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Clinician Spotlight: Dr. Christine Bestvina

*November 2023*

This month, we are honored to feature Dr. Christine Bestvina, Assistant Professor at the University of Chicago Medicine Comprehensive Cancer Center, specializing in thoracic oncology. Dr. Bestvina has been connected with the EGFR Resisters since she was a fellow at University of Chicago! She participated in the first EGFR Resisters Research Summit in 2019, where she received an Honorable Mention Award for her work on “Epigenetic Mapping of Cell-Free DNA in Patients with EGFR-mutated Non-Small Cell Lung Cancer.” We were fortunate to have Dr. Bestvina return to the 2022 EGFR Resisters Research Summit as an alum and share important advice on work-life balance with our Young Investigators. We look forward to working with Dr. Bestvina and collaborating further in the future.

What motivated you to get involved with lung cancer research? How did you do it?
I was motivated to pursue lung cancer research because of the opportunity to push forward where we are in the clinic, and a desire to offer patients not just better treatments in the future, but potentially better treatments today depending on clinical trials. I was able to get involved in research as a fellow, under the excellent mentorship of Dr. Jyoti Patel. Great mentorship has been key in my career path!

What research have you done that would have the most impact on our members with the EGFR mutation?
Patients with EGFR mutations typically receive liquid biopsies, tissue biopsies, or both when their cancer treatments are no longer working. We looked at the concordance of liquid biopsy and tissue biopsy, or how frequently the two tests have the same results or different results, both at the time of diagnosis and at the time of progression. We found that at progression, concordance was much lower. This can impact patients with EGFR mutations, knowing that if a liquid biopsy is non-informative, or doesn’t find a mutation, a tissue biopsy would still be considered standard of care.

What new projects are you working on?
I am currently working with a basic science collaborator, Dr. Chuan He, on plasma cell-free DNA hydroxymethylation. It is currently difficult to predict who will and won’t respond to osimertinib or other EGFR TKIs. Our research asks the question, “Can we better identify patients who are and aren’t likely to respond to TKIs using the hydroxymethylome?”

What was treating lung cancer/lung cancer research like when you first started to practice, and when was that?
I started my practice in 2018. It took time to build up a clinical trial research portfolio and to develop good relationships with industry partners. It also took time to develop translational collaborators. Patience and persistence were key, given the foundational structure took a few years.

What do you think lung cancer treatment will look like five years from now?
I’m hopeful that in the next 5 years we will get better at individualizing patient treatment plans. This is across the board, for patients with targetable alterations and those without, and includes decisions like who would benefit from the addition of upfront chemotherapy to osimertinib, or which patients may benefit from the addition of a CTLA-4 (checkpoint) inhibitor.

What treatments/research of interest do you consider will make a significant impact in the not-too-distant future?
There  are many trials with data soon to be released in the EGFR space that are highly anticipated – FLAURA2 and Mariposa in particular.

How could treatment be done differently at this time to improve care?
The research I am currently doing that I am most excited about involves “whole person care”, and in particular identifying social determinants of health in the cancer population. In the past six years at University of Chicago I have taken care of many patients from a variety of backgrounds and a variety of means. I am interested in increasing health equity and working towards reducing barriers for equitable clinical trial participation.

Do you have any advice for people considering clinical trials?
Clinical trials can be scary, whether it be the initial randomization, early drug development, or even the number of blood draws required. But there are many unseen benefits, such as earlier access to drugs in development and increased touch-points with your healthcare team. Don’t be afraid to ask questions of your clinical care team.

Is there anything else you would like our readers to know?
I participated in the inaugural EGFR Resisters Summit many years ago, and it has led to multiple long term research collaborations, as well as close relationships with many of my colleagues. I am very thankful for all of the support and opportunities as a junior investigator!