Double lung transplants successfully treat late-stage lung cancer, for the first time using a new technique

A new double lung transplant technique has been successful in two patients with lung cancer, Northwestern Medicine announced. The hospital said it is capitalizing on this success for a new clinical program that will offer transplants to patients with end-stage lung cancer.

“Every morning when I open my eyes I just can’t believe it and life has a different meaning now,” Tannaz Ameli, the second person with lung cancer to receive the transplant, said during a news conference.

According to the CDC, lung cancer is currently the third most common cancer in the United States after skin cancer, breast cancer in women and prostate cancer second. Still, more people die from lung cancer than from any other type of cancer.

Treatment for lung cancer mainly depends on how far the cancer has spread. Patients can be treated with targeted drugs, chemotherapy, radiation, or surgery to remove the tumor. But these treatments don’t always work, and for some people, a lung transplant is the only option.

Single lung transplants have been successfully performed since the 1980s, and today more than 1500 single lung transplants are performed each year, according to the CDC. But lung transplants for lung cancer are not common.

That’s because there’s a high risk of cancer cells spreading from the lungs to the rest of the body during the procedure — making the cancer more likely to come back, said Dr. Ankit Bharat, chief of thoracic surgery and director of Northwestern Medicine Canning Thoracic Institute, in a press release.

When a patient needs both lungs replaced, the lungs are usually removed one at a time, Bharat said. If the first lung is transplanted while the other cancerous lung is still in the body, there is a risk that cancer could spread from that lung to the rest of the body, he said.

But Northwestern Medicine’s surgical team found a way to minimize that risk. Their approach allows surgeons to remove the cancerous lung from the body while the patient is connected to a bypass machine that diverts their blood away from the heart and lungs. If blood does not flow through the cancer during surgery, there is less risk of the cancer spreading.

“We’re pretty confident that we can help some patients with no other options,” Bharat said. He said the surgery involves “gently removing both cancerous lungs at the same time along with the lymph nodes, washing the airway and chest cavity to remove the cancer, and then inserting new lungs.”

He added: ‘These patients can have billions of cancer cells in their lungs, so we have to be extremely careful not to let a single cell enter the patient’s chest cavity or bloodstream.’

The Northwestern Medicine team first applied the technique to Albert Khoury, a Chicago man who came to them in 2021 after chemotherapy failed to treat his stage 4 lung cancer. His condition continued to deteriorate and he ended up in intensive care, according to a press release.

His doctor at Northwestern Medicine, oncologist Dr. Young Chae said a double lung transplant may be his only hope. Without one, Chae said Khoury would not live more than a year.

Thus, on September 25, 2021, after 2 weeks on the transplant list, Khoury became the first person with lung cancer to receive a successful double lung transplant.

A year later, Ameli, who lived in Minnesota, was also diagnosed with stage 4 lung cancer. She said she tried chemotherapy, but just like Albert Khoury, it wasn’t enough. Her husband saw a video of Khoury’s procedure, she said, and made an appointment with a surgeon at Northwestern Medicine. She was a candidate – and received the second successful double lung transplant in July 2022.

“We are so happy,” Ameli said at the press conference. “I’m back. I made it. I made it.”

Because of these achievements, Northwestern Medicine is launching a unique clinical program for people with end-stage lung disease.

The program plans to track the results of its first 75 patients receiving double lung transplants for lung cancer in a new research registry called DREAM (Double Lung Transplant Registry Aimed for Lung-limited Malignancies). While patients in the clinical program can receive a double lung transplant without having to enroll in the DREAM voluntary research registry, the researchers hope to use the data to track overall survival, disease-free survival and transplant rejection rates.

“I hope all cancer patients are as lucky as me and Albert,” said Ameli. “Every day we wake up and are thankful for it.”

Aerial Petty, DO, is a primary care physician at New York-Presbyterian/Columbia University Irving Medical Center and a staff member at the ABC News Medical Unit.

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