Lung Cancer

When it comes to lung cancer, there’s little doubt we’ve made meaningful progress.

Since 2000, the number of new cases has fallen by almost 27 percent, and the survival rate has improved by more than 50 percent. Meanwhile, teen smoking rates continue to shrink.

Yet, one number remains sobering: 130,000.

That’s the estimated death toll from lung cancer in 2022, making lung cancer the nation’s leading cause of cancer deaths. More than 76 percent of patients diagnosed with the disease die within five years.

At IU Melvin and Bren Simon Comprehensive Cancer Center, our team of 10 clinical scientists focused on lung cancer know there are many questions that remain unanswered.

Can we use immunotherapy to blunt lung cancer in its earliest stages? How can we adapt and tailor treatment to a patient using biomarkers? What new targets might we uncover if we could get reliable samples of aggressive disease? And how do we ensure our patients remain strong in body and spirit throughout their fight to overcome lung cancer?

Fortunately, we have you.

Our donors are close partners, making vital investments that help the lung cancer research program amass talent and obtain equipment that leads to breakthroughs. In some cases, your generosity grants us the flexibility to pursue bold ideas that would otherwise go unexplored.

Together, we’re making progress that will save more lives in Indiana and around the world. Here is a glimpse of what you make possible at IU Simon Comprehensive Cancer Center.

We strive to recruit the most talented faculty to join us at IU School of Medicine, and donor support is essential in making it happen.

In July 2022, the lung cancer research program welcomed a trio of researchers whose bold ideas and expertise fill critical roles on our team.

Thanks to philanthropic support, Hanna was able to provide protected research time for each faculty member. “It’s really simple,” he said. “You recruit exceptional people, give them broad objectives, support them, and let progress happen.”

Generous contributions also allow IU to attract fellows like, Ali Ajrouch, MD, (left) and Ahmad Karkash, MD. They play a central role in a dozen non-therapeutic clinical trials, meaning the trials are focused on better understanding cancer and its impact on patients’ lives.

Typically, patients whose lung cancer had spread endured rounds of chemotherapy and radiation that could last for a year or more. IU researchers have shown that the timeline can be trimmed, sparing patients from unnecessary treatment.

Today, we’re focused on finding new drug combinations that can be tailored to the patient while shortening their therapy.

One potential solution is a vaccine that’s shown promise as a treatment for non-small cell lung cancer. What started as a collaboration between American and Cuban researchers has now moved into a small clinical trial, and IU School of Medicine is one of just a few sites in the U.S. testing whether the vaccine enhances the effectiveness of immunotherapy.

While immunotherapy makes a tremendous difference for many patients, we know there’s still room for improvement in using it to treat patients with early-stage lung cancer.

Currently, Hanna and Greg Durm, MD, are running a pair of clinical trials assessing that potential. In both instances, immunotherapy is given in combination with chemotherapy. Hanna oversees its use among a group of stage I patients, while Durm manages a collection of patients grappling with stage II and III disease.

The lung cancer research program is finding ways to guide adjustments to each patient’s therapy using circulating tumor DNA. These faint remnants of cancer circulate in the bloodstream, and we can measure them by taking a simple blood draw. That data can be used to determine whether the cancer is truly gone.

Now, Hanna and Maniar plan to use this robust biomarker as a real-time tool. In an upcoming trial, it will help them personalize how long a person receives consolidated immunotherapy—a critical step in improving the standard of care.
While immunotherapy makes a tremendous difference for many patients, we know there’s still room for improvement in using it to treat patients with early-stage lung cancer.

For decades, patients have reported feeling that their minds were cloudy and that they had become more forgetful. Now, we know why. Chemotherapy can save lives, but it also brings about slight but essential changes to blood flow in the brain that affect thinking, memory, and concentration.

Immunotherapy also has the same effect. Since it becomes a standard tool to treat lung cancer, it’s critical to understand its impact. Now, IU is recruiting patients for a study that will detail changes in cognition for patients only receiving chemotherapy versus those who get combination therapy.

Meanwhile, we’re trying to create a tool that simply but accurately gauges how a patient feels physically and emotionally. Laura B. Vater, MD, PhD, developed a method where a patient simply answers a series of questions with a yes or no. Ideally, the results would tell us whether patients are eating well, getting enough rest, and have a stable support system. We recently completed an initial trial of the tool—called SMILE—and are reviewing data to see how useful it might be. 

One reason lung cancer is such a challenging disease is that obtaining a simple tumor biopsy can be difficult and risky.

That’s especially true in patients with aggressive small-cell disease. In these tumors, cancer cells multiply so quickly that any sample is swamped with dead cells. The quality of samples gets worse when a patient’s treatment fails, and their cancer no longer responds.

There’s a solution to help researchers, but it is grim: obtaining a biopsy shortly after a patient passes away.

Some patients who want to further research have consented to donate such a sample within 12 hours of their death. The tiny bit of tissue is a significant contribution.

Led by Shadia Jalal, MD, this tissue biorepository will be invaluable for researchers. Samples will go into cell and animal models, teaching us about lung cancer’s deadly mechanics. They will let us explore the microscopic and harsh environment around a tumor. And they will serve as a proving ground for drugs aimed at new targets.