This month we have the honor of featuring Dr. Elaine Shum, who is Assistant Professor of Medicine at NYU Perlmutter Cancer Center in New York. Dr. Shum participated in the 2021 EGFR Resisters Research Summit and received the Distinguished Young Investigator Research Award for her study Lung Cancer Screening in Female Asian Women without a Smoking History. Early findings of the ongoing study were reported at ASCO 2023, determining the feasibility of a screening group for Asian women in the United States.
What motivated you to get involved with lung cancer research? How did you do it?
I have been interested in oncology research since I was a high school student when I worked in a laboratory focused on oncolytic viruses. Around the same time, imatinib, a tyrosine kinase inhibitor for CML was approved and its role as a targeted therapy particularly drew me to the idea of personalized medicine. Eventually, I became involved with lung cancer through amazing mentors, Dr. Balazs Halmos and Dr. Haiying Cheng, during my oncology fellowship at Montefiore. By then, as we all know, targeted therapies in oncology and particularly lung cancer have become well-established!
What research have you done that would have the most impact on our members with the EGFR mutation?
I am the site Principal Investigator of several clinical trials targeting the EGFR mutation at NYU. In addition, I believe early detection and screening is important especially for populations with no smoking history, as finding a cancer early remains the best chance for cure. As such, I am conducting the Female Asian Nonsmoker Screening Study (FANSS) which is a pilot lung cancer screening program for Asian women who have never smoked. I am hoping these efforts will one day lead to expanded guidelines in the U.S.
What new projects are you working on?
We continue to enroll and analyze the data from FANSS, but we are thinking of the next steps in these efforts including a larger study with additional sites throughout North America. In addition, we are working on learning more about lung cancer in nonsmokers through collaborations in the lab.
What was treating lung cancer/lung cancer research like when you first started to practice, and when was that?
I graduated oncology fellowship in 2017 when osimertinib was already beginning to make an impact for lung cancer patients with EGFR mutations. Immunotherapy also was gaining momentum with the first approvals of nivolumab. Now only six years later, it is amazing how far we have come with new first-line combination treatment options for EGFR mutated lung cancer, multiple immunotherapy indications in the metastatic space, adjuvant treatment for EGFR mutated lung cancer and all the neoadjuvant treatment approaches that are being developed. It is truly incredible all the progress that has been made!
What do you think lung cancer treatment will look like five years from now?
I hope that we will have better tools to identify which treatment options would benefit which patients. This is what drew me to oncology in the first place: personalized medicine, improved biomarkers, assays for minimal residual disease and better and more comprehensive understanding of resistance mutations with novel treatment options targeting these mutations.
What treatments/research of interest do you consider will make a significant impact in the not-too-distant future?
Antibody drug conjugates will likely become approved. Hopefully we will also have potential companion biomarkers or other tools to help guide their use.
How could treatment be done differently at this time to improve care?
We are seeing more combinations entering the first-line space and new options are certainly needed and welcome to give patients more choices. Right now as of October 2023 and as a physician, I do not feel we know yet what is the best sequencing of treatments to offer patients particularly with EGFR mutated lung cancer. The toxicities of these regimens need to be considered; and as a community, we certainly have to listen to the patient voices, preferences, and concerns as we offer these regimens.
Do you have any advice for people considering clinical trials?
The concept of a clinical trial has changed dramatically over time. In the past, most clinical trials were seen as options when all standard treatments had been exhausted; but nowadays, clinical trials can offer novel treatments that can have individual patient impact and benefit. For example, some novel drugs are being developed for rare or uncommon mutations that can only be given on a clinical trial. It is undoubtedly scary to be on an experimental trial but listening and understanding the clinical trial rationale, side effect profiles, and other important information from the healthcare team can help in determining if this option is the best one.
Is there anything else you would like our readers to know?
The lung cancer community is an incredibly strong one and one of the main reasons is the strong support and collaboration we as physicians and the healthcare community have with the patient advocates. I think it has been amazing to see and hear your voices on the internet, on social media, and at our scientific conferences. Working together continues to make the science stronger and hopefully meaningful to all affected by lung cancer.