Delaware Public Media

Christiana Care doctors examine gene editing to improve patient response to lung cancer treatments

Apr 16, 2018

Lung cancer is the leading cause of cancer deaths in Delaware and nationwide, which is why doctors at Christiana Care Health System are working towards new approaches to catch it in early stages and improve treatments.

Local and regional doctors presented findings, treatment advances and lessons on screening for lung cancer Monday at Christiana Care’s inaugural Lung Cancer Symposium.

Scott Siegel, the director of population health psychology at Christiana Care’s Value Institute, says doctors want to reduce the burden of lung cancer on members in the community.

“It’s more treatable in its earlier stages,” Siegel said, “but it doesn’t typically present symptomatically until later stages.”

Christiana Care has been involved for almost three years in promoting lung cancer screenings and working with the state on smoking cessation, Siegel said. 

“We are making progress and we’re just looking to accelerate that,” Siegel said.

About 80 percent of lung cancer cases are attributed to smoking.

Common treatments for lung cancer include chemotherapy and immunotherapy. Doctors at Christiana Care’s Gene Editing Institute in the Helen F. Graham Cancer Center are looking to gene editing to help decrease a patient’s resistance to chemotherapy and improve their quality of life.

“Gene editing can help by augmenting the response whether it’s from reducing the amount of toxicity so a patient can tolerate things better,” said Eric Kmiec, the head of the center’s Gene Editing Institute. “The lifespan for people with lung cancer is not good and so improving three to six months is a major victory.”

Gene editing won’t replace chemotherapy, but it’s another tool to lessen the burden, Kmiec said.

“We know that chemotherapy is not what people want,” Kmiec said. “And unfortunately immunotherapies have come along at a great time, but they’re extremely expensive.”

An editing tool called a CRISPR has been making headway in modifying genes in everything from crops to embryos. Christiana doctors are looking to this tool to aid treatment for lung cancer and are working towards a clinical trial.

“Essentially we think about gene editing as a spell checking program that’s on your Word program for a computer,” Kmiec said. “What we know is to replace a misspelled word, the computer goes back and it cuts it out and replaces it with a correct version.”

Kmiec says the same thing happens inside a cell.

“There are enzymes we create called CRISPR/Cas9 that can identify the misspelled word, excise it and then if we provide the right spelling, right copy of the gene it can incise it properly,” he said.

Once they know the gene sequence they want to target in a patient, they can engineer these molecular scissors to go in and destroy a specific sequence in tumor cells.

Kmiec says it’s still unclear is if those tumor cells will have a different sequence from normal cells.

Doctors are concluding trials on animals and working towards a clinical protocol – a step towards developing a human clinical trial using gene editing to improve a patient’s responses to different treatments for lung cancer.