Each November, Lung Cancer Awareness Month offers the opportunity to reflect on the progress that’s been made in addressing the disease responsible for nearly 2.5 million diagnoses in 2022: lung cancer. [1] Therapeutic innovations have dramatically transformed outcomes for people living with lung cancer. Less than two decades ago, median overall survival for many lung cancer patients was just eight-to-10 months, yet advancements in targeted therapies have propelled survival rates to over 50 months for some patients. [2]
While advances in treatment have changed the lives of countless patients and families across the world, there is still much work to be done to ensure that improved survival can be achieved for more patients. Lung cancer continues to be the leading cause of cancer-related deaths, with an estimated 1.8 million deaths in 2022. [1]
So, while we rightly celebrate the significant breakthroughs made to date, we cannot be complacent. Patients urgently need the industry to adopt innovative strategies that push the boundaries of scientific progress, accelerate the availability of new treatments, and work across disciplines to deliver new standards of care to patients.
Pushing Boundaries to Accelerate New Treatments
In my experience as a clinician, I saw firsthand the urgent need for patients to receive timely diagnoses and a personalized treatment approach to increase their probability of living longer and healthier lives. Routine screening for patients at higher risk and universal biomarker testing at the time of diagnosis are now essential components of oncologic management, allowing us to diagnose patients earlier and personalize therapies to specifically target the genetic profile driving their unique case. However, testing still sometimes identifies tumor features conveying a poor prognosis, including mutations that do not respond to standard treatments or for which we currently lack targeted therapies.
Recognizing these challenges, biotech companies play a crucial role in advancing solutions for these patients when they lean into strategies that reflect a clinician’s mindset to treating patients: there’s no one size fits all solution, and no one tool for every job when caring for people with cancer.
A modality-agnostic approach starts with identifying high-impact targets and then determining the best modality for that target – with the goal of developing new standards of care. Adopting a modality-agnostic mindset allows for the agility to pursue new therapeutic opportunities based on emerging science and opens new doors for collaboration at all points across the development continuum – from discovery to the clinic.
Now, in my role as Chief Medical Officer at Cullinan Therapeutics, I am proud to be part of a multi-disciplinary team working to support two distinct populations of lung cancer patients facing limited treatment options. Our modality-agnostic approach has enabled two different approaches designed to address the needs of patients living with non-small cell lung cancer (NSCLC): (1) patients with exon 20 insertions (ex20ins) of the epidermal growth factor receptor (EGFR), a relatively rare genetic alteration that characterizes one of the largest unmet need segments of the lung cancer population with EGFR mutations, and (2) those with oncogenic mutations whose tumors no longer respond to available targeted therapies but are typically unresponsive to standard therapies such as checkpoint inhibitors that work in other subtypes of NSCLC. [3]
Building Coalitions to Set New Standards
It is often said that drug development is a team sport, and that team is not only the people at an individual company. It involves collaboration across academic investigators, community investigators, patients, caregivers, and other organizations, such as patient advocacy groups, that support our work.
Delivering new standards of care to these difficult-to-treat patient populations will not be achieved by one company or institution. It’s only by working together that we’re able to bring exciting new medicines to patients with the potential not only to treat their disease, but to change their lives.
For instance, Cullinan is currently collaborating with our partners at Taiho Oncology to more fully explore the potential of a novel investigational treatment for EGFR ex20ins NSCLC in combination with chemotherapy as a first-line therapy for these patients, hoping to potentially extend the duration of clinical benefit beyond what can be achieved with chemotherapy alone. However, after scientists working at both our companies identified that this molecule might also have the potential to treat patients whose NSCLC has even less common EGFR mutations, we decided to study the drug in these patients, hoping to create an option for therapy where few effective treatments currently exist.
Yet fostering external collaboration beyond the walls of biotech is crucial to advance new ideas and improve outcomes for patients. A robust partnership network fueled by external collaboration with other scientists and the practitioners directly caring for these patients helps advance new ideas that have a higher chance of benefiting patients and provides different perspectives to most effectively advance programs together.
The commitment, dedication, and perseverance demonstrated by the broader lung cancer community over the years inspires great optimism for the future, and the advancements seen over the last two decades are just the beginning of what we can achieve together in the years to come. We must remain vigilant in our efforts to enhance the lives, outcomes, and overall outlook of those affected by lung cancer. Together, we can develop innovative treatments that have the greatest potential impact on people living with lung cancer and their families.
Sources
[1] Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, et al. Global Cancer Statistics 2022: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A cancer journal for clinicians. 2024 Apr 4;74(3)
[2] Lung cancer treatment: 20 years of progress. The Lancet. 2024;403(10445).
[3] Bai Q, Wang J, Zhou X. EGFR exon20 insertion mutations in non-small cell lung cancer: Clinical implications and recent advances in targeted therapies. Cancer Treatment Reviews. 2023 Nov;120(102605)
About the Author
Jeffrey Jones, MD, MBA., is the Chief Medical Officer of Cullinan Therapeutics, a biopharmaceutical company focused on creating new standards of care for patients with cancer and autoimmune disease. With nearly 20 years of clinical development experience in academia and industry, Jeff’s expertise spans clinical trial design and recruitment, drug development, medical education, and healthcare management. In his current role, Dr. Jones manages a diverse pipeline of clinical-stage programs that span multiple therapeutic areas and modalities. Dr. Jones holds an MBA from The Ohio State University Fisher College of Business, an MD from the University of Michigan Medical School, completing his residency in internal medicine at McGill University and fellowship in medical oncology and hematology at The University of Texas MD Anderson Cancer Center.