recipients Dr. Michele Coté, left, and Dr. Richard                                                          combination experienced no vomiting at
  Pietras, right, and Partnership President, Dr. Joan
      Schiller, center, presented at the meeting.       The challenge now is to pinpoint where the            all and 66% experienced no nausea during
                                                        tumor is. Lung cancer tumors move, not only           their chemotherapy treatment. Although this
                                                        with breathing, but also with circulation and         was a small study and needs to be repeated
The Partnership held its 7th Annual Meeting,            heartbeats. Thus, advances in tumor imaging
Advancing Individualized Care in Lung                                                                         with more patients, it provides hope that
                                                        are critical to improvements in how patients          chemotherapy-induced nausea and vomiting
Cancer: New Hope for Screening and                      receive radiation therapy.
Treatment, on May 29 in Orlando, FL. This                                                                     can be completely controlled for many patients.
symposium brought together researchers,                 Recent advances in imaging are improving
health care professionals and patient                                                                         Targeting critical molecular pathways in lung
                                                        how patients receive radiation therapy. Fusion        cancer to find more effective treatment
advocates to learn about the progress towards           technology allows images from different
personalizing care for lung cancer patients.            imaging equipment to be combined. Dynamic             David Beer, PhD, (University of Michigan)
                                                        imaging allows monitoring of the tumor                described his work applying sophisticated
Detecting circulating tumor cells:                      movement throughout the entire respiratory
implications for screening, diagnosis and                                                                     genetic analyses to identify what genes and
                                                        cycle. Online imaging allows a patient’s tumor        processes are most critical in lung cancer.
treatment                                               to be imaged in the room where they will              Studies like this may determine which tumors
                                                        receive therapy and guide radiation treatment         will be aggressive and better predict which
All cancers, potentially even in their earliest         in real time. Clinical trials have led to these
stages, shed cells into the circulatory                                                                       patients will respond to certain therapies.
                                                        improvements in the quality of radiation
system. A portion of these cells may play               therapy and, thus, better patient outcomes.
a role in forming metastases. An in-depth                                                                     Tony Mok, MD, (Chinese University of Hong
understanding of these circulating tumor                                                                      Kong) discussed results of the ground-breaking
                                                        Control of chemotherapy-induced nausea                IPASS clinical trial, which demonstrated a
cells (CTCs) may allow for earlier detection of         and vomiting: new studies and new agents
invasive disease, increase our understanding                                                                  significant response to the targeted therapy
of metastasis and allow monitoring of disease                                                                 drug gefitinib (Iressa®) in lung cancer patients
                                                        Chemotherapy-induced nausea and vomiting              with tumors containing mutations in the
progression or response to treatment simply             can seriously impact quality of life for patients
by using blood samples. However, CTCs                                                                         epidermal growth factor receptor (EGFR)
                                                        and may even prevent patients from receiving          gene. Dr. Mok discussed how these findings
constitute less than one cell in a billion in the       or completing the most effective cancer
blood, making detecting and studying these                                                                    and others will help doctors select and treat
                                                        treatments. Women, and especially younger             patients based on molecular biomarkers in
cells technically challenging.                          women, are at greater risk of experiencing            addition to clinical parameters.
                                                        nausea and vomiting during their cancer
Lecia Sequist, MD, (Harvard Medical School)             treatments than men. Understanding ways to
reviewed the latest developments in the use of                                                                Heather Wakelee, MD, (Stanford University)
                                                        control nausea and vomiting during treatment          reviewed the role of vascular endothelial
CTCs for screening, diagnosis and treatment of          is critical to providing the best possible care for
lung cancer. She described her team’s work in                                                                 growth factor (VEGF) pathway inhibitors in
                                                        patients.                                             the treatment of lung cancer. She discussed
adapting microfluidic chips, a new technology
that captures CTCs so they can be studied.                                                                    how these drugs may affect men and women
                                                        Richard Gralla, MD, (North Shore-Long Island          differently and the potential role estrogen may
The small chips contain 78,000 microscopic              Jewish Health System) reviewed the newest
posts covered in antibodies that can “grab”                                                                   play in treatment.
