As a member of the National Comprehensive Cancer Network (NCCN)—an alliance of the world’s leading cancer centers — we are at the forefront of outcomes research. Our multidisciplinary group is investigating lung cancer through basic, translational, and clinical research. A wide variety of clinical and research projects are led by our thoracic surgical oncologists, medical oncologists, and radiation oncologists, as well as basic scientists, population scientists, pulmonologists, and radiologists.
Duke Cancer Institute’s thoracic cancer disease group is recognized for its innovative, aggressive, and personalized approach to detecting and treating lung cancer, the leading cause of death from cancer in the U.S. Our lung cancer program guides treatment decisions for the newly diagnosed or those seeking a second opinion.
Visit DukeHealth.org for more information about thoracic cancer.
- Clinical Trials
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Assistant Research Practice Managerdebra.email@example.com 919-681-4768
Visit DukeHealth.org for more information about thoracic cancer.
S. Scott Balderson
Erin M. Kunz
Roshni P. Mapp
Lung Cancer Screening
Our thoracic oncology surgeons are national leaders in minimally invasive surgical procedures. We perform more than 1,600 minimally invasive surgeries every year on all types and stages of lung cancer. As a result, patients experience less post-operative pain and recover faster.
Our radiation oncologists have access to specialized techniques, such as stereotactic body radiation therapy (SBRT) for early-stage lung cancer and radiation treatment planning aided by four-dimensional computed tomography (4D CT).
Our board-certified lung imaging specialists undergo advanced training in the early detection of lung cancer.
An important research strategy is the study of how individual genes affect oncogenesis and tumor progress. In the laboratory, some investigators are studying mouse models to determine the role of stem cells in the development of cancer in humans and in the development of resistance to treatment.
Clinically, researchers hope to discover how to use unique genetic mutations to personalize treatment and are looking at subgroups of patients to see how they respond to treatment.
Several studies are also ongoing utilizing a large tissue bank and database of patients treated for lung cancer at Duke University since 1995.
For example, some researchers are studying epidemiological factors related to lung cancer — why certain patient groups respond to treatment better than others.
In addition, other researchers are examining the role of age, gender, minimally invasive surgery, and other patient-specific factors in outcomes, including quality of life.
Lung cancer clinical research at Duke has focused on biomarker discovery and development —the use of molecular signatures to improve the assessment of prognosis and the development of specific new therapies.
The formation of the program has allowed for the optimal collaboration of the best basic science underway on the Duke campus with ongoing clinical and translational lung cancer research programs.
Our medical oncologists have developed several drugs that have received FDA approval. These drugs help improve patient outcomes.
Clinical Trials Results
Related News Results
On October 12, just before her 66th birthday, Henrietta Carr surprised her care team with a cancer ribbon-themed wall hanging she’d embroidered. “When I was diagnosed with stage 4 lung cancer, I moved from Greensboro to Durham so I could get treatment at Duke; I just wanted to come to Duke because I think they’re better,” says Carr. “I was feeling hopeless and as I was being treated by Dr. Crawford and Susan Blackwell, I started feeling hopeful of a future. They would share in my happiness, as the cancer would shrink. I am so grateful to my cancer team and wanted to show this gratitude.” Carr, a mother of two adult children, began embroidering cancer-ribbon-themed wall hangings to support individuals with cancer — friends, friends of friends, family, and friends of family — after she retired from nearly 30 years of service as a clerk and IT specialist for the Social Security Administration. This was well before she was diagnosed with cancer. “I did about 30 individual pieces and sent them out across the United States,” says Carr, who continued to embroider after her cancer diagnosis. It took about 25 hours to create the 36 by 56 (inches) piece she made for her cancer care team. To be diagnosed with cancer after bringing so much joy to other individuals with cancer was an unfair turn of events, Carr agrees. “But it is, what it is,” she says. It’s been nearly two years since Carr’s diagnosis. She’d gone to the Emergency Department at a hospital in Greensboro feeling a little fatigued and hoarse and came out of the ED with a diagnosis of pneumonia, which she was subsequently treated for. However, within a few weeks, she’d lost her voice and was hurting in her chest. Her second trip to the same ED resulted in a diagnosis, by an oncologist there, of lung cancer and pneumonia. “It was in both lungs and in between my lungs,” says Carr, noting that she wasn’t coughing or experiencing any breathing problems at the time. “I was kind of surprised. Because they kept saying it was (only) pneumonia.” Not Too Late In April 2020, she began radiation treatments to her right lung under the care of DCI radiation oncologist Christopher Kelsey, MD. She would also receive various combinations of chemotherapy and immunotherapy. There were promising clinical trial results at the time that indicated that chemotherapy and immunotherapy taken in combination might be more effective than either alone, Crawford explained. In December 2020, she underwent radiation to her left lung. Since then, she has been on immunotherapy (Keytruda, pembrolizumab) alone. Carr's specific diagnosis was lung adenocarcinoma, the most common primary lung cancer in America. This particular type of non-small cell lung cancer (NSCLC) has a strong association with previous smoking. Carr smoked cigarettes. As soon as she learned she had lung cancer, she tried to quit. With the aid of DCI physician assistant and trained tobacco cessation specialist Kelly M. Young, PA-C, she “cut way back.” “Quitting smoking can be extremely difficult and at times patients may not even know where to start,” said Young. “I value being able to help patient accomplish their goal of quitting smoking by offering medications and counseling based on the most current research.” People who currently smoke or have ever smoked make up more than 80% of lung cancer diagnoses. Quitting smoking can reduce your chance of developing lung cancer. Even after developing cancer, Young explained, quitting smoking can make cancer treatment more effective and prevent recurrence of cancer or new cancers from developing. By the end of this year, more than 235,000 new cases of lung cancer will have been diagnosed in the U.S. While the number of annual lung cancer deaths is decreasing, it remains the leading cause of cancer death in the U.S. (not including skin cancer). Lung cancer will take the lives of roughly 132,000 people in the U.S. this year — including about 5,000 in North Carolina — estimates the American Cancer Society. A Path to Home More than 75% of lung cancers are diagnosed in people over the age of 65. Carr, 66, has been on treatment for more than a year and a half and is still going strong. She’s even cheery. She says she feels “much, much, better,” though she admits she doesn’t have a lot of energy. In September 2021, Carr and her sister Sharlene were able to settle into a new house back in their hometown where they have extended family — in an area down towards Wilmington, not far from the Duplin Winery. Her treatments have now been extended to once every 6 weeks. She drives an hour-and-a-half to her immunotherapy infusion appointments and clinic visits at Duke Cancer Center in Durham, her sister by her side, and at the end of the day they drive right back home. “It’s going good. I feel pretty good,” said Carr, who describes herself as a homebody who avoids crowds. “We are just enjoying our house. And staying away from the Delta COVID.” Susan Blackwell, MHS, PA-C, and Jeffrey Crawford, MD, have been caring for patients with lung cancer at the Duke Cancer clinic for more than 30 years and are more excited than ever about the many treatment options now available. They work especially closely with primary clinical nurse, Mallory Tassone, BSN, RN, thoracic oncology fellow, Hilary Dietz, MD (who's training in medical oncology), and radiation oncologist Christopher Kelsey, MD, in a team approach for the benefit of their patients. Susan noted, “Ms. Carr is a wonderful person, always thinking of the needs of others. She is a true lung cancer survivor, living well and living longer.”
