Our science team offers an overview of the three lung cancer studies presented at the ASCO Annual Meeting’s plenary session, and an update on this year’s Research Advocates program. Watch the video below.
Featured:
Aubrey Rhodes, LCRF Executive Director
Dhru Deb, PhD, Senior Director, Research & Administration
Antoinette (Toni) Wozniak, MD, Chief Scientific Officer
The 5-year outcomes of the CROWN trial were presented at the annual American Society of Clinical Oncology (ASCO) meeting with results showing the longest progression-free survival in anaplastic lymphoma kinase positive (ALK+) non-small cell lung cancer (NSCLC) to date.
The standard of care for the first-line treatment of patients with advanced ALK+ lung cancer is an ALK tyrosine kinase inhibitor (TKI). Lorlatinib is a third generation ALK-TKI. The CROWN study is a Phase 3 trial in which 296 ALK+ patients received crizotinib, a first generation ALK-TKI, or lorlatinib.
The initial results of the trial showed that lorlatinib was superior to crizotinib1 and it is FDA approved for the treatment of metastatic ALK+ NSCLC. The update presented at the ASCO meeting revealed that after 5 years of follow-up, the median time of disease control or progression-free survival was not yet reached for lorlatinib and was only 9.1 months for the patients treated with crizotinib. At 5 years, 60% of the patients receiving lorlatinib still had no progression of their disease. Loratinib also demonstrated both superior control of existing brain metastases and a reduction in the eventual development of brain metastases.2
What It means for patients
Lorlatinib is very effective in the treatment of patients with advanced ALK+ NSCLC. Of importance is its ability to control existing brain metastases and prevent the development of new central nervous system disease. There were no new side effects of concern related to the longer time on treatment. Side effects associated with lorlatinib treatment can include increased cholesterol and triglycerides, weight gain and cognitive effects among others. Patients should always discuss risks and benefits and options for treatment with their oncologist.
What to look for
Progress is being made in the treatment of metastatic ALK+ NSCLC. Unfortunately, these new advancements do not represent a cure for the vast majority of patients. It is very important to determine how cancer cells develop resistance to treatment. Look for new research in overcoming resistance and novel approaches to treatment.
It is with great sadness that we learned of Laura Greco’s passing on July 14, 2024.
Laura was a self-described fighter and lung cancer activist, determined to take on her disease while working to increase funding for lung cancer research. She served as a lung cancer research consumer reviewer on the Congressionally Directed Medical Research Program (CDMRP) and many lung cancer advocacy organizations in multiple capacities. Her commitment to educating elected officials, the medical community, and the community at large was second only to her commitment to her family.
Laura’s “Die, Cancer, Die” campaign in 2022 rallied the lung cancer community, supporting her desire to defeat the disease that had invaded her brain while continuing to remind people that all you need to get lung cancer is a pair of lungs. Laura continually told her story to underscore this fact and to contribute to improving general awareness of lung cancer and the huge disparity in lung cancer research funding compared to other, less deadly, cancers.
LCRF was one of many beneficiaries of Laura’s energy and determination.
The lung cancer community has lost a champion, and she will be missed by so many. We send our condolences to her husband, her sons, and all who loved her.
October 2022
Laura Greco is facing a nemesis that has threatened her numerous times. And she has made her beef public, emblazoning her bold intention towards her enemy right across her chest.
Laura has lung cancer. On September 23, 2022, she put on the outfit she has worn for every first day of treatment since 2018: a simple black t-shirt with the words, “Die, Cancer, Die!” across the front. Then she began her third assault on a brain tumor that has refused to go away.
“It seems like the third time is the charm for me,” Laura noted. “This is my second brain radiation therapy on this tumor. And, I’ve had a brain surgery to try to remove it. I’ve nearly died twice, saved by my husband both times. And, I keep fighting. I’m still here.”
To mark that first of six rounds of radiation, she posted a photo of herself on Twitter with the caption “Really pumped up to kill my cancer today. Die Cancer, Die!” To Laura’s surprise, the tweet took off – 30,000 likes, more than 800,000 views, and shared nearly 1,000 times within a few short days. She saw an opportunity to raise awareness that anyone with lungs can get lung cancer, and, maybe, raise a few dollars for research in the process.
