Projects

Tracheal Regeneration Project:

This is one of our primary projects in which we are working to create a bioengineered trachea for patients in need of substantial tracheal reconstruction. Such reconstructions can be necessary for patients with traumatic injury, tumor ingrowth, or stenosis of the trachea. Currently, there is no adequate alternative and if successful we aim to provide lifesaving or palliative treatment.

In order to achieve our goals, we have employed the principles of tissue engineering and associated techniques. We are currently working with a novel collagen scaffold, bioreactor and stem cells, and have thus far observed promising early results. In addition to this, we are exploring the realm of 3-D printing and the benefits it may provide in tracheal regeneration. As the field of medicine continues to rapidly evolve, our group aims to remain at the forefront of these revolutionary technologies in order to provide the best patient care possible.

Radiation sensitivity in lung cancer cells:

Radiation therapy (RT) is increasingly becoming an integral component in the management of NSCLC. However, patients with NSCLC exhibit a wide-spectrum of response to RT both in vitro and in vivo. A reasonable percentage of stage I patients go on to develop loco-regional recurrence and the survival rate still remains less than 25% in patients with locally advanced disease. Hence, there is a gap in our knowledge as to why certain patients respond better to RT compared to others. Over the past decade, molecular genotyping and genomic sequencing has significantly contributed to our understanding of molecular mechanisms underlying NSCLC. The discovery of various driver events in adenocarcinomas has led to the development of various targeted therapies. Molecular genotyping is becoming a routine practice to guide clinical care in patients with lung adenocarcinoma.

Patients with lung adenocarcinoma frequently harbor oncogenic mutations in EGFR, KRAS, BRAF, PIK3CA, ERBB2, ALK, ROS1 and MAP2K1 genes. Very recently, comprehensive genomic characterization of squamous cell cancers has identified recurrent somatic mutations in FGFR, CDKN2A PIK3CA, BRAF and NOTCH1. Usually, the mutations are mutually exclusive, determine distinct underlying biology and are associated with differential sensitivity to various therapies.

We believe that these mutations can serve as effective biomarkers to help tailor RT according to individual cases.

Airway stenting:

A major concern for patients with lung cancer is the development of central airway obstruction due to tumor ingrowth or external compression of the central airways. We closely follow the outcomes of this cohort, and thus far have been able to show that patients have a substantially longer survival following early intervention.

Other ongoing projects:

In addition to these main projects, we also invest much time into other aspects of thoracic surgery / thoracic oncology. Active areas of interest includes outcomes research of tracheoplasty for patients with Wegener’s granulomatosis, lymph node assessment / staging for lung cancer surgery with EBUS, effects of herbs when used as a chemotherapeutic agent, HIV associated lung cancer, as well as cost analysis and outcomes of robotic thoracic surgery.