In continuing efforts to expand Duke Cancer Institute’s community outreach and engagement matrix of research, programs, and strategic partnerships to reduce the cancer burden and close the cancer disparities gap in its catchment area, DCI senior leadership is excited to welcome a new leader to the COE team. On Feb. 1 this year, cancer epidemiologist Tomi Akinyemiju, PhD, MS, was named DCI’s new associate director of Community Outreach and Engagement. (how to say her name) “She's a rising star in the world of cancer epidemiology and cancer disparities,” said deputy director of DCI Steven Patierno, PhD, who provides senior oversight to DCI’s community outreach and engagement efforts and helped recruit her to Duke two years ago. “She’s still in the early stages of her career but is already funded with an R01 from the National Cancer Institute. She’s also doing extraordinary work on breast cancer disparities in women of African ancestry. It’s very exciting research at the intersection of social determinants of health and the biology of cancer.” Akinyemiju joined Duke and DCI in Feb. 2019 as an associate research professor in the Department of Global Health and as an associate professor in the Department of Population Health Sciences where she also serves as vice-chair for Diversity, Equity, and Inclusion. She has a secondary appointment in the Department of Obstetrics & Gynecology. “Duke is a very well-known brand, a well-known institution with really cutting-edge smart people doing outstanding research,” she said. “I was really excited to come here, to be in North Carolina and be in an environment that values innovation, excellence and collaboration.” Previously, Akinyemiju was Assistant Dean for Inclusive Excellence and an associate professor of epidemiology with the Markey Cancer Center at the University of Kentucky. Akinyemiju’s current research to improve public health is focused on studying the social and biological mechanisms driving disparities in cancer risk, tumor aggressiveness and survival. “Access to care is a very consistent theme in my work,” she said. “In Kentucky, there is the Appalachian region, with underserved and low-income white populations. Similarly, in North Carolina, we have pockets where there is a lack of access to care as well as low-income underserved minority populations.” Akinyemiju is midway through a five-year $2 million NIH/National Cancer Institute-funded R01 study to assess the relative importance of race-specific barriers to healthcare access in Black and White ovarian cancer patients across nine states in the US, including Kentucky and North Carolina, and evaluating the impact of healthcare access on quality of cancer treatment, quality of life, and ovarian cancer survival. She expects that these new insights will help identify and prioritize ways to reduce disparities and improve care for these patients. Akinyemiju was born in Michigan, but grew up in Nigeria. She came back to her birthplace in 2004 for her undergraduate, graduate, and post-graduate education, but her latest research project, also NIH/NCI-funded, brings her back to where she grew up. Nigeria, which is seeing a rapid increase in breast cancer cases in addition to other non-communicable diseases, including obesity-related diabetes, has the highest breast cancer mortality rates on the African continent. Triple-negative breast cancer, an aggressive, fast-growing hard-to-treat subtype with a poor prognosis, is the most prevalent breast cancer sub-type at nearly 45% of breast cancer cases. Akinyemiju is exploring how rising rates of metabolic dysregulation brought on by changing lifestyle and dietary patterns may impact breast cancer risk in Nigeria. To do this she’s collecting biospecimens in women with and without the triple negative breast cancer subtype in order to study the biological mechanisms of different subtypes that could predispose one person over another to be at higher-risk. She also plans to extend this study to the U.S. to examine biological data in African American breast cancer cases where the triple negative breast cancer prevalence is 20%. One outcome could be the discovery of an epigenetic (heritable DNA changes) link to triple negative breast cancer in those of West African heritage, including Americans with enslaved ancestors of West African descent. “In this study, we are interlinking genomic data with social determinants of health,” Akinyemiju explained. “We need more research to figure out what the risk factors and biological mechanisms are and what we can target to treat. We’re having to build this data from scratch, but once we build it, the implications for important scientific discoveries are endless.”
Thomas A. D’Amico, MD, Gary Hock Endowed Professor of Surgery, chief of General Thoracic Surgery, and director of the Thoracic Oncology program at Duke Cancer Institute, has been appointed to a two-year term as medical director of the American Association for Thoracic Surgery (AATS). The AATS Medical Director is responsible for assisting the association in its efforts in content planning, faculty selection, and faculty development. The person in this role is also the physician champion during the ACCME (Accreditation Council for Continuing Medical Education) re-accreditation process and interviews. According to an announcement published in the AATS Update (December 2020 issue), D'Amico was chosen for this role "based on his leadership, expertise, and continued support of the association." "AATS is honored to have Dr. D’Amico serve as it’s medical director for the next two years," read the announcement. D’Amico earned his MD from the College of Physicians & Surgeons of Columbia University after completing undergraduate studies at Harvard University. He received training in general surgery and thoracic surgery at Duke University Medical Center. D’Amico joined Duke as a faculty member in 1996 following completion of a fellowship in thoracic surgical oncology at the Memorial Sloan Kettering Cancer Center. As director of the Thoracic Oncology Program of the Duke Cancer Institute, D’Amico supervises the clinical and research programs in lung cancer and esophageal cancer. As a member of the Duke Quality and Safety Committee and the Perioperative Executive Committee, he is involved in improving safety and quality in patient care. In addition to AATS, he holds leadership positions with the Society of Thoracic Surgeons and the International Association for the Study of Lung Cancer. He is also active in the National Comprehensive Cancer Network (NCCN), as a member of NCCN Board of Directors and Guidelines Steering Committee, the chair of the Quality and Outcomes Committee, as well as a member of the Non-Small Cell Lung Cancer and Small Cell Lung Cancer Guidelines Committees, and co-chair of the Esophageal Cancer Guidelines Committee. D’Amico is also an associate editor of the Journal of Thoracic and Cardiovascular Surgery and serves on the editorial board of the Annals of Surgery.
