Thoracic and Esophageal Disease

St. Joseph's Center for Thoracic Disease and Transplantation places a heavy emphasis on research to advance patient care for those with lung and esophageal diseases.

Current Lung and Esophageal Research Projects Include: 

Personalized Treatment for Patients with Lung Cancer

Novel therapeutic approaches known as “personalized medicine” have demonstrated promising activity against cancer, suggesting a breakthrough in cancer treatment that occurs by matching a specific anti-cancer medicine to a person’s genetics and the particular characteristics of the cancer. Researchers at St. Joseph’s are collaborating with TGen to identify biomarkers that will allow us to predict what chemotherapeutic a patient might respond best to as well as develop new therapies.

Improving Outcomes in Patients Undergoing Surgery for Lung Cancer

Historically, there has been no therapy given around the time of surgery for lung cancer for fear of interfering with a successful surgical outcome. However, we believe that the administration of anti-cancer medicines around the time of surgery might reduce the risk of recurrence. We are studying this effect on gene expression in patients undergoing surgical resection of their tumors and are working with novel agents to improve outcomes.

Optimizing Treatment Strategies for Patients with Barrett's Esophagus

The incidence of esophageal adenocarcinoma (EAC) has increased 400% over the past 2 decades. The primary risk factor for EAC is Barrett’s esophagus. We are attempting to identify genetic markers that might predict which patients will progress to cancer from Barrett’s esophagus and what role lifestyle choices have upon this process. In addition, we are investigating which treatment option provides better protection from developing cancer.

Targeting the LKB1 Signaling Pathway for the Diagnosis and Treatment of Lung Cancer

Researchers at St. Joseph’s are working to identify genes that directly influence the progression of lung cancer. One such gene is the tumor suppressor, LKB1, a gene that is commonly lost in lung cancer. Cells, and most importantly lung cancer cells, that lack this gene respond differently when they are deprived of nutrients and with extreme deprivation will die. We are currently identifying differences between lung cancers lacking LKB1 and lung cancers with LKB1, so that we can use this information to design new treatments. Already, we have identified a possible treatment for lung cancers lacking LKB1 and are working to confirm its effectiveness as a treatment for lung cancer.

Lung Transplant Rejection

After lung transplantation, all patients are at risk of acute organ rejection and over the years following transplant nearly all patients will develop obliterative bronchiolitis (OB) or chronic rejection of the transplanted organ. The process of how OB develops within the lungs is poorly understood, but studies have shown that epithelial-mesenchymal transition (EMT), or a process by which epithelial cells transform and deposit excess fibrous tissue, is involved in the OB process. The aim of this research is to determine the role of EMT in chronic lung rejection and to identify risk factors in order to minimize and control them.

The Research Team

  • Ross Bremner, MD, PhD
  • Landon Inge, PhD
  • Valerie Felton