October 2013

Thoracic Oncology Program at UNC Lineberger

 

The UNC Thoracic Oncology Program brings leading-edge multidisciplinary and compassionate care to patients with thoracic malignancies. Incorporating specialists from pulmonary medicine, surgery, medical and radiation oncology, thoracic radiology, pathology, and oncology nursing into a single patient care team, our team ensures that expertly developed care is individualized for each patient and delivered in a well-coordinated and caring manner.

To make a referral, call the Program Coordinator at 919-966-8128. For additional information, visit the program's website.

Find out more about the Thoracic Oncology Program by watching this video of Dr. M. Patricia Rivera, MD, FCCP, Professor of Medicine, UNC Division of Pulmonary and Critical Care Medicine.

Screening for Lung Cancer

Projections show that there will be 8,040 new cases of lung cancer in North Carolina in 2013. Lung cancer is the leading cause of cancer deaths in the United States, killing more people each year than colon, breast, prostate, and pancreatic cancers combined. Why is there such poor survival? The answer lies in the fact that the majority of patients with lung cancer present with advanced stage disease at the time of diagnosis; only about 26% of NSCLC patients present with stage I disease, which is the most curable stage. Until recently, screening for lung cancer was not recommended because no study had demonstrated that screening decreased mortality. This changed when results of the National Lung Screening Trial (NLST) were published.

 

The NLST, the first study to determine the impact of low-dose computed tomography (LDCT) screening on lung cancer–associated mortality, was a randomized study of 53,454 high-risk individuals; participants were 55–74 years old, had a smoking history of at least 30 pack-years, and were current smokers or had quit within the preceding 15 years. The study compared 3 annual screenings with either LDCT or single-view chest radiography, and it found a relative reduction in lung cancer–specific mortality of 20% over a median follow-up period of 6.5 years in patients randomized to the LDCT screening arm compared with patients in the chest radiography arm.

Recently, the U.S. Preventive Services Task Force (USPSTF) issued a grade B recommendation for annual LDCT lung cancer screening for adults aged 55–79 years who have a 30 pack-year history of smoking and who currently smoke or who quit in the past 15 years. A grade B recommendation means that USPSTF believes that "There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial."

At UNC, we have a multidisciplinary team of clinicians including pulmonologists, thoracic surgeons, internists, family practitioners and chest radiologists who participate in screening for lung cancer. We have modeled our practice to include adherence to NLST CT scan protocols and interpretations, as well as to recently published guidelines and USPSTF recommendations. We strongly advocate for smoking cessation and are fortunate to have an excellent smoking cessation program to partner with. In addition, our research goal is to examine the delivery and quality of lung cancer screening in North Carolina by creating a prospective population based registry that captures patient, physician, and outcome information on the use of LDCT.

New faculty members join the Thoracic Oncology Program

Dr. Jason Akulian, MD, MPH

Jason Akulian, MD, MPH, assistant professor of medicine, is an interventional pulmonologist interested in the early diagnosis and treatment of lung cancer. His focus is on the use of multidisciplinary teamwork to treat patients with malignant central airway obstructions. His research interests also include the use of palliative care and treatment of malignant pleural diseases, including metastatic lung cancer.

A graduate of the St. Georges University School of Medicine, Dr. Akulian served as an Interventional Pulmonology Fellow at Johns Hopkins University before coming to UNC.

Dr. Jason Long, MD, MPH

Jason Long, MD, MPH, assistant professor in the UNC Division of Cardiothoracic Surgery, is a surgeon specializing in thoracic and lung transplant surgery. His research involves finding ways to expand the pool of available donor lungs for transplant. He is preparing a grant to study survival in transplant recipients from brain-dead and non-heart beating donors using animal models.

A graduate of the Wake Forest School of Medicine, Dr. Long served as a cardiothoracic surgery resident at the University of Michigan before coming to UNC.

Dr. Chad Pecot, MD

Assistant Professor Chad Pecot, MD, assistant professor, is a lung cancer specialist with an interest in how RNA interference regulates cancer metastases. As metastases are responsible for the majority of cancer deaths, Dr. Pecot researches how to target the metastatic process using nanoparticle-based drug delivery.

Another area of research that Dr. Pecot's lab will explore is using The Cancer Genome Atlas to explore the cellular regulatory networks involved with metastatic lung cancer, specifically adeno and squamous carcinomas. The ultimate goal is develop microRNA-based therapies to inhibit metastases in these cancers. He also intends to explore nanoparticle-based inhibitors for use in the KRAS oncogene.

Dr. Pecot served as an Oncology Fellow at the MD Anderson Cancer Center in Houston before coming to UNC.

Selected clinical trials in Thoracic Oncology

NEW! 2B3-101-CR-001: An open-label, Phase I/IIa, dose escalating study of 2B3-101 in patients with solid tumors and brain metastases or recurrent malignant glioma (PI: Anders)

9090-14: A Randomized, Phase 3 Study of Ganetespib in Combination with Docetaxel versus Docetaxel Alone in Patients with Advanced Non-Small-Cell Lung Adenocarcinoma (PI: Weiss)

CALGB31102: Phase I Study of Accelerated Hypofractionated Radiation Therapy with Concomitant Chemotherapy for Unresectable Stage III Non-Small Cell Lung Cancer (PI: Stinchcombe)

ECOG5508: Randomized Phase III Study of Maintenance Therapy with Bevacizumab, Pemetrexed, or a Combination of Bevacizumab and Pemetrexed Following Carboplatin, Paclitaxel and Bevacizumab for Advanced Non-Squamous NSCLC (PI: Stinchcombe)

LCCC1030: A Phase Ib Study of Bavituximab plus Carboplatin and Pemetrexed in Chemotherapy-Naïve Stage IV Non-Squamous Non-Small Cell Lung Cancer (PI: Grilley-Olson)

LCCC1034: Gene Expression Profiling of Bronchial and Nasal Epithelial Cells: A Novel Approach to Screening High Risk Patients for Lung Cancer (PI: Rivera)

LCCC1210: Tolerability of weekly nab-paclitaxel as second line treatment for elderly patients with advanced lung cancer (PI: Weiss)

LCCC1309: Prospective pilot study of high-resolution manometry to assess radiation-induced changes in esophageal function in patients with lung cancer (PI: Zagar)

RC1126: Randomized Phase II Trial of Erlotinib Alone or In Combination with Bevacizumab in Patients With Non-Small Cell Lung Cancer and Activating Epidermal Growth Factor Receptor Mutations (PI: Stinchcombe)

RTOG0937: Randomized Phase II Study Comparing Prophylactic Cranial Irradiation Alone to Prophylactic Cranial Irradiation and Consolidative Extra-Cranial Irradiation for Extensive Disease Small Cell Lung Cancer (ED-SCLC) (PI: Zagar)

UWCC-1: Improving Access to Treatment for Lung Cancer Patients (AccessTLC): Main Needs Assessment Study (PI: Weiss)

 

 

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For questions about all clinical trials at UNC, contact the UNC Lineberger Protocol Office at 919-966-4432 or (toll-free) 1-877-668-0683. For questions about clinical trials offered at other sites, contact the UNC Cancer Network at 919-966-7359 or (toll-free) 1-877-668-0683.

 

To make an appointment at the N.C. Cancer Hospital for one of your patients, visit our web page for referring physicians. You may also contact the Carolina Consultation Center at 1-800-862-6264.