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 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.


Research

Watch Dr. Justin Gainor discuss immunotherapy research at Mass General Cancer Center.

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 World Lung Conference

The International Association for the Study of Lung Cancer 19th World Conference on Lung Cancer took place in Toronto, Canada during September 23-26, 2018.

  • Jessica Lin, MD, presented on the Safety and Preliminary Clinical Activity of Repotrectinib (TPX-0005), a ROS1/TRK/ALK Inhibitor, in Advanced ROS1 Fusion-Positive NSCLC. Repotrectinib demonstrated promising preliminary efficacy in ROS1 TKI-naive and ROS1 TKI -pretreated ROS1+ NSCLC. Activity was also observed in the central nervous system.
  • Alice Shaw, MD, PhD, presented an ongoing global study of First-Line Lorlatinib Versus Crizotinib for Advanced Anaplastic Lymphoma Kinase-Positive (ALK+) Non Small Cell Lung Cancer. In this presentation, she described the study objectives, the study design, and the study treatments. To date, 66% of the patients have been accrued. This study will establish a role for lorlatinib as first-line therapy in advanced ALK-positive lung cancer. Dr. Shaw also presented at a symposium on Navigating the Spectrum of Resistance Mutations in ALK+ NSCLC: How to Identify and Treat Them. In this talk, Dr. Shaw described resistance mechanisms to first, second and third generation ALK inhibitors, with a special focus on secondary ALK kinase domain mutations. Dr. Shaw showed preclinical and clinical data supporting the utility of repeat biopsies after failure on a next generation ALK inhibitor to inform the selection of subsequent therapies. The third generation inhibitor lorlatinib can overcome all known single ALK resistance mutations, but loses activity against compound (double or triple) ALK mutations. New strategies and therapies are needed for patients who develop refractory compound ALK mutations.
  • Anna Farago, MD, PhD, presented on Dynamics of DLL3 and ASCL1 Expression in SCLC Over Disease Course. Using patient biopsy samples and tissue from patient-derived xenograft models, Dr. Farago and colleagues showed that expression of DLL3 in small cell lung cancers remains mostly stable over time, despite intervening lines of therapy over multiple points. This result has important implications for drugs like Rovalpituzumab tesirine that target DLL3. In addition, Dr. Farago presented on Rapid, Robust and Durable Responses to Larotrectinib in Patients with TRK Fusion Non-Small Cell Lung Cancer. NTRK gene rearrangements in non-small cell lung cancer are rare events, occurring in approximately 0.2% of patients. However, Dr. Farago and colleagues showed that these tumors are highly sensitive to the TRK inhibitor larotrectinib, indicating that NTRK gene rearrangements are a targetable and important molecular subset of NSCLCs.
  • Ibiayi Dagogo-Jack, MD, presented on Clinical Utility of Detecting ROS1 Genetic Alterations in Plasma. Dr. Dagogo-Jack collaborated with the scientific team at Guardant Health to analyze plasma specimens from approximately 60 patients with ROS1+ lung cancer. The study demonstrated the feasibility of detecting a variety of ROS1 fusions in plasma. In addition, Dr. Dagogo-Jack studied plasma specimens from a cohort of 16 patients relapsing on crizotinib and found that approximately 40% contained acquired ROS1 tyrosine kinase domain mutations, a finding similar to what has been demonstrated from analyzing tissue specimens at resistance. This is the largest plasma study of ROS1+ NSCLC to date and provides preliminary rationale for incorporating plasma genotyping into clinical management of ROS1+ NSCLC.
  • Lecia Sequist, MD, participated in an academic debate about the use of Adjuvant Targeted Therapy for patients with Genomic Alterations. She also presented a poster with follow-up results from a Randomized Phase 2 Trial of Seribantumab in Combination with Erlotinib in Patients with EGFR Wild-Type Non-Small Cell Lung Cancer. This trial was a negative trial for the whole group of patients, though suggested that NSCLC patients with heregulin-expressing tumors might do well with seribantumab combinations. This concept is being further tested in an ongoing phase 2 trial called SHERLOC: A Phase 2 Study of Seribantumab in Combination with Docetaxel in Patients with Heregulin Positive, Advanced NSCLC.
  • Meghan Mooradian, MD, presented on Immune-Related Adverse Events: The Growing Pains of Immunooncology. This work evaluated the spectrum of immune-related side effects that affected thoracic oncology patients and required hospitalization. Through her work, Dr. Mooradian hopes to advance the understanding of these toxicities in order improve detection and treatment of these events.
  • Zofia Piotrowska presented on Activity of Osimertinib and the Selective RET Inhibitor BLU-667 in an EGFRMutant Patient with Acquired RET Rearrangement. She also served as a discussant for the presentation: Oncogene-Driven Patient Groups: A New Era for Research Partnerships.
  • Rebecca Heist, MD, served as a discussant on Distinct Origins of Lymphatic and Brain Metastasis in Lung Cancer.
  • Mari Mino-Kenudson, MD, presented on the Utility of PD-L1/CD8 Dual Immunohistochemistry for Prediction of Response to Immunotherapy in Non-Small Cell Lung Cancer (NSCLC). Dr. Mino-Kenudson also presented on Laboratory Developed Test – CON.

View more research presentations

Patient Stories

These stories highlight the strength, courage, resiliency of our patients and the coordinated effort of the Thoracic Oncology team to provide the best care to our patients.

Yariv Kafri

“Training is about perseverance and setting goals. I want to give the doctors something they can recommend to their patients, just like they’ve given something to me.” Read Yariv's Story

Andy Lindsay

"We felt we were with people who knew what they’re doing and they were so kind. It was such a shining moment." Read Andy's Story

Linnea Olson

"In my particular case, I wouldn’t be alive if I didn’t come here. I have stage 4 lung cancer and my care here has been just absolutely cutting edge."
Read Linnea's Story

Allison and Rich Orpen

"Maybe I can’t cure it, but I can make it better. I can’t see giving in, I’ve got to fight." Read Allison and Rich's Story

Justin Perry

"Everyone at MGH went above and beyond and helped each and every day toward winning this wedding. They cared about me, checked in daily and treated me like family." Read Justin's Story

Jay Petri

"I was never afraid of coming here. I’ve always felt right at home. I actually enjoy coming here at this point. I have so many friends that have gone beyond the doctor-patient relationship. They are truly friends." Read Jay's Story

Greg Vrettos

"I was the first patient enrolled in the initial EGFR-targeted therapy clinical trial at Mass General. I didn’t have any hesitancy about starting a clinical trial because I had so much confidence in Mass General and in my team that I believed it had to be the best option.” Read Greg's Story

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 & Support

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.

Support Us in the Fight Against Cancer

We appreciate your interest in supporting the Center for Thoracic Cancers at the Mass General Cancer Center and we invite you to join the Cancer Center community by participating in whatever way you are able.

Click here to donate directly to the Center for Thoracic Cancers. Be a Piece of the Solution was started by a Mass General Cancer Center patient family to provide direct financial support to the Thoracic Cancer Center. Click here to read more about Be a Piece of the Solution.

Request an Appointment Request a Remote Second Opinion

Talk to an access nurse today 877-726-5130

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