Genomics of Young Lung Cancer Study

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Genomics of Young Lung Cancer Study

geoffrey-oxnard

Geoffrey R. Oxnard, MD
Dana-Farber Cancer Institute

barbara-gitlitz

Barbara J. Gitlitz, MD
University Southern California

Lung cancer at any age is a catastrophic illness but it is particularly devastating when it affects young adults in the prime of their life. In other cancers, such as breast cancer and leukemia, research has clearly demonstrated that occurrence at a younger age is associated with a distinct biology that guides treatment. Thus, development of a unique treatment approach for young lung cancer is needed. The reason lung cancer occurs in young adults is not clear and this question has never been formally studied.

 

Click on a topic below more more information.

This research study, facilitated by the patient-founded Addario Lung Cancer Medical Institute (ALCMI), includes collaborating institutions in the United States and Europe: University of Southern California, Los Angeles, CA (Barbara Gitlitz, MD), Dana-Farber Cancer Institute, Boston, MA (Geoffrey Oxnard, MD), University of Torino, Turin, Italy (Giorgio Scagliotti, MD, PhD), and soon others.

Study Objectives

To perform a focused, multi-institutional, prospective genomic analysis of primary lung cancer occurring in 60 patients diagnosed at age less than 40 years to provide new insight into lung cancer biology, facilitate the identification of new genome-defined subtypes of lung cancer, accelerate delivery of targeted therapies and lay the groundwork for further studies of lung cancer risk and inheritance.

Inclusion Criteria

Men or women age less than 40 years at lung cancer diagnosis

Diagnosed with bronchogenic lung carcinoma (non-small cell or small cell) of any stage at any treatment time point. The study participant does not need to be treatment naïve or between treatments to participate in this study.

For individuals diagnosed with advanced disease (stage IV or recurrent) enrollment must occur within 2 years of diagnosis

Impact on Lung Cancer Community

We hope this study will lay the groundwork for discovery of novel targetable genotypes as well as heritable and environmental lung cancer risk factors. Performing comprehensive genomics on lung cancer tumors from patients diagnosed at age 40 or younger represents a new and untapped strategy for identification of new targetable genotypes. Discovery of these genotypes is the first step in developing specific drugs to target and inhibit these mutations that drive the cancer. Our results may be an impetus for other groups to further explore other specific populations of lung cancer until it is no longer a disease with a “cookie cutter” approach to treatments and rather one where a personalized approach leads to significantly improved outcomes.

Historical data suggests that roughly 22% of patients will receive targeted therapies for their lung cancer; but we believe that this could be higher in the young lung cancer population. Research genomics prospectively exploring a distinct genomic signature in young lung cancer patients is a driving force of this study.

A unique focus of our project is that
we want to benefit our study participants now!

Thus, we will also review a comprehensive panel of clinical genomics looking for target mutations for which a drug might exist on or off of a clinical trial. We will share this information with the study participant and their referring oncologists in “real time” in order to possibly facilitate treatment options.

Our evolving understanding of lung cancer and new molecular tools to
study the genomic make up of cancer has set the stage for this exciting study.

It is becoming increasingly evident that this disease can be divided into different subgroups based upon certain clinical characteristics. For example, lung cancers in non-smokers and East Asians more commonly carry mutations in the EGFR gene, whereas lung cancers occurring in patients with a smoking history more commonly carry mutation in the KRAS gene. Each of these genomic subtypes of lung cancer requires a different treatment approach.

More recently, two new genomic sub-types of lung cancer have been identified, with mutations in the ALK and ROS1 genes. Interestingly, both of these types of lung cancers are associated with a younger age of diagnosis. Both of these sub-types are also treatable with a new targeted drug called crizotinib. This suggests that young age may be an under-appreciated clinical marker of new genomic subtypes to be discovered. An important hope for this research project is that we will find a new genotype-defined sub-type of lung cancer deserving a distinct treatment strategy.

Very little is known about familial or inherited lung cancer. It has long been appreciated that there exists familial clustering of lung cancer that cannot be completely explained by environmental exposures. This study initiates a new perspective on inherited lung cancer risk by studying patients most likely to carry an inherited predisposition – those with lung cancer at a young age. We will study both the tumor for mutations and also normal tissue (blood cells) looking for mutations that might be an inherited step leading to lung cancer in these young people. This project, therefore, represents a first step in a broader effort to use young lung cancer to better understand inherited and environmental risks for lung cancer.
This study is currently open to enrollment at USC and will be available at other institutions in the US and Europe in the near future.

Do you live near or are you a patient at USC?
If you live near or are a patient at USC, please contact Nancy Berman, RN, BSN, OCN, Lung Nurse Navigator, USC/Norris Comprehensive Cancer Center at 323-680-3534 or by email at nancy.berman@med.usc.edu or Gina Tse, RN, Protocol Coordinator, USC/Norris Comprehensive Cancer Center at 323-865-0514 or by email at tse_g@med.usc.edu for more information on how to participate in this study.

Don’t live near USC?

You do not need to visit an enrolling institution to participate. Individuals with lung cancer living anywhere in the United States can participate in this study, if eligible.

  1. The first step is to review and sign the informed consent form. An informed consent form is a document that details your rights as a voluntary participant in a research study. It also details the activities involved in the research study. Click on the “View Informed Consent Form” button to access the document.
  2. After you electronically sign the informed consent form, your screen will refresh and you will be asked to complete a brief, mandatory pre-screening questionnaire. The questionnaire will help determine your eligibility for the study. Your questionnaire responses will be reviewed by a member of the study team and you will be contacted with next steps.

If you have any questions regarding the online informed consent form or this study please contact Nancy Berman, RN, BSN, OCN, Lung Nurse Navigator, USC/Norris Comprehensive Cancer Center at 323-680-3534 or by email at nancy.berman@med.usc.edu or Gina Tse, RN, Protocol Coordinator, USC/Norris Comprehensive Cancer Center at 323-865-0514 or by email at tse_g@med.usc.edu.

 

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