Really pumped up to kill my cancer today. Die Cancer, Die! #1 done, 5 more to go. #LCSM pic.twitter.com/DzV4SyoN9R
— Laura Greco (@lgreco_ny) September 23, 2022
As a seven-year lung cancer survivor under the age of 50 with no risk factors for the disease, Laura knows how important it is to spread the word that anyone with lungs can get lung cancer. The mom, wife, and lawyer from Saratoga Springs, NY, has become a full-time advocate for lung cancer awareness and funding for research.
“Among the many things I have learned over the last seven years: we deserve better, and we should get better – better attention, better treatment, better survival, and it is only with more research that we will get there. The cure is out there, and we just have to fight for it. It is up to us to advocate for ourselves, to fight for recognition at all levels of government, all levels of society. People need to know that they don’t need to be ashamed of their diagnosis and they matter.”
By raising her voice and sharing her fight, she has given lung cancer survival a national platform – all while under treatment. “I wanted to focus on living and do more advocacy. God put me on this earth to be the beacon for other people with this disease and show them that we can survive it.”
Laura is determined to defeat her tumor. She simply will not allow it to defeat her. “I have lost many friends, and they say it just takes one tumor to kill you. I will not allow that to happen. This is the time that I am going to kill it before it kills me.”
Her journey to this point has been harrowing at best. The mass in her lung led to an initial diagnosis in 2015 of Stage 3A non-small cell adenocarcinoma lung cancer, driven by a translocation within the ALK gene. At that time, the targeted therapy, alectinib, was not yet approved by the FDA for first-line treatment. She was prescribed two rounds of chemo concurrent with six weeks of radiation, followed by surgery to remove the mass in her left lower lung.
“The results weren’t great. I was 40 and had young kids. I kept asking, what can you do for me. I have young kids. I refuse to die. The answer was to do four more rounds of chemo to ‘mop up’ any remaining cells. So, I did.”
Laura did four rounds of chemo and went back to her law practice. The next year had its ups and downs. Laura began having headaches, so she convinced her general practitioner to get her a head and neck MRI – that showed more than 10 tumors in her brain. She was able to start on alectinib days after it received breakthrough designation from the FDA but eventually experienced liver toxicity from the treatment. Going off it only caused the brain tumors to grow back and increase in number. She started back on alectinib and eventually increased to a 150% dosage, but one or two of the tumors continued growing.
In the summer of 2018, Laura had her first round of brain radiation.
“I started to feel worse, but I continued to live my life. I was traveling and fitting in brain mapping and the radiation treatment between trips. Things really went sideways in 2019.”
Unbearable head pain highlighted a new reality. The cancer in Laura’s brain was causing swelling and edema. At the recommendation of her medical team, she waited for the situation to improve on its own. It didn’t. Ultimately, Laura had an emergency brain surgery in early November of 2019, which led to two further surgeries.
Around that time, an actionable MET amplification was discovered in her ALK-driven lung cancer. She was the first to be prescribed a two-drug combination of alectinib for ALK and capmatinib for the MET amplification.
“I remained on the two-drug combo, but in the fall of 2020, it started to show signs that it was no longer working fully. They wanted to do an ALK drug plus chemo. I refused. Chemo doesn’t do much for the brain and it really reduces my quality of life. We agreed to radiating the four growing tumors along with the two-drug combo. It worked for a little over a year.”
In early 2022, Laura was scheduled for surgery because the tumor on the left side of her brain had grown. As a “Hail Mary” move, her alectinib dose was increased to 150% for 10 days ahead of the procedure. She was in pre-op when the surgeon announced that she didn’t need surgery that day; her scans showed significant reduction in the tumor that was scheduled for operation. She went home and went sledding with her kids to celebrate. Unfortunately, she had a seizure in April, after which she was scheduled to have some of her tumors surgically removed.