                                                        anti-nausea and anti-vomiting agents and
the CTCs.                                               discussed ways men and women differ in their          National Lung Cancer Partnership research
                                                        response to these drugs.                              grant recipients, Michele Coté, PhD, (Wayne
Although this technology is still in early
development, it is showing promise for                                                                        State University) and Richard Pietras, MD,
                                                        Thirty years ago, nearly all patients                 PhD, (UCLA) described their work investigating
practical applications. In one study, Dr. Sequist       experienced chemotherapy-induced nausea
and colleagues counted the number of CTCs                                                                     estrogen pathway molecules as markers of
                                                        and vomiting. By the late 1990s, treatment            lung cancer survival and as potential targets for
in patients’ blood during treatment. In several         with two-drug combinations – dexamthasone
patients, the numbers of CTCs detected                                                                        therapy.
                                                        plus serotonin receptor inhibitors, such as
correlated well with their tumor burden,                ondansetron (Zofran®) – controlled vomiting
suggesting it might be possible to monitor                                                                    Details of these latter presentations will be
                                                        in 50-60% of patients. This therapy is still          reviewed in an upcoming article in the Journal
response to treatment using this one-step               considered standard of care for many patients
blood test.                                                                                                   of Thoracic Oncology. We will announce
                                                        treated with certain types of chemotherapy.           the publication of this article as soon as it is
                                                        However, this treatment tends to be less              available.
Dr. Sequist and her colleagues also                     effective for women.
demonstrated it is possible to detect and
characterize epidermal growth factor receptor           Dr. Gralla presented new research showing             Save the Date!
(EGFR) mutations in CTCs from lung cancer               that adding a third type of drug to the
patients. In the future, this technology could                                                                The Partnership’s next Annual Meeting will
                                                        treatment regimen can result in substantial           be June 4, 2010, in Chicago, IL.
allow doctors to genetically profile tumors              alleviation of symptoms. These new drugs
using a blood test, potentially removing the            block NK1 receptors in the vomiting center
need for biopsies.                                      of the brain. When an NK1-inhibitor such as


National Lung Cancer Partnership - Fall 2009                                                                                                         > Page 3
Stories of Strength
                            A Survivor’s Story         After a biopsy, I was diagnosed with Stage IV       on maintaining excellent health, traveling
                                                       adenocarcinoma of the lung. It was the last         and spending time with my family and
                            Melissa Peterson was       thing I expected, as I thought (then) that only     friends. Professionally, I am splitting my time
                            diagnosed with lung        smokers got lung cancer. And except for a bit       between my communications job and doing
                            cancer in June 2008.       of a fondness for red wine and chocolate, I         advocacy work on behalf of the Partnership
                            With a young daughter      have always been a very healthy, outdoorsy,         and for the Global Resource for Advancing
                            and a feisty spirit, she   active person.                                      Cancer Education.
Melissa Peterson with her   is fighting the disease
     daughter, Lucie        with everything she’s      Q: How did you handle the news?                     Q: What do you want other patients to
                            got.                       A: It was the most terrifying and gut-              know?
                                                       wrenching news imaginable. My first                  A: I believe we are now entering a phase of
Q: What were the circumstances around                  thoughts went to my daughter, Lucie. My             hope, where targeted therapies seem to be
your diagnosis?                                        mother died of a brain tumor when I was two         gaining ground in the battle. That’s definitely
A: I was diagnosed after returning home                years old, and being a mother to my five-year-       something to hang on to if you’re unlucky
from a 40th birthday trip to Italy with my             old daughter has been one of the greatest           enough to get this disease – even five years
family. During the trip, I was having some odd         joys of my life.                                    ago, we didn’t have as many options for
sensations in my left arm, and noticed some                                                                therapy. I’m past my one-year mark, and so
hard lumps around my collarbone…along with             Being told that I had an incurable cancer           far, my once-a-month maintenance therapy
some disconcerting amounts of perspiration             that would, in all likelihood, shorten my time      seems to be holding the beast at bay. This
under that armpit. I also had a chronically            with her, devastated me. But it also made           makes me feel incredibly fortunate and also
sore hip, which I had chalked up to my over-           me resolve to fight as hard as I could – not         humbled, as I know that everyone’s struggle
enthusiastic, pre-40th birthday workouts!              only to live longer for her, but also to make a     with this disease is different.