Life threw Chad Eddy “a curve ball" when simple back pain escalated into something much bigger. Now, in recovery, he's giving back. He is all set to join the DCI LUNGe team on September 29 to help raise awareness about lung cancer — and he's the featured speaker. Chad Eddy, a Raleigh resident from upstate New York was excited for his 40th birthday, March 20, 2019. His wife Missy had promised, “This year we’re going to go big.” So, the couple, who didn’t travel very often, set off with their families for Orlando, Florida, to chill at the pool, enjoy some beach time, and take in a spring training Yankee game. There was much to celebrate. Life, no less. A year before, in the span of a month, Chad had gone from feeling perfectly normal, to experiencing numbness in his leg, increasing pain in his back, and limited mobility. No abnormalities were found in an x-ray. Neither a cortisone shot nor physical therapy worked. “Just being an athlete, I’d had injuries, but it wasn’t like I could walk it off, I knew that something needed to be fixed, bad,” recalled Chad. “It got to the point where I had to pull on my leg to move it. It was very scary.” “He was basically the picture of health,” added his wife Missy. “Then suddenly, he could hardly walk. He was only 39.” Finally, an MRI revealed a tumor — likely malignant — that had broken his vertebrae. The couple barely had time to process the news, when less than 24 hours later, Chad fell, immobilized by the pain of a severely compressed spinal cord that had weakened his legs. He was rushed by ambulance to Duke University Hospital. That day, May 16, 2018, he underwent a four-hour spinal surgery that included the removal of a cancerous tumor and the insertion of eight screws and a rod in his spine and a cage in between the vertebral bones. “The morning after surgery, I wanted to prove to Dr. Goodwin that I could walk so I did,” said Chad. “I took two little steps and he said, “Alright, now rest up some.” On the second or third day I was able to walk down the stairs and was cleared to check out of the hospital. Dr. Goodwin said that I was one of the most positive patients he’s ever had.” “His ability to go from not walking to walking is a major predictor of his overall survival,” said Duke neurosurgeon Rory Goodwin, MD, PhD, who co-leads the Duke Center for Brain and Spine Metastasis and performed Chad’s spinal surgery. However, with a diagnosis of stage 4, metastatic, non-small cell lung cancer — lung cancer that had spread to his spine — Chad needed treatment beyond surgery. The couple was shocked that Chad had cancer at all and that it had advanced so quickly. And how did he get lung cancer? Chad wasn’t even a smoker. According to Goodwin, the fact that Chad didn’t discover he had lung cancer until it had already spread to the spine, is not uncommon. Neither is it uncommon for someone who doesn’t smoke to get lung cancer. While smoking is the leading cause of lung cancer, 18 to 20% percent of lung cancer patients, like Chad, have never smoked. Sixty percent, at the time of diagnosis, will have already quit. Chad said he didn’t dwell too much on the cause. After a successful surgery and brief recovery, he just wanted to know the game plan. Chad was referred to thoracic oncologist Jeffrey Clarke, MD, who advised genomic testing — a non-invasive “liquid biopsy” of the tumor DNA and tumor cells in his blood — to identify possible treatments. The test revealed that Chad’s cancer was caused by a particular mutation in the EGFR gene which was driving his cancer cells to grow. Fortunately, a new drug had just been FDA-approved for patients with new diagnosis of lung cancer — osimertinib (brand name: Tagrisso) — that had been shown to bind to the EGFR protein and shut down cancer growth. First, Chad would first undergo 10 radiation sessions with Duke radiation oncologist Jordan Torok, MD. He started taking osimertinib in June 2018, and toughed out the “hard work” of physical therapy to rebuild his strength. Chad was back at his customer service job part-time, then full-time, within a couple months of surgery.