Southern Regional Meeting 2017, New Orleans, LA, February 11-13 ...

Surviving Stage 4 Lung Cancer: A Personal Story

Since then, Ed has worked closely with his care team at the Tampa Moffitt Cancer Center and together they came up with a treatment plan. His healthcare providers decided that Ed would benefit from a three-drug chemotherapy approach. This was because he didn't have an actionable biomarker and targeted therapies weren't an option.

Unfortunately, over time the chemotherapy became less effective, so Ed and his oncologist decided to try a Phase One immunotherapy trial. "Both my wife and I were scared. We had young grandchildren and so many things that we wanted to see and do with them. And I was afraid I was going to miss all of that, when chemo stopped working for me." The first clinical trial caused Ed to experience extreme side effects, so he and his oncologist decided to switch to a different Phase One immunotherapy trail, which quickly began to work. Within a year, Ed's condition stabilized and has remained so for five years after he started.

Ed shared that "There is hope. We are living long lives now, long fruitful lives where we can enjoy being with our family." He recommends getting a biomarker test, so that proper treatment can be determined and that a second opinion can be helpful.

"At my first oncologist appointment, I was told I had only 9-12 months left to live without treatment. But I wasn't ready to give up. I wanted to explore all my options," Ed said. This was nearly 10 years ago. Looking forward, in April 2022, Ed was declared to have "no evidence of disease" and remains so to this day. After surviving stage 4 Lung Cancer, Ed is determined to help others, so he has become an advocate, leading efforts to improve the lives of people diagnosed with lung cancer.

Visit Lung.Org/Liver-Mets for more information.

Support made possible by Regeneron and Sanofi Genzyme.

Researchers Explore The Possibility Of Treating Lung Cancer By Targeting Telomeres

Healthy cells can only divide a limited number of times during an organism's lifetime. In contrast, tumor cells are immortal: they proliferate indefinitely and uncontrollably, and this is the defining characteristic of cancer. Researchers from the Telomeres and Telomerase Group at the CNIO (Spanish National Cancer Research Center), led by Maria Blasco, have studied for the first time the possibility of treating lung cancer by targeting the telomeres, the structures that protect the ends of chromosomes and whose condition determines the cell's ability to divide indefinitely.

The results, as explained by the researchers in the journal Cell Death & Differentiation, show that, indeed, targeting telomeres "might be an effective therapeutic strategy" against non-small cell lung cancer, which is responsible for much of the mortality in lung cancer patients.

The work has Sergio Piñeiro as first author, recipient of a postdoctoral contract from the Spanish Association Against Cancer (AECC).

Removing immortality from cancer cells is a therapeutic strategy that has not yet been exploited in the fight against cancer."

Maria Blasco, CNIO

Focus on the tumor microenvironment

Lung cancer is one of the leading causes of cancer death. The long-term ineffectiveness of current therapies and late diagnosis mean that only one in five patients survive more than five years. Specifically, non-small cell lung cancer is responsible for 85% of lung cancer-associated deaths.

The work now published focuses on the so-called tumor microenvironment, which is a set of cells and factors surrounding the tumor that plays a crucial role in the development of cancer and the response to therapies.

The researchers analyzed the impact of dysfunctional telomeres. Also, they studied the effect of telomerase deficiency on the cellular microenvironment of non-small cell lung tumors, telomerase being the enzyme that repairs telomeres.

Telomerase deficiency

Telomeres are protein structures located at the ends of chromosomes. At each cell division, telomeres shorten until, after a certain number of divisions, the shortening becomes excessive and the cell stops dividing. This happens in healthy cells, but not in most tumor cells.

Telomerase expression is reactivated in 90% of human tumors. Because of the action of telomerase, the telomeres in tumor cells maintain a minimum functional length, which allows them to divide indefinitely.

CNIO researchers studied what happened when they caused a telomerase deficit in the lung tumor microenvironment. They also deliberately damaged their telomeres, using the compound 6-thio-dG.

"It is the first time that the involvement of telomerase and dysfunctional telomeres in the lung tumor microenvironment has been investigated," explains Sergio Piñeiro, currently at the Spanish National Research Council (CSIC) in La Rioja.

Damaged telomeres hold back the tumor

Telomerase deficiency and dysfunctional telomeres slowed tumor progression. The researchers observed a reduction in tumor implantation and vascularization in the lung, while increasing the vulnerability of tumors to DNA damage and cell death. Tumor cell proliferation and inflammation were also decreased, and the anti-tumor response of the immune system was enhanced.

As the authors write in Cell Death & Differentiation, "we address by the first time the implication of TERT [telomerse] and dysfunctional telomeres in the lung tumor microenvironment. Our results demonstrate that targeting telomeres might be an effective therapeutic strategy in non-small cell lung cancer".

Source:

Journal reference:

Piñeiro-Hermida, S., et al. (2023) Telomerase deficiency and dysfunctional telomeres in the lung tumor microenvironment impair tumor progression in NSCLC mouse models and patient-derived xenografts. Cell Death and Differentiation. Doi.Org/10.1038/s41418-023-01149-6.