                                                       difference for others given this diagnosis.
When we got back to Seattle, I went to my                                                                  Want to know more about Melissa’s
doctor, who seemed pretty concerned – I                Q: How has your life changed?                       experience with lung cancer?
went in for scans which showed only a tiny             A: After going through treatment – consisting
spot on my lung, but also a ton of lymph node          of whole brain radiation and chemotherapy,          Visit our website at
                                                       which went surprisingly well, given their           NationalLungCancerPartnership.org to follow
involvement, bone involvement and brain                                                                    our bloggers, Melissa and Lisa Woody, MD,
metastases.                                            nature – I have become much more focused            as they share their stories of strength, OR to
                                                       on what I want to do, both personally and           share your own story!
                                                       professionally. Personally, I want to work


                   A Physician’s                       by clinicians and researchers alike. Some of        my mind, serves that very important purpose,
                   Perspective                         the people who have helped me the most              in bringing people together, to define the
                                                       have been senior lung cancer investigators          future of lung cancer research and therapy.
                Anil Potti, MD, is a doctor and        at different institutions - there is a sense
                researcher at Duke University          of mentoring that goes far and beyond               Q: What is your greatest challenge as a
                Medical Center where he                institutional alliances and collaborative           physician, researcher and Partnership
                investigates genomic testing           efforts. This is very unique to the lung cancer     Committee member?
                strategies to improve the              field.                                               A: I have a lovely family, and balancing my
                treatment of people with                                                                   academic life with the needs of my family is
 Anil Potti, MD lung cancer. Dr. Potti is also         Q: What would you like patients to know             always a challenge for me. I never miss an
                a valued member of the                 about lung cancer treatment now and for             opportunity to thank my beautiful wife and
National Lung Cancer Partnership’s Scientific           the future?                                         three wonderful girls, so I will do that here
Executive Committee.                                   A: These are exciting times. We are on the          again – they keep me going when the going
                                                       cusp of a major turnaround in our approach          gets tough. But, the fact is, the challenges I
Q: What inspired you to enter lung cancer              to treating lung cancer. The development of a       face are nothing compared to what cancer
research and treatment?                                whole new repertoire of drugs will lend itself      patients go through.
A: Cancer biology always fascinated me. I just         to more effective strategies, moving beyond
gravitated to a disease about which very little        traditional chemotherapy. Several recent            Q: As a member of the Partnership’s
was known, but one where you could make a              discoveries and strategies will pave the way        Scientific Executive Committee, what do
tremendous difference in people’s lives, even          for more personalized therapy that will likely      you see as the greatest strength of the
with small advances.                                   improve response rates and survival.                organization?
                                                                                                           A: The ability to motivate and lead, in all
Q: What advances in lung cancer research               “For too long, the lung cancer                      respects. For too long, the lung cancer
                                                                                                           community has waited for an organization
have made you most hopeful?                            community has waited for an                         to lead and bring all the forces together in
A: We now understand the biologic                      organization to lead and bring all the
underpinnings of lung cancer better than ever                                                              this war against a deadly disease. What the
before. This will lead the way in designing            forces together in this war against a               Partnership has achieved in just a few years
rational clinical trials of new therapies that will    deadly disease. What the Partnership                speaks for itself.
likely have a major impact in outcomes. One            has achieved in just a few years                    Q: What is the most important thing you
example is the importance of EGFR mutation             speaks for itself.”