“It turned out that one of the tumors had the ALK mutation. That was completely resected. The other had a completely different genetic makeup. It was MET and EGFR amplified and was so intertwined with my motor function that to remove it would cause me to possibly lose the use of my hand. So, they didn’t get all of it. My ALK tumor was resistant to alectinib at this point, so the next drug to take would have to be loratinib. So, I suggested we test loratinib with capmatinib.”
Laura experienced a severe toxic reaction to loratinib – she lost her ability to speak coherently and to read. “It was the worst time of my life,” she said. It took 15 days for the drug to clear her system. She has lingering effects to this day. “With several dose reductions and hard work with a speech therapist, I have experienced significant improvement.” Laura was stable until about a month ago, when she had another seizure. Another scan showed more edema and growth in the MET-EGFR tumor.
“This is why I am getting radiation now – and that tumor has got to die.”
Laura is determined to beat her tumor, while continuing to advocate for more research funding, and living her life.
“Cancer is a thief, and we need to not let it be. We need to grasp the joy of living and realize how it can free us, too. By choosing to have this attitude, by knowing that the side effects can be managed, I can live with that. I am choosing to fight, and I will win.”
Learn more about Laura’s #DieCancerDie campaign at diecancerdie.org.
This May, Danyelle Shapiro and Ashley Katzen hosted their 7th annual Purple & White Fight Night in Boca Raton, FL. The two women started the event in 2014 in memory of Ashley’s mother, who died of pancreatic cancer at age 54, and Danyelle’s father, who lost his life to lung cancer at age 41.
Proceeds are divided evenly between the Lung Cancer Research Foundation and the Hirshberg Foundation for Pancreatic Research. This year’s event raised about $80,000.
The collaboration between Ashley and Danyelle was sparked by the impact cancer has had on their lives and the grim survival statistics for each disease. Their personal message is simple yet passionate: “Awareness is hope, and hope never quits!”
Dr. Estelamari Rodriguez from Sylvester Comprehensive Cancer Center attended the event and spoke on behalf of LCRF and the lung cancer community.
NEW YORK, NY (July 1, 2024) – The Lung Cancer Research Foundation (LCRF) is pleased to announce the appointment of Kathryn A. O’Donnell, PhD as its new Scientific Advisory Board (SAB) chair, effective July 1, 2024. Dr. O’Donnell succeeds Katerina Politi, PhD, who has served as chair of LCRF’s SAB since 2019.
Kathryn (Kate) O’Donnell, PhD, is an Associate Professor in the Department of Molecular Biology at UT Southwestern Medical Center and co-leader of the Development and Cancer Program in the Harold C. Simmons Comprehensive Cancer Center. She received her B.S. in genetics from Cornell University and her PhD in human genetics from Johns Hopkins School of Medicine, working with Chi Dang on the functions of the MYC oncogene, one of the most important drivers of human malignancy. Following graduate school, she joined Jef Boeke’s laboratory at Johns Hopkins and developed innovative approaches to identify genes that contribute to cancer and may represent new therapeutic targets.
In 2011, Kate was recruited to UT Southwestern Medical Center as an Assistant professor in the Department of Molecular Biology and a Cancer Prevention and Research Institute of Texas (CPRIT) Scholar. Since establishing her independent laboratory, Dr. O’Donnell has made important contributions to our understanding of cancer initiation and progression. She has discovered new cancer genes, including oncogenic cell surface proteins that may be targetable with therapeutic antibodies. Her current work is focused on understanding the mechanisms that contribute to lung tumor development, the regulation of immune checkpoint pathways, and applying insights from these studies towards the development of new therapies for lung cancer. Dr. O’Donnell has served as a member of LCRF’s SAB since 2022.
“I am thrilled and honored to chair LCRF’s Scientific Advisory Board and I look forward to working with my colleagues on the Scientific Advisory Board, the Board of Directors, and the amazing staff and leadership at LCRF to continue funding exceptional lung cancer research,” said O’Donnell.
