Treatment for lung and thoracic cancers at Mass General

Lung Cancer Treatment Program

The Center for Thoracic Cancers offers patients and families access to one of New England's most experienced programs for lung cancer.
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Overview

At the Center for Thoracic Cancers, our multidisciplinary team of lung cancer specialists put together a comprehensive treatment plan just for you. Many lung patients benefit from our approach. You will see lung cancer specialists from medical oncology, radiation oncology and surgery. We:

  • Offer a collaborative approach to lung cancer diagnosis and treatment
  • Provide care and support tailored to each patient’s needs
  • Combine clinical expertise, cutting-edge research and medical technologies to offer patients the most appropriate therapies
  • Ensure patients fully understand their diagnosis and treatment options
  • View patients and their family and friends involved in their care as team members

Patients are usually seen within one week of referral.

Innovative Approaches

The Center for Thoracic Cancers is among the first in the nation to provide new targeted therapies for non-small cell lung cancer. Consistently ranked as one of the best in the country by U.S. News & World Report, we provide the promising new therapies and innovative approaches to clinical care, including:

  • Expertise in minimally invasive surgery for lung cancer, including lung-sparing techniques
  • Genotyping (molecular fingerprinting) to determine which lung cancers carry genetic mutations that might be treated with targeted therapies
  • Rapid diagnosis and staging of all biopsied tumors by pathologists who specialize in lung cancer
  • Groundbreaking research regarding the molecular basis of some lung cancers
  • The Francis Burr Northeast Proton Therapy Center, New England’s only proton radiation facility
  • Access to one of New England’s only Advanced Endoscopy Services

Expertise in Diagnosing and Staging Lung Cancer

All members of our team of pathologists and radiologists are nationally recognized for their expertise. Our pathologists participate in weekly tumor board meetings, sharing information about each patient’s unique cancer with the entire team to help guide care planning. Our radiologists use the most advanced imaging tools to diagnose and stage thoracic cancers and to detect changes in tumors. Our imaging methods include:

  • Chest radiograph
  • Computed tomography scan (CT or CAT scan)
  • MRI
  • PET and nuclear medicine scans

Our minimally invasive image-guided procedures for diagnosis include:

    • Percutaneous needle biopsy and molecular diagnostic tests
    • Esophageal ultrasound
    • Navigation bronchoscopy for biopsy of peripheral lung nodules

Advancing Medical Oncology

Some new cancer drugs currently available or in development are designed to block some of the mutations that cause tumors to grow. By targeting tumor gene mutations with these “smart drugs”, our doctors are beginning to understand how to destroy cancer cells in some patients' tumors without traditional chemotherapy and radiation.

We are among a select few centers in the world to offer comprehensive genotyping of thoracic cancers as part of our pathological assessment. Genotyping allows us to test each tumor for certain genetic mutations, which can reveal weaknesses in an individual’s cancer. We can exploit these weaknesses using targeted therapies. Understanding genetics of a tumor helps us choose the most effective treatment for a patient’s cancer.

Genotyping: Entering a New Era Treating Lung Cancer Care

We are among a select few health care institutions in the world to offer comprehensive genotyping of thoracic cancers as a routine component of our pathological assessment. This genotyping allows us to test each tumor for certain genetic mutations. These genetic markers indicate certain weaknesses in an individual’s cancer; weaknesses that we can exploit using targeted therapies. By understanding the genetics behind each lung tumor we are able to choose the specific type of treatment that will be most effective for that particular patient’s cancer. Learn more about genotyping.

 

Excellence in Surgical Care

Our team of dedicated surgeons treats some of the most challenging and complex cases from across the US. We focus only on thoracic surgery and have pioneered many now-standard procedures used to treat thoracic cancers. The team provides state-of-the-art evaluation, treatment and post-surgical services, including:

  • Chest and airway reconstruction
  • Laser surgery
  • Minimally invasive video-assisted thorascopic surgery
  • Resection of tumors in the chest wall, lungs and mediastinum
  • Lung-sparing techniques for benign and malignant neoplasms of the lung
  • Resection of tumors obstructing a bronchus or in the trachea

We offer many minimally invasive surgical procedures, such as:

  • Bronchoscopy to explore the bronchial passages
  • Navigation bronchoscopy to biopsy peripheral lung nodules or placement of radiosurgical markers to enhance tracking of the lung tumors during radiation treatment
  • Esophagoscopy to sample lymph nodes around the airway or lung
  • Mediastinoscopy to explore the area between the lungs and nearby lymph nodes
  • Thoracoscopy to explore the thorax
  • Esophageal endoscopic ultrasound
  • Endobronchial ultrasound

Pioneering Radiation Therapy Programs

Specialists in the Thoracic Radiation Oncology Program employ high-precision radiation therapy to treat patients with lung cancers and other cancers in the chest with the overarching goal of causing little or no side effects. Pioneering technological advances for the benefit of our patients include:

  • Intensity-modulated radiation therapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) for reducing side effects and improving tumor kill
  • Stereotactic Body Radiation Therapy (SBRT) for the treatment of early stage lung cancers and increasingly also metastatic cancers
  • 4-dimensional (4D) CT scanning and respiratory gating for treatment of lung tumors that move around with breathing
  • Proton beam therapy in patients with certain lung cancers

Our radiation oncologists are part of a highly specialized multidisciplinary team that closely coordinates the care of each patient. Cutting-edge research aims at increasing the efficacy and reducing the side effects of radiation therapy as well as integrating radiation with revolutionizing biological drug therapies.