testing and most recently the promise of                                                                   have learned from your patients?
targeting mutations involving the ALK gene.                                                                A: A patient once told me that, “Hope beats
                                                       Q: What role do you see the Partnership             despair every day of the week and twice on
                                                       playing in the future of oncology?                  Sunday.” A day does not go by where I don’t
Q: What would you like young professionals             A: My dad used to say that there are three
entering the field to know?                                                                                 remind myself of that. As most health care
                                                       types of people in this world – Leaders,            professionals would agree, we learn more
A: There is both tremendous promise and                Followers and Builders. While most fall into
opportunity for a motivated investigator in the                                                            from our patients than from anyone else.
                                                       the top two categories at various points in
field of lung cancer. Personally, as a junior           our lives, the ones that are critical to eventual
investigator, I have been embraced and                 success and bring the leaders and followers
welcomed into the lung cancer community                together are the builders. The Partnership, in


National Lung Cancer Partnership - Fall 2009                                                                                                      > Page 4
Patient Point of Interest
Update from ASCO and World Conference on Lung Cancer
                       Two important                                             disease will have        at EGFR were also described. For example,
                       conferences were                                          their cancer recur. If   preliminary data using the drug BIBW2992
                       held this summer:                                         doctors could better     in patients with tumors with EGFR mutations
                       the American Society                                      understand who           showed the drug controlled the disease in the
                       of Clinical Oncology                                      is likely to have a      majority of patients. This and other agents in
                       (ASCO) Annual                                             recurrence, those        testing give great hope that we will soon be able
                       Meeting and the 13th                                      patients could be        to control disease caused by tumors with EGFR
                       World Conference on                                       followed closely and     mutations.
                       Lung Cancer (WCLC).                                       offered additional
                       Both conferences                                          therapy after            Personalizing therapies
                       highlighted lung cancer                                   surgery. Scientists      With increased understanding of the genetic
                       research advances            are seeking to understand who is and who is           flaws that drive certain cancers comes the
                       that may significantly        not likely to experience a recurrence, using a        ability to better predict which patients will benefit
improve lung cancer patients’ survival.             simultaneous analysis of 100 genes. If this           from particular therapies. Data presented
                                                    multi-gene analysis presented at ASCO can be          at ASCO suggest that individuals with early-
Understanding lung cancer risk                      successfully used in the clinic, doctors may be       stage tumors that express low levels of two
Recent studies show estrogen can affect lung        able to identify which early-stage lung cancer        specific proteins are more likely to benefit from
cancer growth and progression, just as it does      patients will benefit from more aggressive             chemotherapy given after surgical removal
for breast and ovarian cancers. Results from        therapy.                                              of their tumor. These two proteins, called
the Women’s Health Initiative (WHI) presented                                                             mutS homolog 2 (MSH2) and excision repair
at ASCO further suggest that, for women             Maintenance therapies                                 cross-complementation group 1 (ERCC1), are
with lung cancer, continued use of hormone          After an initial chemotherapy treatment               involved in repairing damage caused by platin-
replacement therapy (HRT) may worsen their          regimen, patients with non-squamous lung              based chemotherapies. As additional genetic
chance of survival from the disease. HRT            cancer who were given pemetrexed (Alimta®)            testing methods are developed and matched to
did not, however, increase a person’s risk of       until the disease showed signs of progressing         available therapies, patients can expect more
developing lung cancer. These results add to        lived significantly longer than those who ended        personalized treatments, hopefully resulting in
the body of evidence suggesting that women          their treatment after the initial chemotherapy.       improved survival and cure rates.
going through menopause should use the              This finding, presented at ASCO, has led
lowest dose of HRT for the shortest period of       to a new FDA approval of pemetrexed for               Quality of life improvements
time to control their menopausal symptoms.          maintenance therapy in lung cancer.                   When a new drug, vandetanib (Zactima®), was
For women who have been diagnosed with                                                                    added to standard chemotherapy for advanced-
lung cancer, results of this study suggest HRT      A similar trial treating advanced-stage lung          stage patients, patients experienced improved
should be discontinued.                             cancer patients with erlotinib (Tarceva®) after       progression-free survival, as well as a better
                                                    initial chemotherapy also suggests this agent         quality of life during the course of the treatment.
