At the Center of Excellence for Thoracic Oncology, we work closely with many departments and institutes to develop new treatment options for patients with lung cancer. We collaborate with Mount Sinai’s Institute for Personalized Medicine, Department of Genetics, Institute for Translational Epidemiology, Institute for Personal Immunotherapy, Respiratory Institute, and Division of Thoracic Surgery. We are investigating the following areas to discover improvements in lung cancer care:

New Treatment Modalities for Lung Cancer
Much progress has been made in the treatment of lung cancer over the last decade thanks to development of molecular targeted therapies and immunotherapy.

1. Molecular targeted therapies are directed toward specific molecular abnormalities in the tumor. About 50 percent of lung cancers have a molecular abnormality, which can be targeted by specific drugs (most often in the form of a pill) that cause significantly fewer side effects than conventional chemotherapy. These targeted therapies can produce dramatic shrinkage of the tumor. We have a robust portfolio of clinical trials that include targeted therapies for molecular abnormalities.  Many of these therapies have become today’s standard of care, and are offered to patients outside of the clinical trial platform. We are continuously studying targeted therapies (such as epidermal growth factor mutations and anaplastic lymphoma kinase) with the goal of enhancing their effectiveness, and researching new treatment options.
2. Immunotherapy stimulates a patient’s immune system to fight cancer. We are leaders in developing immunotherapy for lung cancer.

Molecular testing/ Liquid biopsy
Molecular testing of the tumor is crucial for treatment decisions. Molecular testing is usually performed on tumor tissue obtained through surgery or a biopsy. However, we have also developed expertise in blood-based molecular testing, which enables us to determine the molecular profile of the tumor from a blood sample instead of a tissue biopsy (or both may be done, if needed). We are currently researching how blood-based molecular characterization can help us monitor disease course and treatment effectiveness. This enables us to shift quickly from therapy that is not being effective to a different, more effective treatment before disease progression. The earlier we can start an effective therapy, the better for long-term outcome.

Biological indicators of aggressive early-stage lung cancer
We are investigating the cellular changes that cause a pre-cancerous condition or a slow-growing lung cancer to become aggressive. Findings could help us develop tests to guide treatment decisions, including how much cancer to remove and how post-op therapies may prevent recurrence. With our strength in lung cancer screening, we are studying which abnormalities detected by screening behave aggressively and turn into cancer and which less aggressive lesions detected by screening need surveillance only.

Immune-fighting cells in the lung
We are studying how the dendritic cells that patrol the body for abnormalities teach other immune cells to fight cancer and infection. Our findings may lead to new treatment options.

Integrating palliative and traditional care
By evaluating how to combine palliative care with traditional management of critically ill cancer patients, we are developing new treatment options for patients in the intensive care unit.

Clinical Trials

We have a robust portfolio of clinical trials that focus on treatment of all stages of lung cancer and mesothelioma. Some of the trials are unique to Mount Sinai and others are offered in collaboration with other institutions. We are continually expanding our clinical trial portfolio and making them available at multiple hospital sites throughout the Mount Sinai Health System. We offer lung cancer patients and patients with mesotheliomas the most optimal therapy based on the most recent developments in molecular targeted therapies and immunotherapies.

For patients with early-stage lung cancer, we also focus on neo-adjuvant therapy—therapy given before surgery to shrink the tumor and make surgery more successful. And, we offer adjuvant therapy—therapy after surgery—if needed, based on standard of care guidelines and research findings.

Lung Cancer Screening:

Mount Sinai investigators were the first in the world to demonstrate that lung cancer screening with low-dose CT in high-risk groups clearly led to more patients diagnosed with early lung cancer with very good survival odds (more than 80 percent). This observation led to many international studies that verified these promising outcomes, resulting in national and international recommendations for implementation of lung cancer screening as part of clinical care. The national recommendation today is that individuals over the age of 55 years (under consideration to be lowered to 50) with a tobacco history of 30 pack-years (under consideration to be lowered to 20) should undergo lung cancer screening, as it has demonstrated to reduce the risk of death from lung cancer by 20-25 percent.

The Center of Excellence for Thoracic Oncology includes a very strong lung cancer screening program, and is continuously studying new methods to improve the early detection of lung cancer, even in younger, never-smoker individuals. Our investigators are also studying risk models, which include genetic characterization in addition to radiologic imaging, in order to develop a risk model for younger individuals who are at risk for developing lung cancer.

We are conducting the following screening studies:

• Lung screening for current and former smokers: This study involves a low-dose CT scan at no cost to participants. Participants must be age 50 or older and a current smoker or former smoker who has quit in the last 15 years. Participants are compensated. Interested individuals can contact us at 212-241-2420.
• Lung screening for never smokers: This study involves a low-dose CT scan at no cost to participants. Participants must be age 40 or older and never have smoked, but they must have current or former exposure to secondhand smoke. Participants are compensated. Interested individuals can contact us at 212-241-2420.