Double lung transplants successfully treat advanced lung cancer in first with new technique

A new double lung transplant technique has been successful for two lung cancer patients, Northwestern Medicine announced. The hospital said it is building on that success in a new clinical program that will offer transplants to patients with end-stage lung cancer.

“Every morning when I open my eyes I can’t believe it, and life has a different meaning now,” said Tannaz Ameli, the second person with lung cancer to receive the transplant. during a press briefing.

According to the CDC, lung cancer is currently the third most common type of cancer in the United States after skin cancer, breast cancer in women and prostate cancer in men. Yet more people die from lung cancer than from any other type of cancer.

The treatment for lung cancer mainly depends on the extent of the spread of the cancer. Patients may be treated with targeted drugs, chemotherapy, radiation therapy, or surgery to remove the tumor. But these treatments don’t always work, and for some people, a lung transplant is their only option.

Single lung transplants have been performed successfully since the 1980s, and now more than 1,500 single lung transplants take place each year, according to the CDC. But lung transplants for lung cancer are not common.

This is because there is a high risk of cancer cells spreading from the lungs to the rest of the body during the procedure, making it more likely that the cancer will come back, said Dr Ankit Bharat, head of thoracic surgery. and director of Northwestern Medicine Canning. Thoracic Institute, in a press release.

When a patient needs both lungs replaced, the lungs are usually removed one at a time, Bharat said. If the first lung is transplanted while the other cancerous lung is still in the body, there is a risk that the cancer will spread from that lung to the rest of the body, he said.

But the Northwestern Medicine surgery team found a way to minimize that risk. Their approach allows surgeons to remove the cancerous lung from the body while the patient is hooked up to a shunt machine, which diverts their blood from the heart and lungs. If blood does not flow through the cancer during surgery, there is less risk of the cancer spreading.

“We are quite confident that we will be able to help some patients who have no other options,” Bharat said. He said the operation involves “gently removing the two cancerous lungs along with the lymph nodes, washing out the airways and chest cavity to remove the cancer, and then inserting new lungs.”

He added: “These patients may have billions of cancer cells in their lungs, so we have to be extremely careful not to let a single cell spill into the patient’s chest cavity or bloodstream.”

The Northwestern Medicine team first used the technique on Albert Khoury, a Chicago man who came to see them in 2021 after chemotherapy failed to treat his stage 4 lung cancer. His condition continued to worsen and he ended up in the intensive care unit, according to a press release.

His doctor at Northwestern Medicine, oncologist Dr. Young Chae, said a double lung transplant might be his only hope. Without one, Chae said Khoury should not live more than a year.

So on September 25, 2021, after 2 weeks on the transplant list, Khoury became the first person with lung cancer to have a successful double lung transplant.

A year later, Ameli, who lived in Minnesota, was also diagnosed with stage 4 lung cancer. She said she tried chemotherapy, but just like Albert Khoury, it wasn’t enough. . Her husband had seen a video of Khoury’s procedure, she said, and he made an appointment with a surgeon at Northwestern Medicine. She was a candidate – and received the second successful double lung transplant in July 2022.

“We are so happy,” Ameli said at the press conference. “I’m back. I did it. I did it.”

Because of these successes, Northwestern Medicine is launching a first-of-its-kind clinical program for people with end-stage lung disease.

The program plans to track the outcomes of its first 75 patients who receive a double lung transplant for lung cancer in a new research registry called DREAM (Double Lung Transplant Registry Aimed for Lung-limited Malignancies). While patients can receive a double lung transplant in the clinical program without enrolling in the DREAM voluntary research registry, researchers hope to use the data to track rates of overall survival, disease-free survival and transplant rejection. .

“I hope all cancer patients can be as lucky as me and Albert,” Ameli said. “Every day we wake up and are grateful for that.”

Aerial Petty, DO, is a family medicine resident at New York-Presbyterian/Columbia University Irving Medical Center and a contributor to the ABC News Medical Unit.

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