{"id":20103,"date":"2019-01-02T14:10:38","date_gmt":"2019-01-02T21:10:38","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=20103"},"modified":"2023-09-01T11:57:20","modified_gmt":"2023-09-01T17:57:20","slug":"at-forefront-of-lung-cancer-battle","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/at-forefront-of-lung-cancer-battle\/","title":{"rendered":"At the forefront of lung cancer battle"},"content":{"rendered":"
<\/div>

Sheri John\u2019s life has mostly been a model of stability. A Colorado native with farming roots in the soil near Sterling, she moved to the Denver area in grade school, graduated from Sheridan High School in 1976 and became a dental assistant. Over the past 38 years, she\u2019s applied her skills at precisely two places \u2013 the last one for 21 years and counting.<\/p>\n

Now 61, John has also kept her life on an even keel. She doesn\u2019t smoke or drink and says she stuck to the straight and narrow, even in her younger years.<\/p>\n

\u201cI was not a wild child in school,\u201d she said.<\/p>\n

\"Sheri
Sheri John with Lassie, her agility dog.<\/figcaption><\/figure>\n

In addition to job and family, John puts her energy into agility training for dogs, a pursuit that requires plenty of stamina. Taking her dog \u2013 Lassie, appropriately enough \u2013 through his paces on the twists and turns of an obstacle course was no sweat until the summer of 2016. She\u2019d had a cold and gotten treatment for it. But the symptoms hung on, and John found herself short of breath when she ran with Lassie.<\/p>\n

\u201cWhen I can\u2019t run my dog on a course I\u2019ve been doing for 10 years, I knew something was wrong,\u201d John said. She stuck it out, but in October 2016, knifing back pain derailed a planned trip to Kansas and sent her to the hospital for what turned out to be a kidney stone. However, tests revealed a far greater problem.<\/p>\n

Stunning news, with a twist of hope<\/strong><\/h3>\n

Sheri John was to face life\u2019s great destabilizer: cancer. Specifically, it was lung cancer, the leading cause of cancer deaths in women. Adding to the shock, John had the most advanced form, stage IV, meaning that the cancer had spread to other parts of her body. The first oncologist she met with bluntly told her she had six months to a year to live.<\/p>\n

\u201cI was numb,\u201d John recalled. Her mind began whirling through all she needed to prepare for in the time she had left: saying good-bye to her husband and family, finding a home for her dog, shedding possessions.<\/p>\n

\u201cI felt like I was at the end,\u201d John said.<\/p>\n

\"Lassie
Sheri’\u0092s lung cancer treatment has allowed her to once again keep up with Lassie on his agility training.<\/figcaption><\/figure>\n

Two years later, John has changed oncologists and is still here and battling back with the aid of a lung cancer-fighting drug, brigatinib, she receives through the UCHealth University of Colorado Hospital<\/a>\u00a0on the Anschutz Medical Campus that has shown promising results in clinical trials conducted by the University of Colorado Cancer Center<\/a>. Brigatinib is the latest generation of drugs that inhibit an acquired genetic mutation, ALK, that occurs in about 4 percent of people with non-small cell lung cancer.<\/p>\n

Brigatinib was the focus of a 275-patient, multinational, phase III clinical trial called ALTA-1L <\/a>whose results appeared in the New England Journal of Medicine<\/em> <\/a>in late September. At the same time, attendees at the International Association for the Study of Lung Cancer (IASLC) World Conference on Lung Cancer 2018 also heard the results.<\/p>\n

Strong performance<\/strong><\/h3>\n

They were impressive, said Dr. Ross Camidge<\/a>, a medical oncologist at the University of Colorado Hospital and Joyce Zeff Chair in Lung Cancer Research at the CU Cancer Center. Camidge was lead author of the
\nALTA- 1L study. The trial, Camidge said, pitted brigatinib against crizotinib, an older ALK inhibitor approved in the United States since 2011. In one key measure, study participants who received brigatinib had a 51 percent decreased risk of cancer progression or death compared with those who received crizotinib.<\/p>\n

Camidge puts that number in perspective. \u201cIf you say as a patient, \u2018What are my chances of my cancer not growing and my being alive at one year,\u2019 it\u2019s 87 percent for brigatinib and 43 percent for crizotinib.\u201d<\/p>\n

The trial results argue for brigatinib becoming the first-line treatment for lung cancer patients with the ALK mutation, Camidge said. He cited at least two key points for that conclusion. First, he noted that lung cancer has a tendency to metastasize to the brain in these patients.<\/p>\n

\u201cCrizotinib has a low penetration into the brain, and the cancer often remains essentially untreated,\u201d Camidge said. In contrast, the study results show brigatinib had much greater success in \u201cextending coverage to the whole body, including the brain,\u201d he added. \u201cWe see with the data that this a very early differentiator between the two drugs.\u201d<\/p>\n

Apparent advantages<\/strong><\/h3>\n

Camidge explained that in about half of the patients treated with crizotinib whose lung cancer had metastasized to the brain at the start of the study, the brain cancer progressed further within roughly five months. In patients with the same diagnosis treated with brigatinib, the percentage whose brain cancer progressed was much lower, said Camidge.<\/p>\n

\"Dr.
Dr. Ross Camidge was lead author of the ALTA-1L study.<\/figcaption><\/figure>\n

Secondly, Camidge said, with just 10 months to a year of follow-up for patients in both of the treatment arms, researchers are \u201cbarely scratching the surface in terms of the difference\u201d between the power of the two drugs to halt the progression of disease outside of the brain. He compared the ALTA-1L study results to a \u201cmovie trailer saying there is going to be really interesting stuff coming out of this when we start to see the full differential effects read out. \u201cMore mature data\u201d should be available in about another year, Camidge said.<\/p>\n

