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Clinician Spotlight: Dr. Laura Petrillo

*January 2024*

This month we have the honor of featuring Dr. Laura Petrillo, MD.  Dr. Petrillo is a palliative care physician-investigator in the Division of Palliative Care and Geriatrics at Massachusetts General Hospital and an Assistant Professor of Medicine at Harvard Medical School  Dr. Petrillo attended the 2021 EGFR Resisters Research Summit featuring her work on Patient-Reported and End-of-Life Outcomes Among Adults with Oncogene-Driven Lung Cancer in a Palliative Care Clinical Trial. Laura’s research focuses on improving palliative and supportive care for adults living with advanced cancer in the era of precision medicine.

Dr. Petrillo and EGFR Resisters co-founder Jill Feldman started and co-chair the Survivorship Task Group, which is part of the National Lung Cancer Roundtable.

What motivated you to get involved with lung cancer research? How did you do it?
As a palliative care physician, I noticed in my clinical practice that our model of palliative care needed to evolve to match the new challenges that patients are facing. The group of patients with oncogene-driven lung cancer seemed like an ideal population to study to understand how precision medicine has changed the patient and family experience.

What research have you done that would have the most impact on our members with the EGFR mutation?
I started with research to describe the experience of people with lung cancer receiving targeted therapy with communication about what to expect, living with uncertainty, quality of life and unmet supportive care needs. I learned that even though the survival benefits of targeted therapy are very exciting, we still have work to do to help people manage toxicities and the psychological impact of cancer, and that there is also room for improvement in how we communicate about the future. I was struck by the common themes that came up for many different people – gratitude and hopefulness related to the evolving therapeutic landscape, but also a profound effect of uncertainty on their lives and the lives of everyone around them.

What new projects are you working on?
There are a couple of things I am really excited about! We are working on a new supportive care intervention that blends palliative care and survivorship care for people with advanced lung cancer receiving targeted therapy. I am also very fortunate to work with colleagues on the Survivorship Task Group of the National Lung Cancer Roundtable, which I co-chair with the extraordinary Jill Feldman, and we have a few survivorship projects in the pipeline. It’s been very cool to shift to thinking about survivorship in advanced lung cancer, which reflects how much things have changed.

What was treating lung cancer/lung cancer research like when you first started to practice, and when was that?
When I was in medical school in the 2000s, I remember learning about a subtype of lung cancer that affected Asian women- that was the boards question prompt – that could be treated with erlotinib rather than chemo. It was rare and we were not taught about EGFR mutations outside of that specific demographic at that time. Since then there has been an explosion of molecular testing, targeted therapies, and immunotherapy, and it seems like every few months there are new drugs. It’s such an exciting time.

What do you think lung cancer treatment will look like five years from now?
I think we will continue to see more targeted therapies that help with overcoming resistance to what we have now, and the continued use of immune checkpoint inhibitors, probably in combination with other drugs, for patients who are eligible for that approach.

What treatments/research of interest do you consider will make a significant impact in the not-too-distant future?
Drugs that activate the immune system to fight cancer, like immune checkpoint inhibitors and CAR-T therapy, have been transformative. I am hopeful that the evolution of immunotherapy will lead to more options for helping people have durable responses to treatment or even cures.

How could treatment be done differently at this time to improve care?
I think there is a ton we could be doing better. Right now, it is a very location- and clinician-dependent kind of supportive care services people have access to. Everyone should have a core set of services offered that could be tailored to their needs. Palliative care, mental health care, nutrition, physical activity support, and psychosocial support from peers are some of the services that people need and that are part of high-quality personalized care.

Do you have any advice for people considering clinical trials?
Clinical trials are incredibly important and a generous thing to do since they help move the science forward. Transitions onto and off of clinical trials can be challenging so it is helpful to have continuity in team members — such as a social worker or palliative care clinician — and to speak up to advocate for what you need. I am glad to see the movement toward more pragmatic clinical trials and toward decentralization because they lower the burden on clinical trial participants.

Is there anything else you would like our readers to know?
I am really grateful for the support that advocacy organizations like EGFR Resisters provide to people and their families who are living with lung cancer and for the advocacy that drives research and policy forward. I recommend that newly-diagnosed patients find their peers because the support and education from other people dealing with something similar is invaluable.