Lung transplants extend lives of sickest cancer patients better than standard treatment: study

Patients with advanced lung cancer are far more likely to survive if they receive a lung transplant compared to patients who received a standard cancer treatment, a landmark study from Northwestern Medicine found.

The medical community has long considered it too risky to transplant lungs into patients with advanced cancer because of the potential risk for cancer cells to spread to the new lungs.

But the new study, published Wednesday in the Journal of the American Medical Association, challenges that notion, said Dr. Ankit Bharat, Northwestern's chief of thoracic surgery and a co-author of the study.

Lung cancer is the leading cause of cancer-related deaths in the U.S. It's also the most common part of the body for other types of cancers to spread to, Bharat said.

The study included 404 adults with end-stage pulmonary disease, including 98 patients with stage four lung cancer. Of that group, 17 received a lung transplant and 89 were treated with standard cancer treatments from September 2021 through June 2025. The patients in the study only received a lung transplant if the cancer was isolated to their lungs, had caused significant damage to their lungs and if they had exhausted all other standard treatments, like immunotherapy and chemotherapy.

During the nearly four-year study period, every transplant patient was alive after a year, while less than half of patients treated with medical therapy alone were alive after a year.

"Those patients were not only dying from cancer, but they can’t breathe. They're likely on a ventilator, and they basically had no life left," Bharat said.

The lung transplant also turned the patients' conditions around. One of Bharat's patients was about to withdraw care when they offered the lung transplant. He survived.

"That's one of the most profound aspects of this study is how patients benefited from it," Bharat said. "They were at the end of their lives and had no other hope, no other treatment options. Then we were able to extend their life and give them a higher quality of life, too."

Bharat told the Sun-Times the idea for the study came while he and his colleagues were treating patients hospitalized with COVID-19 early on in the pandemic.

The experience made Bharat wonder if that approach can be replicated with patients suffering from advanced lung cancer that was isolated in the lungs.

"We were the first in the nation to understand how COVID was killing people and destroying the framework of the lungs," Bharat said. "Our observation from that was that the only way to save these patients was to replace these lungs, which was very controversial at the time because these were really sick patients."