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A strategic approach to fighting cancer

A conversation with PETER SHIELDS, MD, deputy director at The Ohio State University Comprehensive Cancer Center — Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James)

The OSUCCC – James is a comprehensive cancer center, as designated by the National Cancer Institute, and home to the third-largest cancer hospital in the U.S. Its doctors and researchers strive to create a cancer-free world by integrating scientific research with patient-centered care, a strategy that leads to optimal methods of disease prevention, detection and treatment. Peter Shields, MD, a medical oncologist who specializes in lung cancer treatment and cancer-prevention research, describes how he and his colleagues translate basic science into innovative treatments.

What is the research mission of the OSUCCC – James?

Our research mission is rooted in our vision to create a cancer free world. Our research spans basic, translational and population science, and focuses on four priorities: Immuno-oncology, cancer engineering, translational genomics and cancer prevention and survivorship. Those are not the only things we do, but we’re thinking strategically about how to significantly invest in these key areas to make a substantial change in the way cancer is prevented, detected and treated.

How does that research impact patients?

One area is in the treatment of chronic lymphocytic leukemia and related blood cancers. John Byrd, MD, co-leader of the Leukemia Research Program at the OSUCCC – James, and others here have developed two recently FDA-approved oral chemotherapy drugs, ibrutinib and acalabrutinib, that have dramatically changed the prognosis and quality of life for these particular blood cancer patients.

In lung cancer, the field was almost stagnant for 20 years. Eight years ago, we had less than a handful of drugs for lung cancer, and they were all chemotherapy. But now lung-cancer treatment seems to be changing every six to 12 months. What used to be less than a year survival has turned into multi-years for patients. We never used to talk about cures for lung cancer, but now we are quite optimistic.

How has lung cancer care changed?

Today we start with a molecular analysis of the patient’s lung tumor. What we learn from the molecular test informs the best treatment path for each patient. Thankfully, there are now many options available to lung cancer patients; the first-line therapy may be immunotherapy, chemotherapy or a combination of both. Molecular testing can also identify some patients for targeted therapy. With better diagnosis and better, less-toxic treatments, patients who previously lived only months are surviving years with a great quality of life.

As someone who knows lung cancer, what is your opinion of vaping?

There are different types of vaping. The type associated with lung illness is mostly related to inhaling oils — like THC— that was cut with vitamin E acetate. Then, there’s the conventional electronic cigarette, or e-cig, which is a nicotine-delivery device.

The general perception among the public is that e-cigs are safer than cigarettes. The reality is the industry is changing so fast that usage is outpacing the rate of our scientific understanding. It’s becoming a public health crisis we should all take very seriously from a general lung health, cancer risk and addiction perspective. E-cigs may be safer than smoking, but that is not the same as safe, and we need to know how unsafe they are.

The recent outbreak for serious lung effects and deaths linked to vaping shows us how serious the adverse impacts can be. Rates of e-cig usage have risen at alarming speeds, especially among young people, and that’s a concern. More research is needed, and that is exactly what we are tackling at the OSUCCC – James.

How does work at the OSUCCC – James improve people’s overall lives?

A lot of my research is trying to use what we know to inform the population about healthier lifestyles, as well as influencing policy to improve population health. Here at the OSUCCC – James, that’s what we all want to do — make as many people as possible healthier.

This depends on doing the research, translating it to treatments and winning with prevention where you can. You need to complete the circle.

To learn more about the OSUCCC — James, visit cancer.osu.edu.