Fall 2009

Targeted Treatments for Lung Cancer

Lung cancer is the leading cause of cancer death worldwide. UCSF Thoracic Oncology Program is at the forefront of treating patients with early- through advanced-stage lung cancer, mesothelioma, esophageal cancer, sarcoma and other forms of lung cancer, and is also a leader in clinical and translational research.

"We are patient advocates in the operating room, the clinic and the tumor board," said David Jablons, M.D., chief of the section of General Thoracic Surgery and leader of the Thoracic Oncology Program.

"Many patients who have been referred to us have technically challenging tumors which they have been told cannot be resected because they are too frail, or the tumor is too big or invasive," said Jablons. "With our surgical skills, combined with the expertise of our medical oncologists, radiation oncologists, interventional radiologists and others all working together, we can often do a complete resection that leads to a cure in patients who otherwise would be relegated to recurrent disease and poor outcomes."

The Thoracic Oncology Program is a high-volume center performing nearly 600 operations annually. Its perioperative mortality rate is less than 1 percent, even though the program treats some of the most acutely ill patients. The program is particularly skilled in achieving local control of lung cancer, which is made possible by innovative, combined modality treatments tailored to each patient.

For example, a patient may receive preoperative induction chemotherapy or chemoradiation therapy to shrink the tumor prior to resection. Through translational research, surgeons are discovering targeted, molecularly guided approaches made possible by histological analysis. UCSF Medical Center has developed an early-stage prognostic gene analytical method that predicts outcomes for stage 1 lung cancer patients, which could help determine the most effective treatments for a patient with a particular type of lung cancer.

UCSF Medical Center surgeons are also leaders in minimally invasive techniques, including minimally invasive thoracotomy and thoracoscopy as well as esophageal surgeries. These procedures have a low perioperative mortality rate and shorter hospital stays for the patient.

The Thoracic Oncology Program also has a robust clinical research program. It currently has seven open clinical trials, and is testing state-of-the-art therapeutics for patients with esophageal cancer, mesothelioma, non-small cell lung cancer, small cell lung cancer and solid tumors. The program has a history of pioneering successful new drugs, including Avastin and Alimta, which are now the dominant, front-line drugs for advanced-stage lung cancer.

Worldwide Leaders

To bring the latest therapies to patients who would otherwise not have access to them, the Thoracic Oncology Program established the Institute for Thoracic Surgery and Thoracic Oncology. This institute partners with Sequoia Hospital in Redwood City to enroll patients in clinical trials, and is about to expand to other hospitals in San Francisco and the South Bay. UCSF Medical Center surgeons also treat veterans at the San Francisco Veterans Affairs Medical Center, providing them with the most advanced standard of care.

Building on 15 years of collaborative work with leading scientists in China, the institute also launched the China Clinical Trials Consortium. This consortium will offer potentially lifesaving therapeutics to thousands of patients in Beijing, Shanghai and Guangzhou.

In the next two decades, China is predicted to experience an epidemic of lung cancer and mesothelioma as a result of widespread smoking, increasing industrial pollution, unregulated asbestos control and apparent genetic susceptibilities. Results from these clinical trials will help accelerate the pace of clinical research, while helping patients who would otherwise face poor outcomes.

This summer, the Thoracic Oncology Program co-hosted the International Association for the Study of Lung Cancer's 13th World Conference on Lung Cancer, with Jablons as conference co-chair. Nearly 7,000 health care professionals dedicated to lung cancer attended. In addition to co-hosting this definitive lung cancer meeting, the Thoracic Oncology Program has also established and co-chaired many conferences, including the International Lung Pan Pacific Cancer Conference, the UCSF/UC Davis Thoracic Oncology Conference, the UCSF Clinical Cancer Update and Summit 2007.

"There's one common theme for everything we do, and that's excellence," said Jablons. "From our medical oncology group to our interventional radiology group and our thoracic surgical interventions, we have the best outcomes and the most state-of-the-art treatments. What we do daily is all for the benefit of our patients, and our goal is to do it extremely well."

Consultations and Referrals

For more information, call David Jablons, M.D. at (415) 885–3882 or email david.jablons@ucsfmedctr.org.

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