Education
Experts Discuss Life-Saving Advances in Lung Cancer Treatment
3 min. read
Baptist Health Miami Cancer Institute
Twenty years ago, a lung cancer diagnosis offered limited options. Today, survival rates have doubled, and patients are living longer, healthier lives thanks to groundbreaking advances in both surgical techniques and precision medicine.
“We’re seeing response rates and survival times that we weren’t even talking about five years ago,” said Nicole Eiseler, M.D., a medical and sarcoma oncologist at Baptist Health Miami Cancer Institute.
Dr. Eiseler and Ian Bostock, M.D., a thoracic surgeon with the Institute, recently presented “Pathways to Hope: Advances in Lung Cancer Care,” (view by using Passcode tp?PY+N5) a free educational webinar during Lung Cancer Advocacy Week.
The Deadliest Cancer
While lung cancer is the third most diagnosed cancer, it is the deadliest, killing more people in the U.S. than breast, colon and prostate cancers combined. Tobacco remains the leading risk factor for lung cancer.
The U.S. Preventive Services Task Force recommends annual low-dose CT lung cancer screenings for people who:
- Are between 50 and 80 years old, and
- Have a 20 pack-year or more smoking history (such as smoking one pack a day for 20 years or two packs a day for 10 years), and
- Currently smoke or have quit within the past 15 years
Dr. Bostock suggests speaking to your primary care physician about screening even if you smoke less. “Early detection of lung cancer improves a patient’s chances of surviving by 20 percent. It’s the most impactful thing we can do,” he said. “It’s a simple message: Get a low-dose CT scan.”
The Surgical Revolution
If symptoms, imaging and physical exam indicate lung cancer is probable, surgeons will do a biopsy to confirm the diagnosis. “Using a local anesthetic, we can guide a needle into the chest and grab a small piece of the tumor,” Dr. Bostock said, “or we can do a robotic bronchoscopy under general anesthesia, introducing a video camera through the windpipe to the tumor and taking a small segment of tissue.”
Just as biopsy techniques have changed, so too have surgical approaches. Gone are the days when removing a lung tumor required large incisions and lengthy recoveries. Robotic surgery uses tiny incisions and provides surgeons with enhanced precision and visualization.
“About 80 percent of our patients go home the day after their procedure,” Dr. Bostock said. “The benefits are substantial and include less pain, a faster recovery, lower complication rates and better outcomes. Patients return to normal life much more quickly than with traditional surgery.”
Precision Medicine Targets Cancer at Molecular Level
While robotic techniques have revolutionized the surgical approach to lung cancer, advances in precision medicine, featuring an arsenal of new, sophisticated drugs, are transforming how doctors select and tailor treatments for each patient.
Precision medicine is fundamentally changing lung cancer treatment, said Dr. Eiseler. “What has changed survival is our ability to study the tumor and to understand the molecular makeup of your tumor. Now we are able to match patients to specific therapies based on their tumor’s unique characteristics.”
One of the first breakthroughs was the development of EGFR inhibitors in 2003. These medications target specific mutations in lung cancer cells, blocking the EGFR protein that can cause cancer cells to grow out of control. “Testing for the EGFR mutation became the standard of care and really marked the beginning of personalized medicine,” she noted.
In 2007, the first ALK inhibitors became available. Although fewer than 5% of lung cancer patients have an ALK mutation, they are often resistant to therapy. And, in 2021, medications that block the KRAS G12C mutation, once thought impossible to target, were approved.
The newest class of drugs — antibody drug conjugates (ADCs) — seek out and target cancer cells, releasing their toxic payload within the cell itself. Medications such as Enherlu, Datroway and Emrelis are dramatically improving overall survival rates for specific mutation types, Dr. Eiseler said.
Clinical Trials at Miami Cancer Institute
Also providing breakthroughs in treatment, as well as greater insights into lung cancer, are cutting-edge clinical trials at Miami Cancer Institute. Dr. Eiseler shared several exciting clinical trials currently available:
- The COPERNICUS trial is testing a dual-target medication that addresses both EGFR and MET mutations. The drug is delivered through a skin injection rather than an IV.
- The SUNRAY-01 and SUNRAY-02 (opening soon) trials combine targeted therapy with immunotherapy to potentially improve survival.
- INTerpath-002 is a potentially groundbreaking cancer vaccine study. It is determining if the vaccine, developed from a person’s own tumor, combined with the drug pembrolizumab, can prevent lung cancer from returning in patients who have had surgery to remove Stage II-IIIB non-small cell lung cancer followed by chemotherapy.
The bottom line, the experts say, is that advances in cancer care have made it possible for lung cancer patients to live longer than ever. But early detection is still key. For information, or to schedule an appointment for a lung cancer screening, go to lung cancer screenings or call 833-596-2473.
Featured Providers
Ian Christopher Bostock Rosenzweig, MD
Ian C. Bostock, M.D., MS, FACS, is a board-certified thoracic surgeon at Baptist Health Miami Cancer Institute. He specializes in treating lung and esophageal cancer, mesothelioma, mediastinal and chest wall tumors, and benign esophageal diseases such as reflux, achalasia, and paraesophageal hernias.
Dr. Bostock serves as an associate professor of surgery at Florida International University. Prior to joining Baptist Health, he was an assistant professor in the Department of Cardiothoracic Surgery at the Medical University of South Carolina.
Dr. Bostock earned his medical degree and a master’s degree in Science and Clinical Investigation at Anáhuac University Medical School in Mexico City, Mexico. He completed a general surgery internship at Brigham and Women’s Hospital, Harvard Medical School and a general surgery residency at Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth. He also completed a cardiothoracic surgery fellowship at MD Anderson Cancer Center, The University of Texas.
Dr. Bostock has received several awards for his research in cardiovascular and thoracic surgery. He has published numerous peer-reviewed articles, abstracts and book chapters and has presented at many national academic conferences. He is a fellow of the American College of Surgeons and member of several professional associations.
The focus of Dr. Bostock’s care philosophy is patient-centered care and shared-decision making. He believes that each patient should be viewed as an individual and care plans should reflect the patient’s values, goals and motivations.
Dr. Bostock is fluent in English and Spanish. When he is not treating patients, he enjoys spending time with his wife and kids and dog, Oli. He also likes to stay active, work out on his Peloton bike and travel to exciting places with his wife.
Nicole Therese Eiseler, MD
Nicole Eiseler, M.D., is a medical oncologist at Miami Cancer Institute subspecializing in the treatment of soft tissue and bone sarcomas, and thoracic medical oncology. Her interest in soft tissue sarcoma began when she worked as a medical oncologist treating sarcomas of the uterus. She has additional expertise in cancer-related blood clotting disorders. When treating patients for their sarcoma diagnosis, Dr. Eiseler emphasizes the importance of close communication between all subspecialties, including surgery and radiation oncology. She takes great pride in the team she works with at Miami Cancer Institute and the shared vision of helping a patient maintain quality of life during and after treatment. Related to the future of medical therapy for the treatment of sarcomas, Dr. Eiseler is particularly excited that personalized medicine utilizing genetic testing is playing an increasingly important role. She believes the more we can predict how a patient might respond to a certain drug, the better the outcome and quality of life will be.