Prevention                                          can provide a benefit in progression-free              However, in spite of these positive effects of the
Individuals who smoked in the past remain           survival, as well as improving overall survival.      drug, patients didn’t live longer when vandetanib
at risk for lung cancer for up to 20 years after    Another study showed the combination of               was added to their therapy regimen. More
they quit smoking. In order to decrease the         bevacizumab (Avastin®) and erlotinib given after      studies are underway to better characterize who
risk of developing the disease, research in         initial chemotherapy provided a substantial           is most likely to benefit from vandetanib.
“chemoprevention” – using drugs to prevent          improvement in progression-free survival versus
disease – is underway. One study discussed          treatment with bevacizumab alone.                     Conclusion
at WCLC showed the drug iloprost (Ventavis®)                                                              These brief summaries represent only a
effectively reversed airway damage in people        Progression-Free Survival Rate describes the          fraction of the advances that are being made
who used to smoke. This airway damage may           percentage of people who do not experience            in understanding how we can better prevent,
lead to the development of lung cancer. If          any new tumor growth or cancer spread during          screen for, diagnose and treat lung cancer.
these results are seen in larger numbers of         or after treatment, including those whose             Future lung cancer research offers great
people, iloprost and agents like it could be        disease has either completely or partially            promise towards ending lung cancer’s reign as
prescribed to people after they quit smoking to     responded to treatment, or those whose                the #1 cancer-killer.
help prevent lung cancer.                           disease is stable (the cancer is still present but
                                                    not advancing).                                       Lung Cancer Call to Action
Screening updates
What if doctors could detect lung cancer            Experts caution, however, that both pemetrexed        The National Lung Cancer Partnership is
just by “smelling” a person’s breath? At the        and erlotinib are already known to be effective       pleased to announce a partnership with
WCLC, researchers described their progress in       for second-line treatment (once the disease
differentiating lung cancer from other cancers                                                            EmergingMed, a personalized clinical trials
and normal cells by using new technologies to       has progressed after the first line of treatment),     matching service.
identify the chemicals being given off by the       so it is not clear whether the timing of the
cells – essentially “smelling” them. Although       medication is what’s important, as opposed
                                                    to just getting it at all. Nonetheless, these         This unique service helps patients quickly
early results are promising, further studies        results make clear that patients and their            identify clinical trials that match their specific
need to be completed before such an advance         doctors should discuss the pros and cons of           diagnosis and treatment history. Patients
could be used in the clinic.                        maintenance therapy before the first line of           are encouraged to call EmergingMed as soon
Another new screening technology, 3D Cell           treatment is complete.                                as they are diagnosed, in order to maximize
Analysis, was also presented at WCLC. This          Targeted therapies                                    the potential benefits of the service.
method uses computed tomography (CT) to             Much interest at both conferences centered on
look for irregular cells, which are indicative of   agents designed to inhibit the epidermal growth       For more information, please visit
cancer, in the sputum people cough up. This         factor receptor (EGFR). Mutations in EGFR
technology could prove useful in determining                                                              emergingmed.com/networks/
whether someone has pre-cancerous or                have been found to drive the growth of some           NationalLungCancerPartnership/ .
cancerous cells in their lungs at a very early      tumors. Results from the IPASS (Iressa Pan-
stage.                                              Asian Study) trial, described in the summary
                                                    of the Partnership’s Annual Meeting (see page
Predictors of disease severity & progression        3), were cited throughout both conferences as
Lung cancer in its earliest stage is typically      demonstrating the utility of targeted therapy to
treated with surgery. However, approximately        substantially improve progression-free survival
30% of people with the earliest stage of            rates in those with activating EGFR mutations.
