Lauren Byers, M.D. Hi, I'm Dr. Lauren Byers. I'm a professor in the department of Thoracic and Head/Neck Medical Oncology. And I'm here today with Dr. Jennifer Litton, vice president of Clinical Research. And this is the Cancerwise podcast. Thanks, Jen. I really appreciate you being here today. You know, and we've. 

Jennifer Litton, M.D. We've been friends for so long. This is so fun to do this podcast together. 

Lauren Byers, M.D. It really is. I mean, it's great to be back together. And and, you know, I was going to talk a little bit about a phone call that I got from you a few years ago. 

Jennifer Litton, M.D. Absolutely.

Lauren Byers, M.D. So, you called me about a consult for somebody. But this was a little bit unusual because it wasn't your patient. Can you tell me a little bit about why you call me that? 

Jennifer Litton, M.D. No, I will. I called you because, you know, as an oncologist and we've been treating cancer patients for a very long time. You know, it it inevitably, at some point, comes home and hits someone you love. And in this case, it was my dad. And, you know, it's a really interesting story because and I know we've known each other for so long, but I never even wanted to be a doctor. I didn't grow up thinking I was going to be a doctor. I was an English and History double major and didn't take a single pre-med class, and I was working at the restaurant I've always worked at all through college, and I went back and except for October, rolled around and I had graduated. And my boss, I didn't have anywhere to go. I was still didn't know what I wanted to do. And my boss at that time, he was a scalloper, and he said, "Well, why don't you scallop through the winter?" And I thought, "This seems very Hemingway-esque and I should definitely do that." And I remember a very specific phone call from my father, very calm. He picked up the phone and all I heard was, "I want to see you in 48 hours with a life plan." And then the phone hung up. And you think, "I have to come up with something big."

Lauren Byers, M.D. No pressure. 

Jennifer Litton, M.D. No pressure at all. So what sounds really big? Go to medical school. "That's fine. That's great. Okay. Go to medical school." And I did a post-bacc. I did a pre-med, and I, I worked as a study coordinator running clinical trials in the breast clinic at another cancer center and was immediately very hooked on being a cancer doctor, doing cancer research and doing breast cancer research, and then was very directed on getting to Houston, getting to MD Anderson and joining the breast group here, which I did. And, you know, been so lucky to be here. Have been working on research and kind of a full circle from starting as a study coordinator to now running clinical trials. And I got another 48-hour phone call saying, "We need you to step in as the vice president of clinical research running all the trials." And that phone call was for me to start on March 1st, 2020. 

Lauren Byers, M.D. Wow. 

Lauren Byers, M.D. So, we all knew what was about to happen. I didn't know at the time. And so March 1st, 2020 hit,s and I come in and two weeks later with Covid, and we have to rethink everything about clinical research. How we even, you know, do all of the different regulatory matters, how we move tissue and blood specimens across. You know, I think a lot of places just closed down trials completely. But and I know you feel the same way as I do that, you know, clinical trials and clinical research is how we care for patients at MD Anderson. And it's not something we do on the side. 

Lauren Byers, M.D. No. Yeah. 

Jennifer Litton, M.D. Sometimes it's, you know, the patient's best hope. 

Lauren Byers, M.D. Yeah, I remember during that time, you know, there were new walls being put up to protect patients from, you know, risk of infection. But I also remember there was a scientist in our group who was really adamant that we included a pass through window for the samples so that even though the people and, you know, the the clinical side were being, you know, kind of limited in terms of not having a lot of people come across, you know, into where the patients were. But the samples and the research could still continue, and I just thought that was so amazing to, you know, to see how people pulled together to to keep that going. 

Jennifer Litton, M.D. Absolutely. I mean, I think we're one of the cancer centers, we kept 98% of our trials open when most places weren't able to do that. And that's because everyone from, you know, every part of MD Anderson just really dug in to get this done, because we know how important it is for our patients. But little did I know how important that would be for my own dad. You know, I, around November of that year, he'd had a cough and it just wouldn't stop. And he got diagnosed with stage III lung cancer. And I think that's exactly when I called you. I did a full phone-a-friend, and talked about his diagnosis and that, you know, what should we do? 

Lauren Byers, M.D. I remember that very well. And I knew that you had also helped me many times when people had reached out for for your expertise. 

Jennifer Litton, M.D. And it is one of the beauties of MD Anderson that we all really do take care of each other, too, and help each other through this. And, you know, he took neoadjuvant preoperative chemotherapy and immunotherapy and had surgery and he was doing well. He had some side effects from the from the immunotherapy. But about a year later, so November 2021, he's coming down the escalator at an airport and he gets really dizzy and he falls and they bring him to the hospital and they do an MRI and they just see too numerous brain mets, right. And we're both oncologists. So, you know you know, when I heard too many to count, I remember that phone call where I called him and I said, "Oh, Dad, I'm, I'm so sorry. Like, we're going to get you radiation. We're going to get you steroids. We're going to get you hospice." I know you've had to have lots of conversations with folks like that, too. 

