Research in Thoracic and Cardiovascular Surgery
The research program of the Department of Thoracic and Cardiovascular Surgery emphasizes gaining new knowledge through clinical and basic science research programs to improve the treatment of patients with thoracic cancers and to provide a better biological foundation for thoracic cancer surgical treatments. Treatment advances in thoracic cancers, which include lung and esophageal cancers and lung metastases, have been slow to develop, even though these cancers are among the most common of all neoplastic diseases.
Clinical trials have focused on the development of combined-modality treatment approaches involving novel chemotherapy agents, radiotherapy techniques and surgical approaches. These protocols represent a major collaborative effort with the departments of Thoracic/Head and Neck Medical Oncology, Gastrointestinal Oncology and Digestive Diseases and Radiation Oncology. Current protocols for lung cancer include both preoperative and postoperative adjuvant chemotherapy with novel agents.
Protocols combining chemotherapy, radiotherapy and surgery are being evaluated for esophageal cancer. A novel strategy of pulmonary perfusion with doxorubicin for sarcomatous lung metastases is being evaluated. A major collaboration with the Department of Thoracic/Head and Neck Medical Oncology is directed toward chemoprevention of second primary cancers in patients with early-stage lung cancer.
It is a departmental goal to acquire a basic understanding of the cellular and molecular mechanisms leading to the development and progression of lung cancer and to apply these findings to further the development of gene-based prevention and treatment strategies. Major research programs in the department include identification of oncogenes and tumor suppressor genes important in lung cancer development and progression, development of techniques to alter oncogene and tumor suppressor gene expression, investigation of genetic events in premalignant lesions, development of efficient viral and nonviral vectors for gene delivery to cancer cells, and application of these systems in human gene therapy.
This department has completed clinical trials to evaluate replacement of the p53 tumor suppressor gene by delivering a functional p53 tumor suppressor via retroviral and adenoviral vectors in patients with non-small cell lung cancer. New trials combining p53 gene replacement are planned in combination with radiotherapy and chemotherapy in collaboration with the Department of Thoracic/Head and Neck Medical Oncology.
The department is a recipient of a Specialized Program of Research Excellence (SPORE) in Lung Cancer grant jointly with The University of Texas Southwestern Medical Center in Dallas. This program has major projects focused on molecular early detection, susceptibility genes, and chemoprevention of lung cancer. The department actively pursues its mission and vision of developing new treatments for lung cancer and rapidly translating laboratory findings into clinical applications.
Gene-Based Prevention and Treatment Strategies
- Identification of Oncogenes and Tumor Suppressor Genes
- Techniques to Alter Oncogene and Tumor Suppressor Gene Expression
- Investigation of Genetic Events in Premalignant Lesions
- Development of Efficient Viral and Nonviral Vectors for Gene Delivery to Cancer Cells