Lung Cancer Research Highlights

Grantee: Fang Lei, MPH
Institution: University of California, Los Angeles
Area of Focus: Health Professional Training in Cancer Control
Term: 7/1/2019 to 6/30/2021

The Challenge: Just as in the general US population, lung cancer is the leading cause of death from cancer among Chinese Americans. Regularly screening people who are at higher risk for lung cancer can help reduce the number of deaths from the disease. However, lung cancer screening isn’t often used as recommended in the US. Previous studies have found that this may be because of people’s cultural beliefs, especially among minorities. Scientists have created a tool called the Lung Cancer Screening Health Belief Scales (LCSHBS). It looks at what people see as the risks, benefits, and challenges of getting screened. But there is no version of this tool that’s culturally sensitive to Chinese Americans. 

Note: The ACS recommends yearly screening for lung cancer with low-dose computed tomography (LDCT) in adults age 55 to 74 who meet certain criteria.

The Research: Fang Lei, MPH and her  team want to fill that gap by translating the LCSHBS into Chinese and ensuring it’s culturally appropriate. They’ll test their revised LCSHBS with 120 Chinese Americans who were born in China and are now living in the US. The participants will be 55 to 74 years old who are fairly healthy and are either current smokers or who quit smoking in the last 15 years. To be eligible to review the tool, participants will have had to have smoked at least 1 cigarette pack a day for 30 years. 

The Goal and Long-Term Possibilities: The revised LCSHBS could provide a more accurate look at Chinese Americans’ beliefs about lung cancer screenings, which could help increase the number of screenings. The study may also help in designing lung cancer screening programs specifically for Chinese Americans. 

Grantee: Pasi A. Jänne, MD, PhD
Institution: Dana-Farber Cancer Institute in Boston
Area of Focus: Cancer Drug Discovery
Term: 7/1/2017 to 6/30/2022

The Challenge: Epidermal growth factor receptor (EGFR) is a protein on the surface of cells. Normally, it helps cells grow and divide in the usual way. Some non-small cell lung cancer (NSCLC) cells have a hyperactive EGFR, which makes the cancer cells grow faster. These gene mutations are more common in women, people who haven’t smoked (or light smokers), and in Asians, especially people from China.

NSCLC is hard to treat, but targeted (or precision) therapies tend to work better than traditional chemotherapy. Drugs called EGFR inhibitors can block the signal from EGFR that tells the cells to grow. But so far, within 1 or 2 years the drugs stop working in almost all people with EGFR mutant lung cancer, meaning patients have developed a resistance to the treatment.

The Research: American Cancer Society Clinical Research Professor Pasi Jänne, MD, PhD, was one of the researchers who discovered EGFR mutations and has led the development of treatment strategies for patients with EGFR mutant lung cancers. Jänne and his team are now developing and evaluating combination therapies to prevent or treat resistance to precision therapies. With his ACS grant, he is conducting preclinical studies in mice and clinical trials with lung cancer patients.

The Goal and Long-term Possibilities: Jänne hopes this research will help extend the lives of people with lung cancer that has an EGFR mutation and help scientists develop new targeted therapies for other types of lung cancer. He believes this work could improve the outcome for many people with lung cancer.

Grantee: Carla F. Kim, PhD
Institution: Children's Hospital Boston
Area of Focus: Mission Boost
Term: 1/1/2019 to 1/1/2021

The Challenge: Precision medicine is like having a special dart that heads right for the bulls’ eye on a dartboard. When doctors know which exact mutation a cancer cell has, they know which targeted treatment will be most likely to work.

Right now, there aren’t any approved targeted treatments for a specific mutation in the SMARCA4/BRG1 gene that appears in up to 20% of non-small cell lung cancer (NSCLC). These cancers are called BRG1-deficient lung cancers.

The Research: In earlier studies, Carla Kim, PhD, found a potential precision treatment for BRG1 mutations in NSCLC using drugs that target a protein called ATR and block its function. With her grant from ACS, Kim’s team is using patient-derived xenografts, which are mice that have had lung cancer tumors implanted in them. The goal is to see whether treatments that block ATR work better than the current standard treatments used for this kind of lung cancer.

The Goal and Long-term Possibilities: ATR inhibitors are already being used in Phase 1 (human) clinical trials for other types of cancer. If Kim’s team gets positive results in mice, these treatments also might move quickly to human clinical trials for lung cancers with BRG1 mutations.

Grantee: Kathrin Milbury, PHD
Institution: University of Texas MD Anderson Cancer Center in Houston
Area of Focus: Cancer Control and Prevention Research
Term: 1/1/2019 to 12/31/2022

The Challenge: People living with lung cancer may have symptoms like fatigue and depression. Their partners, who are often caregivers, also report high rates of fatigue, disturbed sleep, depression, and anxiety. Support programs that recognize both partners are affected by lung cancer can help them improve their quality of life.

The Research: Previous studies by Kathrin Milbury, PhD, showed promising results for using yoga as a way to improve symptoms and quality of life of patients and their partners during the weeks of radiation treatment. Now, Milbury is doing a larger study with the support of an ACS grant.

During 6 weeks of radiation treatment, patients and their partners are randomly assigned to 1 of 3 groups: couples’ yoga, patient-only yoga, or no yoga. Those in the yoga groups receive 15, 1-hour sessions of yoga. All patients and their partners fill out reports on their symptoms and quality of life before being assigned to a group and answer the questions again during the last week of radiation, and 1, 3, and 6 months after radiation is done.

The Goal and Long-Term Possibilities: Milbury’s team wants to see if taking yoga improves physical function and quality of life in lung cancer patients receiving radiation therapy. They also want to learn whether taking yoga with a partner helps more than doing yoga alone. The results have the potential to give lung cancer patients and their partners another way to boost their quality of life.

Grantee: Bettina Hoeppner, PhD
Institution: Massachusetts General Hospital in Boston
Area of Focus: Cancer Control and Prevention: Psychosocial and Behavioral Research
Term: 7/1/2017 to 6/30/2021

The Challenge: Smoking rates overall haven’t gone up in recent years, but there has been an increase in people who smoke occasionally (not every day), which is still a big risk factor for cancer. Most quit-smoking programs and treatments are focused on helping with nicotine dependence, which may not be an issue for non-daily smokers. So when they want to quit, there may not be much to help them. 

The Research: Hoeppner and her team developed a smartphone app that uses positive psychology exercises to help non-daily smokers quit. It’s built to deliver personalized behavioral counseling by:

• Assessing their readiness to change and guiding them on how to get ready
• Focusing on users’ awareness of positive experiences and encouraging them to pay attention to and savor the experiences.
• Offering customized, interactive tools that provide motivational messages, reminders, information about the benefits of quitting, just-in-time support, and tips about how to combat negative thoughts
• Having a way for users to keep track of their progress 

Hoeppner’s team tested Version 1.0 of the app and 9 out of 10 users said the app helped them smoke less. They liked the reminder to stay on track the best. Hoeppner updated the app based on users’ feedback and is testing the updated version with more non-daily smokers. 

The Goal and Long-term Possibilities: The positive exercises in the app that focus on the mental and emotional part of smoking have the potential to enhance or maintain happiness, which may help non-daily smokers to feel more confident, have less desire to smoke, and have a less positive view of smoking. The app is available for free on Google Play and iTunes.

To learn more about Hoeppner's app, listen to this podcast: Smiling Instead of Smoking: An app to help non-daily smokers quit.