The Boston Lung Cancer Survival Cohort

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The Boston Lung Cancer Survival (BLCS) cohort is a Cancer Epidemiology Cohort of more than 12,000 lung cancer cases enrolled at Massachusetts General Hospital and the Dana-Farber Cancer Institute since 1992. This rich resource enables research to understand lung cancer heterogeneity that has already identified valuable prognostic markers and stimulated new treatment strategies. For example, the BLCS supported the first discovery of the association between EGFR mutations and response to therapy with EGFR-tyrosine kinase inhibitors and enabled research on effective treatments for non-small cell lung cancer patients with ALK and ROS1 rearrangements. In 2017, the cohort evolved into a survivor epidemiology cohort that is sustained by a U01 grant until May 2023. Our progress during the first U01 funding cycle (2017–2022) is substantial—we have published over 100 papers, supported 6 new grants, and worked with 50 collaborators nationally and internationally. With the U01 award expiring soon, there is an urgency to renew to: 1) maintain this first and most comprehensive lung cancer survivor cohort with the longest follow-up period—an unmatched source of data for translational research; 2) establish an innovative, detailed phenotyping database via automated image analysis of high-resolution computed tomography, as well as a radiomics database; 3) enable the established infrastructure to facilitate internal and external investigators to pilot methodologic approaches that will turn into productive multidisciplinary project grants by focusing on survival and treatment toxicity; and 4) leverage the Dana-Farber/Harvard Cancer Center Lung Program resources for creative multidisciplinary collaborations focused on treatment outcomes. Renewed funding is also critical to recruit 2,500 new cases (for a total of 14,500 cases) to this already large cohort. New cases are vitally important to: 1) facilitate comparison of new treatments and traditional therapy as well as evaluation of new clinical investigation in an ever-changing therapeutic environment; 2) allow us to collect more cases with driver mutation data, as well as those treated with immune checkpoint inhibitors; 3) promote collection of repeated biological samples to support developing prognostic/predictive biomarkers; 4) allow us to collect detailed data enabling assessment of environmental determinants as well as racial and socioeconomic determinants of survival; and 5) empower our studies to identify radiomic, genomic, epigenetic, and other phenomic biomarkers, environmental determinants, and racial and socioeconomic determinants that are relevant to patient survival to guide improved lung cancer screening and treatment strategies. The BLCS is one of the largest lung cancer survival cohorts and encompasses a wealth of biomarker, tumor molecular characterization, imaging, lung function, genetic, epigenetic, traditional epidemiologic risk factor, and electronic health record data. With continued support, this comprehensive cohort will provide unique opportunities to explore predictors of lung cancer survival and treatment outcomes, catalyzing powerful translational research that improves the health of individuals with lung cancer.