Lung cancer surgery has changed significantly since the early 1990s. Until then, it required surgeons to remove lobes of the lungs through invasive open surgery. But the past few decades have seen advances in technology that have brought about new techniques. Today, surgeons look to perform minimally invasive lobectomies, replacing one large chest incision with several smaller ones and reducing recovery time as a result. A U.S. News and World Report article on this increasingly common surgical modality features MSK’s Dr. Bernard J. Park, deputy chief of clinical affairs of the thoracic surgery service. He explains that video cameras and robotic equipment allow surgeons to perform minimally invasive surgeries. “About 15 percent of the lung cancer lobectomies are done robotically now,” says Park. “Probably about 40 percent are done by video-assisted surgery. A still substantial amount are done open.” Park stresses that the most important thing for a patient to do — whether a candidate for minimally invasive surgery or not — is to find a skilled surgeon experienced with performing the procedures.
A new study found that some women with early stage breast cancer may be able to avoid chemotherapy. Dr. Larry Norton discussed these findings with PBS Newshour on June 4. According to Dr. Norton, a gene test called OncotypeDX can identify women who’s cancer is at risk for spreading. Patients with high scores benefit the most from chemotherapy, patients with low scores do not, but those in the middle are the ones that doctors have not been able to determine who should get chemo and who should not, until now.
At the 2018 American Association for Cancer Research (AACR) Annual Meeting earlier this month in Chicago, Dr. Matthew Hellmann presented the results of the immunotherapy drug combo of Nivolumb (Opdivo) and Ipilmumab (Yervoy). This drug combo improved progression of disease for a select group of patients with advanced lung cancer that had a number of genetic mutations. The study looked at patients’ tumor mutation burden, a measure of flaws to their cancer genes, and found that of the 679 patients, 299 had a high mutation burden. For those patients, survival without progression of disease was 43% at one year for those on the immunotherapy combo, compared to 13% for those on standard chemotherapy. The median time until progression of disease was 7 months for the immunotherapy combo, compared to 5.5 months for chemotherapy. Medicare recently agreed to cover the $3,000 profiling test for advanced cancer. “We have a tool that helps us determine who are the patients that are most likely to benefit from this combination,” Hellmann said.