“We are excited for Dr. O’Donnell to take the reins of the SAB from Dr. Politi,” remarked Aubrey Rhodes, LCRF’s executive director. “Dr. Politi leaves big shoes to fill. Her leadership has made LCRF’s research program what it is today – funding innovative research with the greatest potential to address unmet need and improve outcomes for the lung cancer community. Her efforts were integral in developing several multi-year, multi-million-dollar research partnerships that have accelerated the pace of lung cancer research. Under her leadership, the SAB developed a long-term vision through strategic planning and its research roadmap, which guides the foundation’s research investments. She has also strived to increase the diversity of the SAB. We’re grateful for her service and are especially thankful that she will remain on our SAB and Board of Directors, assuring a smooth transition for Dr. O’Donnell into her new role.”
Katerina Politi, PhD, Professor of Pathology and Internal Medicine at Yale School of Medicine, has led LCRF’s SAB for five years, overseeing the funding of more than $11 million in lung cancer research grants as well as the development of LCRF’s Research Roadmap and the founding of the organization’s Research Advocates volunteer group. She is a celebrated researcher herself, and a past beneficiary of LCRF’s early investigator grant awards, which provide her a unique perspective on both the process and the impact of early funding on a scientist’s career. Dr. Politi continues as a mentor to other researchers and a partner to LCRF’s board and staff.
“Dr. O’Donnell is an excellent scientist and will continue to build upon LCRF’s legacy of supporting lung cancer researchers and novel, innovative research ideas,” said Dr. Politi. “I’m confident that she will lead the SAB to achieve LCRF’s research priorities and improve outcomes for people with lung cancer.”
###
About the Lung Cancer Research Foundation (LCRF)
The Lung Cancer Research Foundation® (LCRF) is the leading nonprofit organization focused on funding innovative, high-reward research with the potential to extend survival and improve quality of life for people with lung cancer. LCRF’s mission is to improve lung cancer outcomes by funding research for the prevention, diagnosis, treatment, and cure of lung cancer. To date, LCRF has funded 419 research grants, totaling nearly $44 million, the highest amount provided by a nonprofit organization dedicated to funding lung cancer research. For more information, visit LCRF.org.
Contact:
Sheila Sullivan
Sr. Director, Marketing & Communications, LCRF
ssullivan@lcrf.org
Download recent updates from LCRF research grantees:
Drs. Benjamin Levy, Antoinette (Toni) Wozniak, and Isabel Preeshagul discussed the news from this year’s ASCO Annual Meeting – a premier scientific event for oncology professionals, patient advocates, industry representatives, and the media.
ASCO, or American Society of Clinical Oncology, is a leading organization for health care professionals involved in the care of cancer patients. Watch the video below.
It is with heavy hearts that we share the passing of an incredible member of our community, Ivy Elkins. The impact that Ivy has had on the lung cancer community cannot be adequately expressed in words. She touched so many people’s lives, both directly and indirectly, through her tireless advocacy for patients.
Whether through her official capacity as co-founder of the EGFR Resisters, or through her representation of lung cancer patients with the Department of Defense CDRMP, the NIH, and countless advocacy groups, Ivy was able to connect with others in a way that brought hope to the fore. She was instrumental in spearheading numerous fundraisers for lung cancer research. Ivy was also one of the people we counted on to host discussions that helped tie lung cancer research to its impact on people. She helped to forge connections between researchers and the beneficiaries of the research, always focused on the human element of advancements being made.
Her influence on lung cancer research and the lung cancer community will be felt for years to come. She will be sorely missed by us all.
Scalora Consulting Group‘s Helping Hand Fund golf tournament took place June 7, 2024, at the Red Tail Golf Club in Devens, MA and we are so excited to announce that they raised $55,000! Scalora Consulting Group’s Helping Hand Fund partnered with Related Beal to act as the lead sponsors for this event benefiting the Lung Cancer Research Foundation in loving memory of Jennifer Zannini-Cipriani.
Thank you so much to all the supporters, volunteers, Red Tail Golf Club staff, guests, players, and of course to the event sponsors without whom this event wouldn’t be possible: Scalora Consulting Group, Related Beal, Professional Electrical Contractors of CT, Inc., Consigli Construction Co., Inc., HGA, Suffolk Construction, Needham Bank, The Whiting-Turner Contracting Company, Columbia, Lawson & Weitzen, LLP, BOND Building Construction, Sterling Construction, Inc., BLOCK Builders, Inc., Erland Construction, and Commodore Builders.