For more information, please see the Thoracic Radiation Oncology Program.

 

Meet the Team

Our team approach ensures that every patient benefits from a personalized, coordinated and compassionate treatment plan that includes leading experts across many specialties.

Members of your care team meet regularly with you and contact your referring physician on an ongoing basis to ensure clear communication and a seamless coordination of care.

Directors:

See the complete team list treating Lung Cancer

Patient Education

Information About Lung Cancer

Cancer that begins in any part of the lungs is called lung cancer. The two basic types of lung cancer are non-small cell lung cancer and small cell lung cancer. There is also a third type of lung cancer that is very rare, called mesothelioma.

The American Cancer Society estimated that about 222,500 new cases of lung cancer (both non-small cell and small cell) would be diagnosed in the United States in 2017. It is important to remember that great strides have been made in our understanding of lung cancer. Ways to treat lung cancer have advanced even from just a few years ago.

Lung Cancer Diagnosis

While you are being evaluated for a diagnosis of lung cancer you may undergo:

  • Medical history and physical exam
  • X-rays
  • Computed tomography (CT)
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET) scan
  • Biopsy

Lung Surgery

Surgery for lung cancer may involve removal of:

  • A tumor and some nearby healthy tissue (wedge resection)
  • Part of a bronchus, the main airways of the lungs (sleeve resection)
  • An entire section of a lung (lobectomy)
  • An entire lung (pneumonectomy)

Non-surgical Lung Cancer Treatments

Other common treatment options for lung cancer include the following:

  • Immunotherapy uses your own immune cells to destroy cancer cells
  • Chemotherapy kills cancer cells through the use of intravenous (IV) or oral drugs
  • Targeted therapy uses drugs that attack specific parts of cancer cells, depending on if you have a genetic mutation and what type of mutation it is
  • Radiation therapy uses high-energy radiation beams to kill or shrink a tumor while saving healthy tissue
  • Clinical trials may provide access to new and promising therapies for lung cancer

Learn more about Lung Cancer

 

Clinical Trials/Research

Overview of Clinical Trials

Clinical trials are research studies which are conducted to answer questions. They can test many things including new drugs, new combinations of drugs, or already approved drugs being studied to treat patients in new or different ways. They may include new drug doses or new ways (schedules) to give the drugs. Clinical trials are run under strict guidelines with specific criteria for eligibility and treatment. Their purpose is to help find out whether new cancer treatments are safe and effective or better than the standard (current) treatment.

The Mass General Hospital Thoracic Oncology Program has a very active clinical research portfolio with the latest, top-notch investigational studies covering a wide spectrum of thoracic cancer care. The ultimate goal of clinical research is to improve the outcomes for all of our patients. If you are eligible for a clinical trial, your physician will offer you the chance for participation. We will comprehensively review the logistics and purpose of the trial and also offer alternatives including the standard of care.

Find Clinical Trials for Lung Cancer

Find Targeted Therapy Trials for Lung Cancer

The Cancer Center also offers the Lazarex-MGH Cancer Care Equity Program, which strives to promote awareness about and access to cancer clinical trials through community outreach and education, financial assistance, and patient navigation. Learn more about the Lazarex program.

Research

Watch Dr. Alice Shaw discuss two recent studies on next-generation ALK inhibitors for ALK-positive lung cancer patients.

MGH Thoracic Oncology Program at the 2018 AACR Annual Meeting

The 2018 AACR Annual Meeting occurred in Chicago, IL between April 14-18, 2018. The MGH Thoracic Oncology Program was represented in several presentations.

  • Alice Shaw, MD, PhD, gave a clinical trials plenary session presentation, entitled “Efficacy of lorlatinib in patients with advanced ALK -positive non-small cell lung cancer (NSCLC) and ALK kinase domain mutations”. She also served as a panelist in the discussion of “Precision Therapy: When Is Better—Up Front or at Relapse?”. In addition, she chaired and opened the plenary session entitled “Immunotherapy Combinations: The New Frontier in Lung Cancer”.
  • Justin Gainor, MD, served as the discussant for the clinical plenary session, “IMpower150: PFS results for atezolizumab plus bevacizumab and chemotherapy across PD-L1 expression subgroups defined by the SP142 and SP263 IHC assays confirm all-comer benefit in 1L metastatic NSCLC.”

