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Over the past 20 years, researchers have made tremendous strides in the early detection and treatment of lung cancer—early detection chest scans for high-risk populations, immunotherapies for early and advanced disease, and targeted therapies to personalize treatments for patients. The momentum is strong.
Researchers are developing new ways to engineer immune cells to kill cancer cells. They are developing new ultra-sensitive methods to help us understand the evolution of cancer. And so much more. They’re thinking outside the box to help save lives.
Nevertheless, there is still more work to be done. Lung cancer continues to be a major health concern, with over 230,000 new patients expected to be diagnosed this year in the United States alone. Each year, lung cancer consistently claims more lives than colon, breast, and prostate cancers combined. Yet, federal funding for lung cancer research lags far behind other cancers.
The good news is that every lung cancer research donation can help bridge this funding gap for researchers. LUNGevity takes steps to ensure that research-focused donations are invested wisely to build on the current momentum of the field, leverage the latest technologies, and champion the brightest, most promising minds—when they need our help the most.
Solving the Chicken-and-Egg Dilemma
Researchers early in their careers have energy, optimism, and the power of the most current technologies at their fingertips. These researchers are bubbling with new ideas and potential. With expert mentorship and financial support for research projects, they can become leaders of the lung cancer community in the next five to ten years, but it’s difficult for them to secure the initial funding to get started.
“In late 2016, I was at a pivotal turning point. I had just finished my medical oncology fellowship training, and I was working on figuring out the area of focus for my research and selecting which important questions in the intersection of cancer genomics and immunotherapy I wanted to pursue,” noted Valsamo Anagnostou MD, PhD, now associate professor of oncology at Johns Hopkins Medicine.
At the time, immunotherapy had taken the scientific community by storm, and Dr. Anagnostou wanted to understand how it worked at a molecular level. Her goal was to study the molecular underpinnings that made immunotherapy effective so she could optimize therapy for patients living with lung cancer.
“I knew how I wanted to approach those questions, but I needed funding to do it,” she said.
2017 was a big year for Dr. Anagnostou. She was starting her role as a junior faculty member at Johns Hopkins and received a Career Development Award (CDA) from LUNGevity. This award was her first research grant and opened the door to her successful career as a lung cancer physician-scientist. “It was my chance to demonstrate my skills as a researcher and begin building my research lab,” she explained.
Supporting Science as It Evolves into New Ideas
Initially, the team was small—just Dr. Anagnostou and a lab technician working together to process and study blood and tissue samples by next-generation sequencing. Through tumor tissue sample analysis, they studied how the genetic makeup of cancer cells changes over time under the pressure of immunotherapy.
They discovered that cancer cells that are resistant to immunotherapy lose pieces of genetic material that contain mutations (changes in the sequence of DNA) that are important for triggering the immune system. The team developed better ways to study the tumor mutational burden (TMB) and identified mutations that are biologically important and informative in predicting patient outcomes with immunotherapy.
In doing this analysis of tumor mutations, Dr. Anagnostou’s team also discovered an important new way to test for resistance to immunotherapy. They developed sensitive and minimally invasive assays to capture circulating tumor DNA (ctDNA), which is DNA released into the bloodstream by dying cancer cells.
The researchers found that patients who eventually developed immunotherapy resistance had a unique pattern of ctDNA levels after beginning immunotherapy; their ctDNA levels remained detectable, whereas ctDNA was cleared in patients who responded to immunotherapy.
As the researchers made these major discoveries, they were able to apply for (and receive) funding from sources other than LUNGevity, such as the federal government.
“Our discoveries led to new questions. Science is like that,” says Dr. Anagnostou. “As researchers, we anchor ourselves like a tree trunk to a general area of expertise, but as we learn and answer questions, we keep branching out to address the next set of questions… I began as an aspiring medical student, but the evolution of questions is what drew me to study science.”
This process of discovery requires continuity of financial support to allow researchers the time they need to follow leads and try different types of experiments to reach answers.
Dr. Anagnostou and her growing team continued asking questions and conducting important follow-up studies. For example, in the process of analyzing ctDNA, Dr. Anagnostou and her team developed a blood test to quickly and easily determine if a lung cancer treatment is effective or not. This test is now being studied in an international phase 3 clinical trial, where liquid biopsies are used to determine which patients with lung cancer should receive immunotherapy alone versus immunotherapy and chemotherapy.
Celebrating the Wins and Training the Next Generation
Dr. Anagnostou and her team have made several exciting discoveries that have resulted in patents. Additionally, they have published their remarkable findings in several high-profile scientific journals, including Cancer Discovery, Nature Cancer, Nature Medicine, and New England Journal of Medicine.
Today, Dr. Anagnostou’s molecular oncology lab has expanded to two labs—a “wet” lab for hands-on bench experiments, and a “dry” lab for computer-based approaches. They have anywhere from 16 to 20 people working there at a given time. Postdoctoral fellows, graduate and undergraduate students, lab technologists, bioinformaticians, and interns all work together and collaborate with labs down the street within Johns Hopkins and in other parts of the world to improve how we diagnose, characterize, monitor, and treat lung cancer.
“It’s a lot of fun and a lot of responsibility to maintain a lab, train all these folks and keep them excited about their work,” she said. “I have a keen focus on mentoring and training the next generation of scientists such that they learn to reason and form scientific hypotheses and test these hypotheses in the wet or dry lab.”
“But all this would not have been possible without the LUNGevity grant—which gave us the support we needed to get started. I received the award several years ago, but I still acknowledge my first Career Development Award grant from LUNGevity on published research papers because those initial questions have become the basis of my whole career.”
Commit to Making a Difference
You can help an early-career researcher become an accomplished lung cancer expert. Make a donation to support lung cancer research today.
In addition to being an associate professor of oncology at Johns Hopkins Medicine, Dr. Anagnostou is also the co-director of the Division of Upper Aerodigestive Malignancies, director of the Thoracic Oncology Biorepository, co-director of the Lung Cancer Precision Medicine Center for Excellence, leader of the Johns Hopkins Molecular Tumor Board, and leader of Precision Oncology Analytics at Johns Hopkins Medicine.
To learn more about Dr. Anagnostou’s work, visit anagnostoulab.org.