Issue link: https://blog.providence.org/i/1526712
One example of a targeted therapy generating enormous excitement is lorlatinib, a once-a-day tablet designed to attack cancer cells expressing the ALK protein. In a five-year study, lorlatinib stopped the cancer from spreading in 60% of patients, including just over half of patients whose cancer had already spread to the brain before the trial began—an unprecedented outcome. "It's the longest progression-free survival ever reported for a lung cancer treatment," explains Yung Lyou, MD, medical oncologist, who helps lead the hospital's research program. "The potential for this line of research and treatment is enormous." An obstacle to accurately diagnosing lung cancer early is the risks and limitations of current biopsy techniques, which involve guiding a needle through the chest wall to obtain a sample of the suspicious lung nodule. Limitations like impossible-to-reach nodules in the outer third the lung—where most cancerous nodules are located—or testing only one of several nodules because of the risks of needle biopsies, often frustrate efforts to give patients answers. At Providence St. Jude, a leading-edge robotic system, called Ion, eliminates those weaknesses, offering the hospital's lung cancer experts an invaluable new tool: robot- assisted bronchoscopy. "Ion allows us, for the first time, to find and biopsy lesions in all 18 segments of the lung," explains Julie Yoo, MD, a triple board- certified pulmonologist, who says the minimally invasive technique—which inserts an ultrathin catheter through the mouth— allows faster, more accurate diagnoses as well as fewer complications than with traditional biopsy techniques. "It makes testing a nodule simpler and much safer, even when those nodules are very small and located in difficult-to-reach areas." The robotic platform uses advanced mapping techniques, 3D imaging and shape-sensing technology to identify and navigate the safest route through the lung. The precision and dexterity of the robotic arm—far exceeding that of a human hand—permits doctors to direct a catheter around tiny bends and curves in the airways, reaching nodules previously considered inaccessible. Meanwhile, real-time guidance from a hospital pathologist on whether the biopsy sample is adequate and, if so, whether cancer is present eliminates the need for additional procedures. With CT-guided biopsies—the most common technique used today—many patients require multiple biopsies and another procedure to stage the cancer, delaying care by weeks. "We're changing that," explains Dr. Yoo, who says a wait-and-see approach for nodules that couldn't be biopsied because of their size or location is no longer the only or best option. "Patients now have the convenience and peace of mind of getting the answers they need after a single minimally invasive procedure." Getting an Assist from Robotics: Changing the Way Lung Cancer Is Diagnosed Health Matters: Providence St. Jude Medical Center | 11 To learn more about low-dose CT screening and whether you qualify, speak with your physician. To learn more about current lung cancer clinical trials, call 714-446-5177.