Lung cancer among never smokers has increased in the United States over recent decades and is projected to continue to rise as the rates of smoking fall. Lung cancers of never smokers—adults who have never smoked or smoked less than 100 cigarettes over their lifetime—represent a meaningful clinical problem on a population-level. Lung cancers of never smokers are different clinically, demographically, and biologically from lung cancers in ever smokers. Our research seeks to identify preventive strategies and innovative treatments for this specific patient sub-group. Most never smokers with lung cancer are women. Lung cancer among women, as it is a leading cause of mortality, represents a separate but related research area of interest in our department.

Researchers in this area include:

• Raja M. Flores, MD
• Claudia I. Henschke, PhD, MD
• Andrew J. Kaufman, MD
• Emanuela Taioli, MD, PhD
• David F. Yankelevitz, MD
• Rowena Yip, PhD

The Department of Thoracic Surgery is passionate about research that identifies gaps in care that may be contributing towards observed disparate outcomes of lung cancer among Black and Hispanic patients. This includes identifying risk factors specific to these groups, as well as understanding patient- and provider-level barriers to innovative treatment. Our researchers are looking at lung cancer disparities correlating to access to care as part of research on quality of life after surgery.

Additionally, we are committed to increasing our knowledge around the differing molecular profiles of lung cancer among Asian patients, with the goal of expanding treatment options. Our department works closely with the Institute for Translational Epidemiology to investigate such disparities in large databases such as the Surveillance, Epidemiology, and End Results linked to Medicare data.

Researchers in this area include:

• Raja M. Flores, MD
• Emanuela Taioli, MD, PhD

Our department maintains a robust database of patients who have had thoracic surgery dating back to 2012. This includes clinical and sociodemographic factors, pre-operative assessment, surgical approach, and short-term outcomes. For cancer patients, oncologic details such as tumor size, location, nodal involvement, and distant metastases are also available.

To date, there are more than 2,800 patients included in this Institutional Review Board-approved prospective clinical cohort, which can be linked to clinical specimens through the Cancer Institute Biorepository, as well as BioMe, an electronic medical record-linked biobank. Through this data, our researchers are investigating outcomes of patients with incidental lung cancer screenings versus screening detected in stage I lung cancer surgery patients.

Researchers in this area include:

• Raja M. Flores, MD
• Emanuela Taioli, MD, PhD

We provide comprehensive, multidisciplinary clinical care for patients with suspected or diagnosed malignant pleural mesothelioma, while simultaneously leading the field in mesothelioma research. Our researchers focus on the etiology of malignant pleura disease, clinical and demographic prognostic factors, and multimodality management of malignant pleural mesothelioma, including surgical treatments.

We are leading the efforts to identify biological differences responsible for gender differences in mesothelioma outcomes, with the ultimate purpose of identifying molecular targets for new therapeutic agents. Our research also aims to assess the risks of exposure to asbestos during childhood, and examine the relationships between autoimmune disorders, autoimmune antibody abnormalities, and CT-scan evidence of related scarring lung disease.

Researchers in this area include:

• Maaike van Gerwen, PhD
• Raja M. Flores, MD
• Bian Liu, PhD
• Kimberly Song, MD
• Andrea Wolf, MD

Our department is a leader in innovative surgical treatments for lung cancer, including video-assisted thoracic surgery and robotic approaches. Our research focuses on the feasibility of using minimally invasive techniques for older and comorbid patients, as well as the impact of these treatments on nodal assessment, short- and long-term surgical outcomes. We also seek to limit the amount and type of lymph-node resection for early-stage lung cancer, reduce surgical complications, and improve quality of life. Research in these areas is centered around understanding how surgical techniques can be used in combination with other treatments, such as radiation and immunotherapy, to develop personalized and targeted therapies for lung cancer patients.

Researchers in this area include:

• Raja M. Flores, MD
• Brian Housman, MD
• Emanuela Taioli, MD, PhD

Our team of researchers explores treatment for rare, malignant thoracic tumors. The effect on survival and quality of life of surgical treatment of thymoma are examined using large data sets such as Statewide Planning and Research Cooperative System data, and meta-analytic techniques. We are studying survival rates of esophageal cancer—related to type of treatment, access to proper care, and quality of health care delivery in different ethnic groups—using administrative data sets from the Agency for Healthcare Research and Quality (link to: https://www.ahrq.gov/). Our researchers are committed to studying the best treatment strategies for patients who present with a second thoracic cancer after having successfully treated the first cancer, for which surgery may be the best treatment option. These projects are part of our overall efforts focused on developing personalized therapies for a range of thoracic malignancies.

Researchers in this area include:

• Raja M. Flores, MD
• Bian Liu, PhD
• Alan J. Moskowitz, MD
• Emanuela Taioli, MD, PhD
• Andrea Wolf, MD