Precision Medicine and Lung Cancer: Dr. Jarushka Naidoo

Just like people, no two lung cancer tumors are identical. In recent years, the most effective lung cancer research involves a technique known as precision medicine. Also referred to as personalized medicine, precision medicine tailors treatment to each patient based upon the particulars of their cancer. LCFA grant recipient Dr. Jarushka Naidoo sees lung cancer as the “poster child for precision medicine.”

From Actress to Oncologist Researching Precision Medicine

How many physicians do you know that, upon graduating from medical school, decide to move on to drama school to study Shakespearean Acting for the Stage? And, how many do you know who, in their spare time, teach pilates? Or, for that matter, spent much of their youth as a television personality in South Africa, their native country? Meet Dr. Jarushka Naidoo who, as you may have surmised, is just that doctor.

Microbiome and immunotherapy: Jarushka Naidoo

Of Indian descent, and born during Apartheid in South Africa, Dr. Naidoo dreamed not of being an oncologist, but an actress. An exceptional student, she was awarded a scholarship to attend medical school in Ireland – a path her own mother, a radiologist, had taken. This route of Indian women attending medical school in Ireland, was not entirely unheard of, it just had not been part of her plan.

Dr. Naidoo’s first rotation was oncology. She found it fascinating. With her interest piqued, and having been fortunate enough to have a truly inspiring mentor, she had found her niche.

“Oncology is multi-disciplinary and requires a broad skill set, including radiology, pathology, and diagnostics. I enjoyed the fact that you need to be an excellent communicator – so my acting came in handy – in order to explain complicated things in simple language to patients and their families.”

Becoming an Effective Communicator and Clinician

Dr. Naidoo’s path to becoming a professor, researcher, and award winning clinician was not a direct one. It was, though, her return to acting school that actually solidified her career in medicine.

“As much as I love acting, I realized that my people were in medicine and that there was a way for my love of communication to find a home within that community. I firmly believe that my acting background makes me an effective communicator and clinician. So much of acting is putting yourself in someone else’s shoes and fully understanding what and how they are feeling. It truly helps to have the ability to effectively communicate and work with patients.”

The Urgency of Research into Precision Medicine for Lung Cancer

Two years ago, Dr. Naidoo’s work and personal life intersected when her mother was diagnosed with early stage lung cancer, with the EGFR biomarker. At the beginning of her journey, she responded well to her personalized treatment, but a relapse soon after took her life. For Dr. Naidoo, this really drives home the urgency of research, including taking into account the point of view of the doctor, the patient, and the caregiver.

In her work, Dr. Naidoo is keenly aware of the continued stigma not only of a lung cancer diagnosis, but the perception that all lung cancers are fatal, thereby supporting a “why even try” attitude. She is adamant that this has to change. And precision medicine in the lung cancer field is exactly the catalyst for that change.

Changing the Conversation Around Lung Cancer Research

Highly aware – and equally frustrated – by the indisputable fact that other cancers are not affected by limitations in funding, Dr. Naidoo stresses the importance of changing the widely held public perception that all lung cancer diagnoses result in death. Instead, the focus should be on the evidence that lung cancer, thanks to the successful advancements in treatment, is actually the poster child for precision medicine for lung cancer. In just the last several years, for example, biomarker testing and immunotherapy – all discovered through funded research – have transformed the face of lung cancer.

LCFA’s Research Grant and Precision Medicine

“The first critical step for any cancer researcher is gaining critical funds to bring their ideas forward, into real advances for patients.”

A recipient of LCFA’s 2019 LCFA/IASLC/BMS Young Investigator Award, Dr. Naidoo’s project focuses on immuno-oncology and aims to identify whether a patient’s gut microbiome is implicated in their ability to derive benefit, or develop toxicity, from immunotherapy in lung cancer. To explain in layman’s terms, Dr. Naidoo is simultaneously seeing patients and conducting research with the goal of discovering whether a patient’s gut health plays a role in determining the benefits – or, conversely, the harm – of immunotherapy treatment. Until now, there has been scant research connecting gut health with both cancer diagnoses and treatment protocols.

Dr. Naidoo’s Research Project

We are studying whether the gut microbiome of patients with lung cancer is implicated in their ability to respond to immunotherapy, or develop immune-related side effects. By identifying the gut microbiome of patients with lung cancer, we may be able to alter it to help more patients with lung cancer to respond to immunotherapy, or reduce it’s side effects. While we know special features of the gut microbiome may be implicated in response or toxicity from immunotherapy in those with melanoma, very little is known about these features in those with lung cancer, and how they may change over time.”

With her research into the implications of an individual’s gut microbiome in their ability to be effectively treated with immunotherapy drugs, Dr. Naidoo is moving the needle on precision medicine in lung cancer. Not only is each individual’s lung cancer tumor unique, so is their particular gut microbiome. Through research, we have learned that gut health can play a part in determining what is the unique combination of treatments that will be the most effective for a specific lung cancer patient. In this way, Dr. Naidoo is using the concept of precision medicine in an expanding field of gut microbiome research as it relates to lung cancer.

“Research is the fuel that drives change. Funding for lung cancer research continue[s] to drive these changes and improvements for patients living with lung cancer – the #1 cause of cancer-mortality of men and women in the US and worldwide.”

Lung Cancer Oncology is a Team Sport and Precision Medicine is key

“We in lung cancer oncology are very much a team sport. Lung cancer oncologists are, I think, the quarterback of the team coordinating between medical oncologists, radiation oncologist, surgery, palliative care, with the patient in the center of that team.” And, precision medicine targeting specific treatments to specific patients will bring us closer to take that team across the finish line victoriously.

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