Below are some photos from the event.
The results of three lung cancer trials – LAURA, ADRIATIC, and REACH PC – were among the top five presentations at the plenary session of the annual ASCO meeting. This is very unusual and speaks for the advances that are being made in the treatment of lung cancer.
LAURA trial: The standard of care (SOC) for treating stage 3 non-small cell lung cancer (NSCLC) that cannot be surgically removed and containing an epidermal growth factor receptor mutation (EGFRmut+) is chemotherapy and radiation, preferably given together. Despite aggressive treatment, most patients in this category are not cured. In the LAURA trial, over 200 patients with stage 3 EGFRmut+ NSCLC received either osimertinib or placebo after completing SOC chemoradiation. Patients who received osimertinib had control of their disease for a median of 39 months and 74% were alive and free of disease progression at 12 months, compared with 5.6 months and 22% for the placebo group. (Shun Lu et al, New England Journal of Medicine, DOI:10.1056/NEJMoa2402614)
ADRIATIC trial: Small cell lung cancer (SCLC) is a fast-growing type of lung cancer that represents 10-15% of lung cancers. The SOC for limited stage SCLC (limited to the chest) has been chemoradiation and there have been very few advances in treatment since the 1980s. In the ADRIATIC trial, patients with limited stage SCLC were treated with durvalumab (anti-PD-L1 immunotherapy) or placebo after SOC chemoradiation. Patients receiving durvalumab saw a significant improvement in median survival of 55.9 months, compared with 33.4 months for patients on placebo. At 2 years, 12% more patients who received immunotherapy were alive than those in the control group that just received SOC treatment.
REACH PC trial: Palliative care represents a number of services including but not limited to pain and symptom control, psychological and social support, and, when appropriate, end of life care. Palliative care is very important in the management of patients with lung cancer and is known to help them live longer and better. Telemedicine has become a frequently used tool in patient care, particularly as a result of the COVID pandemic. The REACH PC trial took place in multiple centers, led by the palliative care team from the Massachusetts General Hospital. Over 1,200 patients received palliative care through telemedicine or in-person visits. The primary outcome was patient-reported quality of life. Researchers found that the benefits of providing palliative care for patients diagnosed with advanced lung cancer were not diminished when delivered via telemedicine as opposed to in-person visits.
LAURA trial: Osimertinib is already being used in metastatic EGFRmut+ NSCLC and has also been approved for use as treatment after surgical removal of early-stage disease. It now has shown benefit for EGFRmut+ patients who have stage 3 NSCLC that is limited to the chest and is not able to be surgically removed. This represents a major advancement in treatment. Side effects of treatment were as expected and there were no new concerns. Mature survival results are awaited but it is likely that the survival advantage for osimertinib treatment will be maintained.
ADRIATIC trial: Chemotherapy and immunotherapy (atezolizumab or durvalumab) are the standard of care for the treatment of patients with extensive stage SCLC. The results of the ADRIATIC trial establish the use of durvalumab in the treatment of patients with limited stage SCLC. This is of particular importance considering there have not been any treatment advances for these patients in many years. The side effects associated with immunotherapy are well known and there were no new problems seen when it was used with chemoradiotherapy. Of note, there was no increase in the occurrence of severe pneumonitis (lung inflammation) with the addition of immunotherapy.
REACH PC trial: Palliative care already has an important role in the care management for patients with advanced lung cancer. The findings from the REACH PC trial add critical evidence to support ongoing access to telehealth services and show that early palliative care can be delivered successfully via telemedicine. Telemedicine could be very important in providing access to palliative care for patients who otherwise may not be able to get it.
All of these clinical trials will change oncology practice. Expect to see future updates for the LAURA and ADRIATIC trials. Although the results of these trials represent significant advancements, there is more work to be done. More research with new agents will be conducted to try and further improve outcomes for these patients. The REACH PC trial will allow oncologists to provide palliative care to many more patients. The convenience of telemedicine will also allow patients to reap the benefits of these services without the hassle of traveling to appointments. Receiving palliative care remotely will be the norm for patients with advanced cancers of any type.