                                                    Advances in testing other agents directed


National Lung Cancer Partnership - Fall 2009                                                                                                        > Page 5
Upcoming Events
                                                   Free to Breathe® Events                        2010 Free to Breathe® Events
                                                   2009 Fall/Winter Events                        Planning has already begun for the
                                                                                                  2010 Free to Breathe® season!
                                                   Run/Walk
                                                   East                                           Watch FreetoBreathe.org for
                                                   Providence, RI – October 17                    announcements of locations near you.




                                              TM
                                                   Philadelphia, PA – November 1
                                                                                                  Save the Date!
                                                   South                                          Lake Charles, LA – March 27
                                                   Punta Gorda, FL - October 31
                                                   Boone, NC – October 31
                                                   Raleigh, NC – November 7                       Look Deeper Concert
                                                   Athens, GA – November 7                        Join us for the first Look Deeper Concert on
                                                   Jacksonville, FL – November 7                  November 13, 2009 in Dallas, TX!
                                                   Columbia, SC - November 21
                                                   Triad, NC – November 14                        To purchase tickets, please visit
The Free to Breathe® event series unites                                                          NationalLungCancerPartnership.org/
people who are passionate about raising            Midwest                                        LookDeeperConcert09 .
public awareness and vital funding to fight         Dayton, OH - November 7
lung cancer.
                                                   West                                           Thank You!
During 2009, Free to Breathe® has grown            Seattle, WA – November 8
                                                                                                  We would like to thank all of our local event
to 23 events around the country!                                                                  organizers, advocates and volunteers who
Information about each event location,             Nationwide
                                                   National Walk – November 7                     give their time and effort to make these
how to register, form a team, donate,                                                             events successful. Without your dedication,
volunteer or sponsor an event is available                                                        our research, education and awareness
at FreetoBreathe.org .                             Marathon                                       programs would not exist.
                                                   Raleigh, NC – November 1
                                                                                                  We appreciate and applaud your efforts!
November is Lung Cancer                            Yogathon
Awareness Month                                    Baltimore, MD - November 1                     To have quantities of this newsletter or our other
                                                   Durham, NC – December 21                       educational materials delivered to your office or
Show your support for lung cancer                                                                 clinic for FREE, please email us at
research, awareness and change                                                                    info@NationalLungCancerPartnership.org .
by joining thousands of lung cancer
survivors, family, friends and advocates
across the country and participating in a
Free to Breathe® event near you!


Past Events
The 2009 Free to Breathe® season has               Pennsylvania Chapter Update                    campaign designed by students at the
already included these events:                     It has been a busy summer for the              Art Institute of Philadelphia under the
                                                   Pennsylvania Chapter, with the official         leadership of Professor Linda Karp,
Lake Charles, LA – March 14, 2009                  Chapter launch and several fundraising         Chapter Secretary.
Los Angeles, CA – August 2, 2009                   events!
Toldeo, OH – August 29, 2009                                                                      In September, the Pennsylvania Lung
Tacoma, WA – September 19, 2009                    The Life & Breath Party in Plattsburgh,        Cancer Partnership’s Board of Directors
Glastonbury, CT - September 20, 2009               NY, hosted by Brian Brubaker, not only         held the first strategic planning meeting to
Kansas City, MO – September 27, 2009               raised funds but also spread awareness         shape the chapter’s direction for the next
Madison, WI – September 27, 2009                   with a full-page article in the local press.   3 years. And, of course, the chapter is
Lincoln, NE –October 3, 2009                                                                      preparing for the largest Free to Breathe®
                                                   Lanes for Lungs in Philadelphia was            event in the country in Philadelphia on
                                                   hosted by Nicholas Tees and his family         November 1.