Lauren Byers, M.D. Must have been a real shock for you. 

Jennifer Litton, M.D. Yeah. 

Lauren Byers, M.D. You called and said you have to also talk to your dad about what that meant and how serious that was. 

Jennifer Litton, M.D. Serious this was. Absolutely. Except for one of the things is he had a very, very rare mutation in this tumor that's only in about, I believe and I'll ask you, about 2% of patients. It's called a RET fusion. And he ended up not getting radiation. He ended up taking a pill, and the pill had just gotten emergency use authorization based on a trial led here at MD Anderson, and for which we kept open in March of 2020 to help get that data. And I know this has been big in, in lung cancer. 

Lauren Byers, M.D. Wow. No, that's incredible. And it is. I mean, it's, this is the 20th anniversary of the very first of its type in terms of having pill treatments to be able to treat lung cancers. And since then, the research has been so critical. And it's I tell many of my patients who I see now, I said, you know, "You, you may be benefiting from a treatment that isn't even approved yet, but that either as part of a clinical trial or something that gets approved, you know, during the time that you're, you know, receiving cancer care." Because really the the pace of of progress because of research and, you know, the patients who participate in that has really changed, you know, what what we can offer and how we can personalize treatments for each person. 

Jennifer Litton, M.D. Are you getting genomic testing? So looking at DNA changes now in most of your patients with metastatic cancer and maybe some in the early stage do? 

Lauren Byers, M.D. Yeah, it's been really interesting recently. So, we definitely are getting these types of biomarkers and testing for the different gene alterations in basically all of our patients that initially, you know, in for several years it was really the patients who had the most advanced lung cancers where these were approved. But now we've we've found that there's a benefit also, for example, for patients who are undergoing surgery or receiving radiation. And so some of those patients can have these personalized, targeted pill treatments included as part of their treatment. And so really that has has kind of changed the paradigm. And now, you know, essentially all of our patients are being tested for those upfront so we can use that as part of how we, you know, provide the best and most personalized treatment approach for them. 

Jennifer Litton, M.D. So, for a lot of you on this podcast, you might not know, but Dr. Byers has been, you know, not only an amazing clinician, but has done so much discovery in the lab and really identifying new targets that might have been common in other cancers but hadn't been exploited yet in lung. And maybe could you just say a couple words about what you're excited about working on these days? 

Lauren Byers, M.D. Yeah. So, I think there are a couple of things. I mean, first of all, it's just amazing to see how many patients, you know, I am, you know, get to take care of who are benefiting from current clinical trials. And several of these, you know, medicines that patients are on are things that we've been sort of hoping to have for, you know, for many years. But now we have, you know, more and more options to offer to people. So that's, you know, something that we're really excited about. The other thing, you know, one of the cancers that I work on is has been a very challenging type of lung cancer to treat for and not, you know, as much progress for that type of lung cancer in the past, you know, many years. But one of the things that we've found now is that that type of cancer is actually for different types of cancers. And we're getting ready to start the first clinical trial that will match those patients to specific treatments based on which type of cancer they have. And so that that's something that we're really excited about. 

Jennifer Litton, M.D. It is so exciting. You know, when I when I back to when I was a study coordinator a little bit ago, you know, the trials for all, "Here are the four different chemotherapies we use and how should we either sequence them or combine them?" And now just the rate of discovery, and I've said this and I really do believe it in breast and I truly have seen it now in lung, where the rate of discovery for some of my patients is really outpacing their disease for the first time in the couple of decades that I've been practicing. 

Lauren Byers, M.D. It's really true. I have a patient who I saw this week and he's responding really well to a brand new type of treatment for an aggressive lung cancer. And I said to him, I'm, you know, so thrilled that he is benefiting from it, but also that I'm, you know, very hopeful that by his being part of the trial, that there'll be many other people who will also be able to benefit from that down the road. 

Jennifer Litton, M.D. It's just so exciting. Well, it was so great to get to talk to you about this. And I will I will give you the update that my dad is still without evidence of disease now since 2021. And, you know, we're just taking it day by day. But, you know, really grateful for all the work that your group has been doing in this space. So, thank you. 

Lauren Byers, M.D. Thank you. It's great being here with you. And we'll look forward to hearing more about how your how your dad is doing and and updates. 

Jennifer Litton, M.D. Absolutely. 

Lauren Byers, M.D. Well, thanks again for being here today and for sharing your story. 

Jennifer Litton, M.D. Thank you. 

Lauren Byers, M.D. For more information or to request an appointment at MD Anderson, call 1-877-632-6789 or visit MD Anderson.org. And thanks for listening to the Cancerwise podcast from MD Anderson Cancer Center.