The reasons for brigatinib\u2019s apparent advantage over crizotinib are partially but not completely understood, Camidge said. He noted that in some cases resistance to crizotinib occurs through the development of new mutations in ALK, while brigatinib still works on many of these. However, brigatinib may also possess an as-yet unidentified \u201csecret sauce,\u201d he added. That may be through effects on some other pathway in the cancer cell that enables brigatinib to achieve a longer period of control over the rogue cells emerging after crizotinib than any other ALK inhibitor. Understanding the basis of the \u201csecret sauce\u201d is the subject of further study, Camidge said.<\/p>\n

Return to life<\/strong><\/h3>\n

Sheri John only knows she\u2019s gained the gift of time. Not satisfied with the original dismal prognosis in October 2016, her husband sought a second opinion, which led to an appointment with Dr. Tom Purcell<\/a>, a medical oncologist and executive medical director of Cancer Services at UCHealth. Purcell and the lung cancer team identified John\u2019s ALK mutation and enrolled her in the ALTA-1L trial. She began taking brigatinib just before Thanksgiving Day in 2016.<\/p>\n

Two years later, John continues to take two pills containing the medication each night before bedtime. She said she\u2019s had some minor side effects, including diarrhea that she controls with Imodium, and sometimes gets fatigued at the end of a long day. But those issues pale in comparison the benefits of the treatment.<\/p>\n

\u201cI feel great,\u201d she said. \u201cI work five days a week. I go to my agility classes and continue doing my regular stuff. I am active. I love the outdoors. I don\u2019t sit around.\u201d<\/p>\n

As for the shortness of breath that presaged the cancer diagnosis, it is for now a thing of the past. \u201cI can run the course in the agility ring again. Before, I couldn\u2019t make it through, and I have no pain.\u201d<\/p>\n

\"A
Dr. Tom Purcell is encouraged by Sheri John’\u0092s response to the brigatinib treatment.<\/figcaption><\/figure>\n

Purcell views her progress with cautious optimism. \u201cSheri is an amazing person. She has tolerated the study medicine extremely well\u2026and has had a complete response from her cancer. That means 100 percent reduction in her lung cancer,\u201d he said in an email.<\/p>\n

At the same time, Purcell acknowledged the adaptive power of the lung cancer John is fighting. \u201cWe are concerned about the cancer developing resistance,\u201d he said. \u201cFortunately we have many options for treatment if that does occur.\u201d<\/p>\n

For her part, John calls Purcell \u201ca godsend. I left the decision on my treatment up to Dr. Purcell to tell me what he thought would work best. The entire team at the Cancer Center is top-notch.\u201d<\/p>\n

She returns to the Cancer Center once a month for blood work and to get her medication, and receives imaging tests every 12 weeks. Otherwise, she lives her life as she always had before the illness. The unexceptional has become exceptional.<\/p>\n

\u201cI don\u2019t know if I have a timeline,\u201d John said. \u201cMy plan is to go on living life and not dwell on this. I feel like I have hope. I would like to just keep plugging away.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

Sheri John\u2019s life has mostly been a model of stability. A Colorado native with farming roots in the soil near Sterling, she moved to the Denver area in grade school, graduated from Sheridan High School in 1976 and became a dental assistant. Over the past 38 years, she\u2019s applied her skills at precisely two places […]<\/p>\n","protected":false},"author":2143,"featured_media":20104,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5],"tags":[6836,1727],"class_list":["post-20103","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-innovative-care","tag-lung-and-thoracic-cancer","tag-lung-cancer"],"acf":[],"yoast_head":"\nAt the forefront of lung cancer battle - UCHealth Today<\/title>\n<meta name=\"description\" content=\"University of Colorado Hospital and the University of Colorado Cancer Center are at the forefront of treating lung cancer.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.uchealth.org\/today\/at-forefront-of-lung-cancer-battle\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"At the forefront of lung cancer battle\" \/>\n<meta property=\"og:description\" content=\"University of Colorado Hospital and the University of Colorado Cancer Center are at the forefront of treating lung cancer.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.uchealth.org\/today\/at-forefront-of-lung-cancer-battle\/\" \/>\n<meta property=\"og:site_name\" content=\"UCHealth Today\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/uchealthorg\/\" \/>\n<meta property=\"article:published_time\" content=\"2019-01-02T21:10:38+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-09-01T17:57:20+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2019\/01\/02135128\/featurephotoeee.pnger_.png\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Tyler Smith\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@uchealth\" \/>\n<meta name=\"twitter:site\" content=\"@uchealth\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Tyler Smith\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"7 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/at-forefront-of-lung-cancer-battle\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/at-forefront-of-lung-cancer-battle\\\/\"},\"author\":{\"name\":\"Tyler Smith\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/#\\\/schema\\\/person\\\/98c85c0e40c4933eedcec2cd054f349d\"},\"headline\":\"At the forefront of lung cancer battle\",\"datePublished\":\"2019-01-02T21:10:38+00:00\",\"dateModified\":\"2023-09-01T17:57:20+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/at-forefront-of-lung-cancer-battle\\\/\"},\"wordCount\":1456,\"publisher\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/at-forefront-of-lung-cancer-battle\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/uchealth-wp-uploads.s3.amazonaws.com\\\/wp-content\\\/uploads\\\/sites\\\/6\\\/2019\\\/01\\\/02135128\\\/featurephotoeee.pnger_.webp\",\"keywords\":[\"Lung and thoracic cancer\",\"lung cancer\"],\"articleSection\":[\"Innovative care\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/at-forefront-of-lung-cancer-battle\\\/\",\"url\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/at-forefront-of-lung-cancer-battle\\\/\",\"name\":\"At the forefront of lung cancer battle - 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