MGH Thoracic Oncology Program at the 2017 ASCO Annual Meeting

The 2017 American Society of Clinical Oncology (ASCO) Annual Meeting took place in Chicago, IL, between June 2-6, 2017. The MGH Thoracic Oncology Program was well represented across multiple platforms:

  • Christopher (Jerry) Azzoli, MD, was an invited speaker during the lung cancer education session. He gave a talk entitled “Challenges in thoracic pathology: How I approach mixed histologies and differentiating metastasis in the chest from second primaries”.
  • Ibiayi Dagogo-Jack, MD, was the first-author of two poster presentations, entitled “Retrospective analysis of clinical outcomes of early stage ALK-positive non-small cell lung cancer” and “Genomic profiling of circulating tumor DNA from patients with advanced non-small cell lung cancer”.
  • Anna Farago, MD, PhD, discussed the “Clinicopathologic features of non-small cell lung cancer (NSCLC) harboring an NTRK gene fusion” during the tumor biology poster session.
  • Justin Gainor, MD, chaired the education session entitled “Managing resistance to targeted therapies”. During this session, he also presented on the topic of “ALK inhibitor resistance: Mechanisms and therapeutic approaches”.
  • Zofia Piotrowska, MD, gave a poster presentation entitled “MET amplification as a resistance mechanism to osimertinib,” which was selected for the poster discussion session.
  • Alice Shaw, MD, PhD, presented in the oral abstract session for non-small cell lung cancer, presenting the findings from the Global Phase III ALEX study: “Alectinib versus crizotinib in treatment-naïve advanced ALK positive non-small cell lung cancer (NSCLC)”. She was also the chair and speaker of the education session entitled: “Is tissue still the issue? Pathology issues in thoracic oncology”.
  • Jennifer Temel, MD, was an invited panelist during the post-plenary discussion session on health services research.

MGH Thoracic Oncology Program at the 2017 AACR Annual Meeting

The 2017 AACR Annual Meeting was held in Washington, D.C., on April 1-5, 2017. The MGH Thoracic Oncology Program was represented in several research presentations, including the following:

  • Anna Farago, MD, PhD, gave a clinical trials plenary session presentation, entitled “Phase 1/2 study of olaparib tablets and temozolomide in patients with small cell lung cancer (SCLC) following failure of prior chemotherapy”.
  • Alice Shaw, MD, PhD, gave a plenary session presentation, entitled “Drug resistance: Tailoring therapies to mechanisms to improve outcomes”. In addition, she served as a panelist in the discussion of “Optimizing the sequence of anticancer therapies”.

Honors & Awards

Thoracic Medical Oncology team the one hundred honorees

View thoracic oncology team members honored for their commitment to the fight against cancer.


Recent Awards

Dr. Piotrowska presented with the 2018 Jonathan Kraft Team Science Award

Zofia Piotrowska, MD, awarded the 2018 Jonathan Kraft Team Science Awards during the Jonathan Kraft Symposium for her research in cancer immunotherapy. The MGH team who won included Mark Cobbold, MRSC, PhD, MGH Cancer Center; Aaron Hata, MD, PhD, MGH Cancer Center; Zofia Piotrowska, MD, MGH Cancer Center; Kerry Reynolds, MD, Hematology/Oncology Unit; and Alexandra-Chloe Villani, PhD, Rheumatology, Allergy and Immunology Division.

Dr. Temel awarded the Walther Cancer Foundation Palliative and Supportive Care in Oncology Endowed Award and Lecture

Clinical Director Jennifer Temel, MD was recently presented with the Walther Cancer Foundation Palliative and Supportive Care in Oncology Endowed Award. Endowed by the Walther Cancer Foundation, this award and lecture was established to recognize a distinguished lecturer and leader with multiple, significant, and enduring contributions to palliative and supportive care in oncology through the prevention, assessment and management of cancer- and treatment-related suffering. Dr. Temel will accept her award and present a keynote lecture at the 2018 Palliative and Supportive Care in Oncology Symposium taking place November 16-17, in San Diego, California. Click here for more information. Congrats, Jennifer!

Dr. Marcoux presented with the PrIME Oncology Young Investigator Award

Nicolas Marcoux, MD, was presented with the Young Investigator Award 2018 by PrIME Oncology, recognizing his research on small cell transformation in EGFR-mutant lung cancer. Congratulations, Nick!

Dr. Lin presented with the 2018 Conquer Cancer Foundation Young Investigator Award

Jessica Lin, MD, received the Conquer Cancer Foundation/American Society of Clinical Oncology Young Investigator Award for her research on tumor heterogeneity of fusion oncogene-driven lung cancers. Congratulations, Jessica!

Dr. Sequist awarded the Stand Up to Cancer-LUNGevity Foundation – American Lung Association Lung Cancer Interception Research Award

Lecia Sequist, MD was presented with the Lung Cancer Interception Research Award from the collaboration of Stand Up to Cancer, LUNGevity, and the American Lung Association. The $2 million research award focus on lung cancer interception—catching precancerous cells and blocking them from turning into cancer cells. The goal of these interdisciplinary and multi-institutional awards studies is to find noninvasive, widely available diagnostic and early detection tools that will dramatically change outcomes for people with lung cancer. For more information, click here. Congrats, Lecia!

 

View more awards

Contact

If you have any questions or would like to speak with one of our doctors, please call the Center for Thoracic Cancers at 617-724-4000.

Request an Appointment Request a Remote Second Opinion

Talk to an access nurse today 877-726-5130

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