                                                   on the first anniversary of his father’s
                                                   death. Nicholas’ dad loved to bowl, so the
                                                   bowling alley was overflowing with people
                                                   celebrating his life and raising much-
                                                   needed funding.
                                                   Be the Light celebrated the founding of
                                                   the Chapter. Guest speakers included
                                                   Dr. Mike of Fox News and Dr. James
                                                   Stevenson, of the Abramson Cancer
                                                   Center at the University of Pennsylvania.
                                                   The event included an exhibit of “Faces
        Participants run in the Kansas City        of Lung Cancer” from the Moffit Cancer          Pennsylvania Lung Cancer Partnership Board Secretary
         Free to Breathe® 5K Run/Walk.                                                              Linda Karp, Board President Nancy Gatschet, Robin
                                                   Center in Florida, and the debut of the            Barg and Bill Mignucci attend the Pennsylvania
                                                   Philadelphia Free to Breathe® PSA                       Chapter Launch event, Be The Light.




National Lung Cancer Partnership - Fall 2009                                                                                                  > Page 6
Research, Awareness and Change
Second Lung Cancer Advocacy Summit a Rewarding Experience
                                                      The Advocacy Summit brought together a             increasing public awareness and research
                                                      diverse group of 68 advocates, including           funding. These efforts will help to bring
                                                      24 lung cancer survivors. The group also           about the change that is needed for future
                                                      included caregivers, family members, friends       lung cancer patients and their families.
                                                      and medical professionals.

                                                      One of the highlights was a tour of the
                                                      University of Texas-Southwestern Medical
                                                      Center laboratory facilities. Summit
                                                      participants learned about several cutting-
                                                      edge advances in lung cancer research
                                                      directly from researchers and gained
                                                      important insights into the research process.
The National Lung Cancer Partnership
sponsored the second annual Lung Cancer               Advocacy Summit participants put what they
Advocacy Summit from April 23-26, 2009, in            learned into action during the conference
                                                      by organizing a poignant candlelight vigil in       Advocates learn first-hand about lung cancer research
Dallas, TX.                                                                                                     at the University of Texas-Southwestern
                                                      honor and memory of those affected by lung                          Medical Center labs.
This conference included presentations,               cancer.
discussions and interactive brainstorming
on advocacy topics such as: engaging the              Advocacy Summit participants clearly
media, crafting a message, legislative                identified that their two major concerns are        Save the Date!
advocacy and raising community awareness.             insufficient funding of lung cancer research
                                                      and the need to get high-quality information       The 2010 Lung Cancer Advocacy Summit will
The goal of the Advocacy Summit is to                                                                    be held April 22-25 in Tampa, Florida!
empower advocates by giving them the tools,           to patients as quickly as possible after
                                                      diagnosis. Participants also expressed             Look for details in early 2010 at
knowledge and courage to become confident
and effective advocates for lung cancer               their desire for the lung cancer community         NationalLungCancerPartnership.org .
research and awareness.                               to come together with a common goal of

In the News
SELF Magazine mentioned the Partnership                Ted Casablanca wrote an article about             few patients are currently participating in the
as part of an article about lung cancer                Kathryn Joosten’s recurrence of lung cancer       clinical research process.
survivor and advocate Montessa Lee in the              in his E! Online blog, The Awful Truth on
October issue.                                         September 14. The article directed readers        The Wall Street Journal published a
                                                       to the Partnership’s website for information      letter to the editor by Regina Vidaver, PhD,
Good Morning America featured the                      about getting involved in the fight against        Parternship Executive Director, in the May
Partnership’s broadcast public service                 lung cancer.                                      30 issue. The letter was in response to an
announcement (PSA) as part of a segment                                                                  article about comparing the effectiveness of
about controversial PSAs on September 23.              The American Thoracic Society Public              medical interventions.
