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July 12, 2001

Lung cancer initiative gets $12 million grant

The University of Pittsburgh Cancer Institute (UPCI) has received a five-year, $12 million federal grant to study lung cancer, the leading cause of cancer death in the United States.

The award from the National Cancer Institute is called a Specialized Program of Research Excellence (SPORE). UPCI is one of only six centers to receive the SPORE designation for lung cancer research since the award's inception in 1992. Other recipients include the M.D. Anderson Cancer Center in Houston, and centers at UCLA and Denver, Johns Hopkins and Vanderbilt universities.

At a July 11 news conference, Pitt faculty members said they expect that research funded by the grant will lead to better treatments for lung cancer as well as a greater understanding of why some people are more susceptible than others to the disease.

A major area of study will focus on women and lung cancer. More women die of lung cancer than any other cancer type, including breast cancer, according to the American Cancer Society.

"This has been an under-explored area, nationally and internationally, in lung cancer research," said Pitt pharmacology professor Jill Siegfried, co-director of UPCI's Lung Cancer Program and principal investigator on the SPORE grant.

Siegfried will examine the gastrin-releasing peptide receptor, a gene linked to abnormal cell growth in the lung. The gene appears to be more active in women than men, she said.

Previous UPCI research has indicated that the gene may be regulated by estrogen and nicotine, and may help to explain why women are more likely to develop lung cancer even when they are nonsmokers or smoke less than men, Siegfried said. Her new study will try to determine how hormones and exposure to tobacco contribute to expression of this gene. The study also will examine the expression of four other genes that may contribute to lung cancer risk in women.

Siegfried also will examine the role of estrogen in lung cancer development. "Anti-estrogens developed for [treating] breast cancer may also be effective in treating lung cancer, especially in female patients," she said.

UPCI Lung Cancer Program co-director Joel S. Greenberger, chairperson and professor in Pitt's Department of Radiation Oncology, will head a gene therapy project aimed at protecting esophaguses and normal lung tissues of patients receiving radiation therapy for lung cancer.

Radiation combined with chemotherapy drugs is very effective in treating early-stage lung cancer, Greenberger said. Unfortunately, radiation can severely inflame the esophagus.

UPCI is developing a material, containing an anti-oxidant gene called manganese superoxide dismutase, that patients can swallow (to protect their esophaguses against radiation) or inhale (to protect healthy lung tissue).

"If we can protect the esophagus, we will be able to give higher doses of radiation, making the treatment more effective," Greenberger said.

Other UPCI lung cancer research will examine:

* The role of the protein Cyclin B1 as an antigen (a substance that causes the immune system to make a specific immune response) and cancer vaccine for non-small cell lung tumors.

* The use of multi-detector CT as a screening tool in detecting extremely small lung tumors. According to researchers, one reason that lung cancer survival rates are low is that people with lung cancer usually do not develop symptoms until the cancer has spread throughout the lungs or body. Currently, only 14 percent of lung cancer patients survive for five years after treatment. But when lung cancer is found and treated early, the five-year survival rate increases to 42 percent.

The American Cancer Institute estimates that 169,500 people will be diagnosed with lung cancer in the United States this year and that 157,400 Americans will die of the disease. Lung cancer accounts for 28 percent of cancer deaths.

UPCI officials said the center saw more than 600 newly diagnosed lung cancer patients last year.

Despite a decline in the incidence of lung cancer (attributed to an overall decrease in smoking), lung cancer remains the second most common type of cancer diagnosed among U.S. men and women, being surpassed only by skin cancer.

Cigarette smoking causes 87 percent of all lung cancers. The longer a person has smoked and the more cigarettes smoked per day, the greater the risk for lung cancer. Passive smoking has been linked to lung cancer in non-smokers. Other risk factors include cigar and pipe smoking; exposure to radon, asbestos and pollution, and a family history of lung disease or lung cancer.

Lung cancer symptoms may include a chest cough or pain that does not go away or worsens over time, wheezing when breathing, shortness of breath, repeated problems with pneumonia or bronchitis, coughing up blood, hoarseness or swelling in the face and neck, loss of appetite or weight loss and fatigue.

— Bruce Steele

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