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Lung cancer is often first identified as a nodule during a routine lung cancer screening or when someone is getting a chest scan for another reason, such as pneumonia. Lung (pulmonary) nodules are abnormal growths that may form in a lung, most of which are not cancerous.
Cancerous cells are known to be hungry for sugar and have a higher sugar intake than healthy cells. To help understand if a lung nodule is likely to be cancerous, doctors typically recommend a PET scan to study the way the cells take up sugar. PET scans are helpful when diagnosing late-stage lung cancer, but the early stages of disease can be more challenging to identify. People suspected to have early-stage lung cancer are often sent for frequent follow-up scans to monitor the growth of the tumor and determine next steps.
LUNGevity has supported early detection research for years and recently spoke with one of our 2021 Early Detection Award recipients, Claudio Scafoglio, MD, PhD, associate professor at the University of California, Los Angeles, to learn about his work to improve the early detection of lung cancer.
LUNGevity Foundation: How did your interest in cancer research come about?
Dr. Claudio Scafoglio: I grew up in Italy and the system there is very different. After high school, you decide what you want to do. I thought about the decision a lot. I knew I wanted my contribution to society to be practical and tangible, so I decided to study medicine. And then, when I was in medical school, I lost both my father and grandfather to cancer. That was when I found my passion for oncology research. From the beginning, my goal was to do translational research—bringing scientific advancements to help patients.
LF: How did you begin to focus on studying lung cancer?
CS: In the past, during my postdoctoral fellowship at UCLA, my mentor developed a technique to study the way tumors transport a type of sugar (glucose) in and out of cells. They studied how healthy organs use glucose and how glucose is involved in some diseases. They hadn’t done much work looking at glucose transport in cancer, so they supported my interest in studying glucose transport in pancreatic and prostate cancer—two types of cancer that could use improved imaging techniques.
After my fellowship was complete, I had the opportunity to study pulmonary medicine. It was wonderful to have access to good mouse models that allow us to study the full development of lung cancer from precancerous lesions to the advanced stages of disease. When I used these mouse models to study glucose transport, the results were very exciting.
LF: What were these exciting lung cancer results?
CS: I found that one type of glucose transporter, called SGLT2, is found in the early stages of lung cancer. Then when the disease is more advanced, another glucose transporter takes over. It is this second transporter that we see in our current PET scans. This could explain why the current PET scans have struggled to clearly identify patients with early stages of lung cancer—we might be focused on the wrong glucose transporter in the early stages of disease.
LF: Please describe your research project funded by LUNGevity.
CS: We are grateful to LUNGevity Foundation for the support in conducting a phase 1/2 clinical trial to study if SGLT2 could be useful as a biomarker for the early detection of lung cancer. We plan to enroll 60 patients, both with lung cancer and without. The clinical trial is open now.
LF: Why is this research exciting for the lung cancer community?
CS: If this research goes well, we could have a strong biomarker to use during PET scans to help us know if a lung cancer nodule requires monitoring or follow-up care. This could give people peace of mind after a nodule has been discovered, and it could also reduce the financial burden related to multiple follow-up scans and doctor visits.
In my lab, we are also working to develop a new way to prevent or treat lung cancer that is based on inhibiting the activity of the glucose transporter.
LF: How has the LUNGevity award impacted your research career?
CS: This award was a huge stepping stone. It gave me a chance to start my first clinical trial. This is pivotal for a basic scientist like me. I do most of my work with mice and cell lines. It is a huge accomplishment to see my research come together, move toward the clinic, and be used to start a clinical trial. It’s been a dream come true for me.
More LUNGevity-supported research projects: