Thoracic Oncology Disease Management Group Research
At Perlmutter Cancer Center, the Thoracic Oncology Disease Management Group (DMG) collaborates to provide state-of-the-art treatment for patients with thoracic malignancies, including non–small cell and small cell lung cancer, thymic cancer, and mesothelioma.
Our DMG includes nationally prominent thoracic medical oncologists, interventional pulmonologists, thoracic surgeons, and thoracic radiation oncologists with diverse backgrounds and unique strengths. We meet weekly for a collaborative tumor board that includes thoracic radiologists.
Our surgeons have specialized excellence in robotic and other minimally invasive surgical techniques, and our interventional pulmonologists are leaders in the field, performing a variety of advanced interventional techniques. Our medical oncologists have expertise in clinical and translational research, and our radiation oncologists are experts in stereotactic body radiation, proton therapy, image-guided radiotherapy, and intensity modulated radiation techniques. We also collaborate with colleagues in nutrition, social work, and palliative care.
On the clinical side, interdisciplinary management allows us to create personalized treatment plans for our patients. Through our research, we use patient specimens to better understand biomarkers of response and resistance to novel therapies.
Thoracic Oncology Research Leadership
Leena Gandhi, MD, PhD
Director, Thoracic Medical Oncology Program
Professor, Department of Medicine
Harvey I. Pass, MD
Chief, Thoracic Oncology
The Stephen E. Banner Professor of Thoracic Oncology, Department of Cardiothoracic Surgery
Peter B. Schiff, MD, PhD
Vice Chair, Department of Radiation Oncology
Professor, Department of Radiation Oncology
Thoracic Oncology Research Areas of Focus
Our thoracic oncology research helps us develop more effective, personalized therapies for thoracic malignancies. This includes early drug development in the areas of targeted therapy and immunotherapy to treat lung cancer.
Through our research, we seek to understand the impact of chemotherapy, targeted therapy, and radiation on the immune microenvironment by evaluating pre- and post-therapy biopsy specimens. This helps us understand how to maximize the impact and sequencing of immunotherapy in each patient’s care.
Our clinical trials include a global study of the combination of pembrolizumab with first-line chemotherapy in non–small cell lung cancer. Additional trials include oncogene-driven lung cancers, small cell lung cancers, and early-stage lung cancer.
At the Thoracic Surgery Laboratory at NYC Health + Hospitals/Bellevue, part of the National Cancer Institute Early Detection Research Network, we seek to better understand disease development and markers of early detection for lung cancer and mesothelioma. We study the use of plasma microRNA to diagnose the indeterminate pulmonary nodule and proteomic assays for screening, diagnosing, and prognosing mesothelioma and performing blood cell–based investigations of immuno-oncology to diagnose and prognose early-stage lung cancer. Our laboratory is funded by the National Cancer Institute, the Department of Defense, and the Centers for Disease Control and Prevention.
In the area of interventional pulmonology, we study immunotherapeutic responses in lung cancer, particularly within tumor-draining lymph nodes that could impact the systemic benefit of various medications.
Our investigators are the leading developers of genetically engineered mouse models of lung cancer, which are used to discover oncogenic pathways and understand response and resistance to targeted therapies. Recent advances include developing and implementing methodologies for immunoprofiling and immunomonitoring patient specimens to better understand response and resistance to immunotherapies.
Our radiation oncology clinical trials include seeking a better understanding of treatments with stereotactic body radiation therapy (SBRT), also known as stereotactic ablative radiotherapy (SABR). We are investigating which patients benefit most from these advanced technologies. We are also working to detect circulating tumor DNA in SBRT patients and studying this potential molecular marker for predicting outcomes.
We are studying the use of proton therapy in lung cancer and other malignancies. In partnership with NYU Langone’s Applied Bioinformatics Laboratories, we use machine learning and other advanced computational techniques to recognize patterns and extract meaningful data from imaging studies that are not obvious to the naked eye. By combining this data with DNA methylation data, we can help predict tumor behavior and treatment outcomes.
Thoracic Malignancy Basic and Translational Research
Our studies include targeting KRAS-mutant lung cancers with immunomodulatory agents and combinations of treatments in genetically engineered mouse models, and genetically and pharmacologically validating protein kinases as targets in non–small cell lung cancer through specific kinase inhibitors. We have secured funding to evaluate the combination of endobronchial cryoablation as an immunogenic stimulus with PD-1 inhibition using nivolumab in select patients with metastatic non–small cell lung cancer.
We are collaborating to characterize the immune profile through flow cytometry, RNA sequencing, and multiplexed immunofluorescence of biopsies from non–small cell lung cancer patients who are receiving immunotherapy. We are investigating the role of the lung microbiome in response and resistance to immunotherapy in a collaboration involving mouse models and patient bronchoscopies.
Recent discoveries include the knowledge that a certain oncogenic driver in lung cancer is particularly sensitive to glutaminase inhibition, which also influences T cell activation. This has led to a clinical trial combining glutaminase inhibition with PD-1 inhibition.
Thoracic Malignancy Clinical Trials
We focus on biomarker-driven clinical trials for thoracic malignancy treatments. This includes investigating the effects of combinations of immunotherapies in non–small cell lung cancer, small cell lung cancer, and mesothelioma.
Our trials include the study of novel agents and combinations in EGFR-, ALK-, and ROS-driven lung cancer and other oncogene-driven cancers. We are investigating novel therapies, such as photoablative therapy in early-stage lung cancer and partial cryoablation in peripheral lung tumors. We lead a global, randomized phase III clinical trial to demonstrate the superiority of combining chemotherapy and immunotherapy in the initial treatment of metastatic non–small cell lung cancer. Our goal is to create a new standard of care for first-line treatment.
We are developing a broader and more personalized approach to immunotherapy with a focus on understanding immune microenvironment changes resulting from therapy through novel tissue- and blood-based analyses.
We are evaluating neoadjuvant immunotherapy in lung cancer, allowing for pre- and post-treatment tissue evaluation to optimize the role of immunotherapy in boosting the odds of cure after surgery. We are studying novel therapeutic approaches to oncogene-driven lung cancers, and we are developing a large-scale proposal to evaluate methodologies for early detection and strategies for early intervention.