                                                       Advisory Roundtable’s September-October
CNN ran a similar story on the morning news            E-Newsletter included an article about how        The Chicago Sun-Times featured Kathy
that also featured a clip of the Partnership’s         the Partnership’s PSA is raising lung cancer      Albain, MD, Partnership Board Vice President,
broadcast PSA on September 24.                         awareness.                                        explaining how lung cancer affects men and
                                                                                                         women differently in the May 19 article, “No
The Los Angeles Times ran an article                   The New York Times published a letter to          Butts About It”.
about controversial cancer public service              the editor by Joan Schiller, MD, Partnership
announcements on September 22 using the                President, in the August 6 issue. The letter
Partnership’s PSA campaign as an example.              was in response to an article about why so

Memorial Giving:
Donations have been made to the National Lung Cancer Partnership in memory of the following people (April 17 through September 17, 2009):
Lucy Acevedo                    EJ Cole                         Shelly Goldstein            Thomas McDonough                 Susie Smith
Bucky Alexander                 Theresa Rose Convertino         Barbara Goodman             Jill McKay                       Marcos S. Sodre
Innocenzo Ambrosetti            John S. Cordero Jr.             Johnny S. Greer             Joan McVay                       Dorothy Warm Stettner
Zwie Amitai                     Lynn Corts                      William C. Griffin, MD       Linda Mills                      Jim Stevens
Karen Antonucci                 Jill Cotoia                     Ruth Grimsley               Gladys Morrissey                 David Stockwell
David Atkins                    Patricia Jean (Trish) Creegan   Bill Hamberg                Kay Murphy                       Edward Sweeney
Harry Baseman                   Mary Pat Darling                Anna A. Hamel               Nancy Venos Neilson              Daniel T. Sweeney Jr.
Rose Baseman                    Doris Dillon                    Elinor Hanna                Karen Parles                     Max Taft
Paula Belott                    Patrick Duberg                  Delbert Hardratch           Robert L. Pensinger              George Turen
Allen Berman                    Patrick Duffy                   Tim Harvell                 Charles Raynard                  Joyce Turosky
Abuelo Bernal                   Jonnie Duncan                   Bruce Hayworth              Mr. Reed                         James M. Vine
Lorraine Blackwell              Kim Andrews Ebert               Ella Marie Jones            Margo A. Reynolds                Gary Ward
Nancy Boals                     Mary Ellis                      Lynne Jones                 Roberto Rios                     Janice Weir
Tommy Boardman                  Joan Fazzolari                  Madge (Judy) Joplin         Michaelene (Mickey) Robida       Lee M. Williams
John Bowden                     Estelle Flanagan                John Kelley                 Robert Rothlein                  David Woody
Sheryl Brody                    Madeline Fox                    Mildred Kial                Betty Sapolsky                   Louis Wright
Carolyn Burchfield               Ruth Frerichs                   Janet Kohen                 Evelyn Schramm
Harriet Butcher                 Michael Gaudreau                Red Lee                     Jeffrey Scott
Leo Cabro                       Shirley Jane Geisinger          Gracie Levasseur            Karen Siegmund
Bernardina Leynes Casana        Denise Gess                     William Lynch               Stephen Simmonett
Jean E. Chipman                 Matthew B. Ginnetty             Joyce Lyons                 Dr. Susan L. Sipes
Psan Chon                       Kara S. Gobron                  Patricia Alice Maenza       Carlene Smail




National Lung Cancer Partnership - Fall 2009                                                                                                         > Page 7
            Learn about the latest advances in lung cancer screening,
                            diagnosis and treatment!
      See inside for information about upcoming Free to Breathe® events and other ways that you
                           can get involved in the fight against lung cancer.


National Lung Cancer Partnership is dedicated to decreasing deaths due to lung cancer, and helping
            patients live longer and better, through research, awareness and advocacy.




 Thanks to Genentech BioOncology, Novartis Pharmaceuticals, Abraxis BioScience and Boehringer Ingelheim Pharmaceuticals, Inc.,
                    for unrestricted educational grants that made this issue of the Lung Cancer Voice possible.




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