Finding highlights susceptibility to lung cancer

Alexander S. Krupnick, M.D.


A quarter of a million people in the United States are diagnosed with lung cancer each year, though up to one quarter of them have never smoked. New research by Dr. Alexander Krupnick and his colleagues at Washington University School of Medicine suggests that a key immune cell may play a role in lung cancer susceptibility.

Krupnick, 43, a thoracic surgeon at the Siteman Cancer Center at Barnes-Jewish Hospital is the senior author of a report on that finding, published last month in Cancer Research.

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Born in Kiev, Krupnick has been in St. Louis for eight years. He earned his medical degree at the University of Michigan Medical School in Ann Arbor, completed residencies in surgery and research at the Hospital of the University of Pennsylvania in Philadelphia and completed fellowships in thoracic surgery and thoracic transplantation at Washington University.

“Thoracic surgery is a wonderful field. My practice is varied and there is a lot of research to be done. I never pictured myself doing anything else,” Krupnick said. He laughed and added, “Pro football didn’t work out – I was a 5-foot-8 Jewish kid.” Krupnick and his family are affiliated with Central Reform Congregation.

Krupnick made time recently to talk about his research.

In your research on mice, you found that genetic diversity in natural killer cells, which typically seek out and destroy tumor cells, contributes to whether or not the animals develop lung cancer.

Yes — other cells in the immune system need to be activated to kill tumors, but these natural killer cells do not.  It has been known for a long time that this cell population plays a role in fighting cancer, but now we realize for the first time that these cells play a huge roll in clearing lung cancer, at least in mice.

How specific is the research?

We’re down to one cell, and one set of receptors on that cell.

How does this translate to humans?

Hypothetically our bodies are forming cancer cells all the time, and the immune system is consistently detecting and clearing these cells. We want to determine the difference between a poor lung cancer clearer and a person who is a good lung cancer clearer.

What are the implications?

We are looking for the human version of the immunological predisposition to clear lung cancer cells. Plus, there is always a portion of people who get lung cancer who never smoked, and we would like to determine whether they have an immunologic susceptibility to lung cancer.

How are you proceeding?

We are looking at natural killer cells in people with a history of heavy smoking, people with end-stage emphysema but no cancer. They may have an immunological resistance to lung cancer. We are also looking at nonsmokers who develop lung cancer to determine if their immune systems possess certain defects that may be a target for therapy.

So you are studying people, not cancer?

Yes. We’re looking at what makes a person susceptible to lung cancer. At the same time, we are pursuing more mice studies.

What other research in this area is going on?

Papers just came out from our institution focusing on research to find drugs to stop lung cancer.  Sadly, lung cancer kills more people than colon, breast and prostate cancer combined. The cure for lung cancer, or any cancer in general, won’t be a magic bullet, but more like a personalized four- or five-drug cocktail.

What are your next steps?

We are trying to translate our findings into a therapeutic strategy.  Biomedical research takes a lot of time and a lot of money.  It is important to raise public awareness that fewer and fewer research dollars are available for basic research in this age of shrinking budgets, and biomedical research is one of the few areas where funding can make all the difference.