There’s an easy and safe screening for lung cancer that is saving lives, often catching disease at an early stage before symptoms appear. Yet sadly, lung cancer is still the leading cause of cancer death in the United States. Physicians at Baptist Health Miami Cancer Institute, in partnership with the LUNGevity Foundation, would like that to change and are asking for primary care doctors and other healthcare providers to join them in the effort to educate more patients about the importance of screening.

Recently, Manmeet Ahluwalia, M.D., deputy director, chief of medical oncology and chief scientific officer at Miami Cancer Institute — as well as Fernandez Family Foundation Endowed Chair in Cancer Research — sat down with Upal Basu Roy, PhD, MPH, executive director of LUNGevity Research. The LUNGevity Foundation is a non-profit organization focused on lung cancer research and patient advocacy.

Dr. Ahluwalia and Dr. Basu Roy discussed advances in care, how the collaboration between the Institute and LUNGevity has already increased lung cancer screenings in Hispanics and what a similar partnership between the organization and primary care providers can accomplish.

The following is an excerpted and edited version of their conversation, which can be listened to in its entirety here.

Dr. Ahluwalia: We are excited you are sharing an afternoon with us about the importance of lung cancer screenings and who should consider them. Can you enlighten us about that?

Dr. Basu Roy: Lung cancer screening is a lifesaving tool that is available for people at high risk of developing lung cancer. There are three questions to keep in mind when considering lung cancer screening for your patients.

• First, how old is the patient? Screening is available for people between the ages of 50 and 80.
• Second, does the person have any history of tobacco exposure? Lung cancer screening is typically available for patients who have at least a 20-pack year of tobacco exposure (1 pack a day for the last 20 years or 2 packs a day for the last 10 years).
• And third, how long has the person smoked? Screening is available for those who are either current tobacco users or have quit within the past 15 years.

Dr. Ahluawalia: In your work throughout the country, have you seen an uptick in terms of lung cancer screening?

Dr. Basu Roy: I wish we could say that we’ve seen an uptick in lung cancer screening, but even as we speak, despite changing the screening guidelines, nationally only about 4.5 percent of those eligible are screened. And, in the State of Florida, it’s even lower, with about 2.4 percent of people who are eligible for lung cancer screening actually receiving screening.

Dr. Ahluwalia: We’ve been very excited at Baptist Health about our partnership with LUNGevity in establishing the first Hispanic lung cancer screening program. As you know, minorities tend to screen at a lower rate compared to the white population. I think a pivotal piece of our partnership has been ensuring that we have screening education materials and awareness campaigns in Spanish to meet the needs of the community. Our screening numbers have gone up tremendously as a result of our partnership in the last three to four years. We used to see less than 2,000 patients screened for lung cancer each year. This year, we are hoping we’ll reach around 3,800 to 4,000 patients.

Dr. Basu Roy: That’s fantastic to see that the program’s actually having an impact.

Dr. Ahluwalia: But what is interesting is that despite serving a 65 to 70 percent Hispanic population, only 40 to 42 percent of our lung cancer screening patients are Hispanic. Can you share some of the things we can do in partnership with primary care physicians?

Dr. Basu Roy: Anyone who is a primary care provider and listening in, thank you for everything that you’re doing for cancer preventative screening because you are really the gatekeepers to ensure that our patients have access to all types of cancer screenings. We want to make sure you have the necessary tools and information to engage patients in lung cancer screening programs.

Dr. Ahluwalia: Unfortunately, most of our patients are diagnosed when they have locally advanced disease or metastatic disease. The outcomes of these patients is only around 20 to 25 percent survival at five years. This contrasts with 60 to 65 percent survival at five years in patients who are diagnosed with early-stage disease where we can actually surgically remove the disease. Can you talk to our audience about the importance of biomarker testing and targeted therapies?

Dr. Basu Roy: When I started at LUNGevity, we had just one targeted therapy approved for lung cancer for one type of mutation, the EGFR mutation. As we speak right now, we have targeted therapies for nine different molecular biomarkers and these are targetable mutations. Why is molecular testing so important? Because that’s the only way to identify if the tumor has a targetable biomarker, which can ensure that the patient gets matched to the right treatment at the right time.

Dr. Ahluwalia: The EGFR mutation is more prevalent in Hispanic patients compared to Caucasians. In Hispanics, it’s 40 to 50 percent. In white Caucasian patients, it’s only around 10 to 15 percent. Can you share the plethora of drugs now approved for EGFR-positive lung cancer?

Dr. Basu Roy: When I started, all of the drugs for EGFR-positive lung cancer were approved for metastatic disease, a disease that spreads typically to the other lung or to the lymph nodes or to other parts of the body. But two years ago there was this pivotal clinical trial called ADAURA that suggested if you use one of these EGFR drugs, osimertinib, for early-stage lung cancer and give it to patients after they’ve had surgery as an adjuvant treatment, then it dramatically increases the cure rates. That’s why finding early-stage disease and testing for these biomarkers is critically important.

Dr. Ahluwalia: Thanks so much for sharing the early-stage data. And we have seen this in the metastatic setting as well. So, one of the take-home points is that genomic testing is absolutely essential. Another take-home is that EGFR lung cancer patients, even those who have metastatic disease, if treated with chemotherapy, outcomes are like 12 months. But, if you start using targeted therapies like osimertinib, the outcomes are 38 to 39 months. And patients can tolerate these targeted therapies much better than chemotherapy. What about the role of immunotherapy in early-stage disease as well as metastatic disease?

Dr. Basu Roy: Immunotherapy is available for both metastatic lung cancer and early-stage, before or after surgery and sometimes given both before as well as after surgery. I want to go back to the original goal of our conversation, which is about the role and importance of lung cancer screening. Our technology to offer surgery has drastically improved and continues to improve. And we talked about some of the new, innovative treatments in early-stage disease, including targeted therapies, immunotherapies and now combining surgery with targeted therapies or immunotherapies. The chances of a cure are higher than ever before so the time is ripe to offer lung cancer screening to our community.

Dr. Ahluwalia: Recent innovation in the treatment of lung cancer has come with improved understanding of molecular profiles as they relate to which patients will get better benefit from which kind of therapy. For some patients who have oncogenic-driven tumors, we are now using targeted therapies. For patients who do not have those alterations, immunotherapy has truly transformed outcomes.

For more information on lung cancer screenings at Baptist Health, click here. During November, which is Lung Cancer Awareness Month, Baptist Health is offering lung cancer screenings to patients who meet the criteria for $35. For information, click here.