Edinburgh Teen Who Thought He Had Growing Pains Diagnosed With Rare Cancer

An Edinburgh teen who thought he was suffering from growing pains was found to be suffering from a rare cancer.

Keiran Smart, from Niddrie, was an active 14-year-old when he started suffering from a persistent ache in his leg at the beginning of 2022. The youngster's parents and teachers initially put the problem down to growing pains and didn't think much of it, however the pain became increasingly worse and he was eventually forced to give up football.

A few months later, the youngster's world came crashing down when he was diagnosed with Ewing Sarcoma, a rare type of cancer that can affect both the pelvis and lungs. After undergoing 14 rounds of chemotherapy and missing his entire fourth year of school, Kieran and his family are now hopeful that they have reached the light at the end of the tunnel.

Speaking to Edinburgh Live, Kieran's mum Leanne said: "It was the February break just after he went back to school and he phoned me from work saying his leg was really sore.

"I just said it's fine, I'll get you to the doctors. He said mum it's really sore, I've already told one of the teachers and I need to sit out. I took him to the doctors along the road and the GP said a lot of teenagers get fluid on the hip but she said something wasn't quite right.

© Supplied Dad Derek and mum Leanne with Kieran at the hospital.

"I took him straight up to the hospital after she sent a letter. From February to August we were just in and out all the time, with Kieran undergoing tests and scans. They detected a high infection level but couldn't tell where it was coming from.

"After an MRI confirmed it was his pelvis he was operated on in the middle of August. They went in through a C-section, drilled into his bone and cleaned it all out but he wasn't getting any better."

Despite the invasive operation, Kieran was still suffering from significant pain and the decision was made to take him back into theatre to wash out the area again. The schoolboy had expected to be discharged from the Sick Kids at Little France on September 2, but his parents received a worrying phone call asking them to come for a meeting with doctors.

"I just thought 'What's going on?" Leanne said. "We got taken into a room with the doctor who dealt with Kieran and another lady who I didn't know.

"She explained who she was and that Kieran has Ewing Sarcoma, but I had never heard of it. She explained it was a rare form of bone cancer that teenagers can get in their bones and lungs.

"After he underwent chemotherapy, we were advised that he needed radiotherapy due to where the cancer was and because they couldn't operate on it so we were sent down to a hospital in Manchester.

"We just thought he'd be getting the radiotherapy here but we ended up spending six weeks down there and had to leave his sister Myla behind, that was very tough."

© Supplied Kieran and his little sister Myla, aged nine.

Just two days after arriving back from Manchester, Kieran had to undergo further chemotherapy. A few days later, he was back in hospital with a severe infection and wasn't able to return home for three and a half weeks.

Critical and respiratory care teams were looking after Kieran after he was struggling to breathe, but he wanted to stay in the department he was familiar with as he struggled with change, Leanne explained.

The accounts manager continued: "We're now past the final chemotherapy appointment which was last week and we're now on to rest days. He still has his line in his neck where all his chemo and drugs go into his body.

"All of his veins were collapsing so they found it hard to get blood from him. It's part of him now and he has learned to live with it.

"It has been tough. People don't understand. We have friends who don't speak to us now and people who don't even say hello in the street, you wouldn't believe it."

© Supplied All those taking part will be wearing a special t-shirt in honour of Kieran.

Since Kieran's diagnosis, he and his family have been overwhelmed by the support of locals and pupils at Castlebrae.

Leanne said: "We want to make others aware of what this cancer is. I'm glad we got there before it was too late. It could have spread to more bones and to his lungs but they think they caught it in time. Hopefully, we can move on but you never really move on. After treatment, you've got a lifetime of check-ups and appointments.

"Kieran's reaction to his diagnosis and health journey has always been to just get on with it and deal with it. He's been an absolute trooper. A couple of times he has asked 'why me?' and he's allowed to say that."

Ashley Boak, Pupil Support Leader at the high school, has taught Kieran the whole four years he has been at the school and played a huge part in fundraising efforts.

She said: "Kieran is a ball of energy and has always been full of fun, cheek, and charm. He's just so loveable and he is definitely Castlebrae through and through. A lot of Kieran's friends have left school now and have moved on but he is very adamant that he wants to come back and do his fifth year.

"He has a very mature outlook on school now. The boys who are running on the weekend are a bit younger but that is a testament to what the approach from the school has been. Everybody knows of Kieran and even if they are not his best mate, they've wanted to get involved.

"It really has brought us all together while also raising money for the Teenage Cancer Trust. We have done bake sales, Santa dashes and a race night. We tried to do events to include everybody but it was always leading to taking part in the marathon weekend."

Norma Prentice, the headteacher at Castlebrae, is a keen marathon runner and was planning on making it a trio of marathons in three months by taking part in the Edinburgh marathon following races in both London and Barcelona.

Unfortunately for Norma, she recently fell down the stairs and fractured her collarbone and pelvis so is unable to take part, but in her absence, James McPartlin, a fellow Pupil Support Leader at the school, kindly offered to run the full marathon on Sunday in her place.

To make a donation to Kieran's family and Castlebrae High School's fundraising efforts, you can do so here.

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