CHICAGO — Northwestern Medicine published a study in JAMA on Wednesday, July 8, 2026, reporting high survival rates and favorable early outcomes for selected patients with advanced but localized lung cancer who received lung transplants. Northwestern Medicine surgeons and oncologists offered double lung transplants to patients whose late-stage lung cancer had not spread beyond the lungs.

The study followed 404 patients with end-stage pulmonary disease, including 98 with stage 4 lung cancer. It featured 17 lung transplant recipients and 81 similar patients who received standard treatments such as immunotherapy, chemotherapy, or radiation. Through June 2025, all 17 lung cancer transplant patients in the study remained alive, while 88% of patients transplanted for non-cancer reasons also survived.

By January 2026, four of the 17 transplant patients experienced cancer recurrences. Two of these 17 patients died from causes unrelated to cancer; one from an infection and another from a blood clot. Among the 81 cancer patients who continued standard care, 74 saw their cancers progress.

Ankit Bharat, chief of thoracic surgery at Northwestern Medicine and a co-author of the study, said, "We thought by combining a good patient selection to make sure there's no disease outside the lung, improving on the surgical technique, and making sure these patients prior to getting to transplant go through the chemo and immunotherapy that is available now, we can improve those outcomes dramatically." He added, "We actually saw no difference. In fact, there's a trend towards improved earlier outcomes in cancer patients compared to the noncancer patients." Bharat stated, "Now we'll have to see what the long term plays out, but at least the early results have no concerns that this would be not a good use of organs."

Jodi Graf, a 61-year-old robotic software engineer for NASA, received a lung transplant at Northwestern Medicine. Diagnosed with an autoimmune disease and progressive pulmonary fibrosis in 2008, she was diagnosed with lung cancer in 2020 after a biopsy confirmed a spot on a PET scan. Graf stated, "I was already too sick for chemo, and I definitely had too little lung capacity to have surgery on the cancer." Graf underwent lymph node biopsies at Northwestern Medicine to confirm her cancer had not spread. She received a lung transplant 24 hours after being added to the transplant waitlist. The protocol for lung transplants in cancer patients grew from the team's experience performing the first lung transplant in a Covid-19 patient in 2020. Graf stated, "They say when you get a lung transplant, you trade one disease for a new one, right? Because being post-transplant is a thing in and of itself." She added, "But I traded two. I got a twofer." Graf said, "Life is awesome."

Why It Matters

The study addresses the potential role of lung transplantation as a treatment option for a specific subset of lung cancer patients. The patient selection criteria focused on ensuring the cancer had not spread beyond the lungs, which occurs in approximately 300 cases per year in the United States involving stage 4 non-small cell lung cancer. Ece Cali Daylan and Ramaswamy Govindan of Washington University School of Medicine and Siteman Cancer Center wrote in an editorial published in JAMA, "The ethical implications are hard to ignore. Lung transplant operates within a zero-sum system." They wrote, "Each organ allocated to a recipient is unavailable to another recipient."