The Department of Thoracic Surgery at the Icahn School of Medicine at Mount Sinai is committed to enhancing diagnostics and treatment capabilities for congenital and acquired diseases of the lungs, esophagus, mediastinum, and chest wall. Our department is skilled in a number of cutting-edge treatments—including video-assisted thoracoscopic surgery (VATS), lobectomy, and robotic surgery. Our current research initiatives are focused on improving patient care within the following areas.
Center of the Study of Thoracic Diseases
The Center is led by Emanuela Taioli, MD, PhD, who is Professor of Population Health Science and Policy and of Thoracic Surgery. The mission is to advance the diagnosis and treatment of congenital and acquired diseases of the lungs, esophagus, mediastinum, and chest wall, reduce health disparities and improve access to surgical care.
Faculty provides leading-edge treatments including VATS lobectomy and robotic surgery but at the same time strives to further improve patient care through basic, epidemiologic, and clinical research in areas such as the following:
Mount Sinai is conducting an array of research studies and clinical trials to improve upon both the diagnosis and treatment of lung cancer. Areas of focus include the Lung Cancer Early Detection program, led by Clinical Professor in Radiology, Claudia Henschke, MD. The Lung Cancer Early Detection program includes a smoking cessation study, basic science studies that examine biological indicators of aggressive early-stage lung cancer, and immune-fighting cells in the lung. We are also looking at lung cancer disparities correlating to access to care as part of research on quality of life after surgery. This study is being collaborated with Andrew J. Kaufman, MD, Assistant Professor Thoracic Surgery.
Second Primary Cancers Program
The center is committed to studying the best treatment strategies for patients who present with a second thoracic cancer after having successfully treated the first cancer. Dong-Seok Lee, MD, has shown in his studies that surgery is the best treatment option for subsequent cancers.
The Thoracic Surgery Translational Laboratory is working to identify the key proteins and important pathways involved in this form of cancer. Mount Sinai investigators are developing novel tests to determine which mesothelioma tumors have abnormal transcription factor activity, and designing drug therapies intended to inhibit these factors, Andrea Wolf, MD, is leading these efforts to identify biological differences responsible for gender differences in mesothelioma outcome, with the ultimate purpose of identifying molecular targets for new therapeutic agents. Mount Sinai has partnered with an internationally renowned group to identify and validate novel germline DNA variants associated with increased risk of asbestos-induced malignant pleural mesothelioma (MPM) (Collaborator-Carbone). In an effort to develop novel chemotherapeutic agents for MPM, we have identified––through drug repurposing approach––two compounds that show anti-MPM activity. Efforts are underway to validate these compounds. (Collaborator-Narla). Suresh Y. Ramanathan, MD, is also a contributor to these research efforts.
Libby Epidemiology Research Project
Mount Sinai has received a $4.8 million RO1 grant, funded by the Centers for Disease Control and Prevention and the Agency for Toxic Substances and Disease Registry. Principal investigator Raja M. Flores, MD, is examining the health impact of asbestos exposure. Researchers are investigating the disease pathology in the town of Libby, Montana, with the goals of assessing risks of exposure to asbestos during childhood; examining the relationships between autoimmune disorders, autoimmune antibody abnormalities, and CT-scan evidence of related scarring lung disease; and recommending environmental cleanup efforts.
The effect on survival and quality of life of surgical treatment of thymoma is studied by Andrew J. Kaufman, MD, Assistant Professor Thoracic Surgery. Various surgical techniques are examined using large data sets such as Statewide Planning and Research Cooperative System(SPARCS) data, and meta-analytic techniques.
Some of our researchers 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 - are studied by Dr. Flores using administrative data sets from the Agency for Healthcare Research and Quality (AHRQ).
Personalized and Targeted Therapy
Research at the Thoracic Surgery Translational Laboratory is focused on developing personalized therapies for a range of thoracic malignancies. Current efforts include work to identify and design novel small molecule inhibitors for the treatment of drug resistant cancers. Daniel G. Nicastri, MD, is studying ways to limit the amount and type of lymph-node resection for early-stage lung cancer, reduce surgical complications, and improve quality of life. Using the publically available genomic data, we are trying to understand the molecular mechanisms of progression to clinically significant lung cancer. Driven by the hypothesis that the aggressiveness of lung adenocarcinoma is associated with distinct gene signatures, we have identified a set of genes over expressed in these cancers. Through an IRB approved protocol, we are currently validating our computational findings (Collaborator-Reva).
Airway Research Laboratory
The overarching theme of the Thoracic Surgery research laboratory is to bioengineer a viable human trachea using tools of regenerative medicine, 3D printing and stem cells. Pathologies of the trachea can have life-limiting or -devastating events. Patients with long segment airway stenosis secondary to prolonged intubation, severe airway inhalation injuries or cancer lesions, often undergo multiple surgeries or procedures. To date, there is no suitable conduit that can effectively replace a tracheal segment with safety and restore adequate airway function and dynamics. Using advanced imaging and CAD tools, we can pre-correct tracheal anatomy and customize a 3D printed trachea to fit and replace the segment of interest. We have successfully transplanted more than a dozen of bioengineered partial tracheal constructs in a large animal model, and are actively pursuing to translate this research into a lifesaving procedure.
Lung Tumor Biology
Our collaborator is studying Myeloid Suppressor Cells (MDSC) and Tumor-Associated Macrophages (TAM), which are responsible for supporting an environment that promotes lung cancer progression and immune escape. The goal is to understand the modulation of MDSC and TAM functions. Results from this study will be used to better design MDSC/TAM-targeted therapies for lung cancer.
The Center has established a bank of surgical cancer tissues linked to clinical and follow-up data, in collaboration with our Cancer Institute Biorepository.