International and national experts gathered in Melbourne in February for the joint Australasian Lung cancer Trials Group (ALTG) Annual Scientific Meeting and Lung Foundation Australia’s 8th Biennial Australian Lung Cancer Conference 2020: A Time of Hope in Lung Cancer.
The introduction of new therapies and the effect of these changes to existing paradigms of care were major topics of discussion at the Meeting. This included optimal timing of immunotherapy, chemoradiation and surgery in non-small cell lung cancer (NSCLC), and preliminary evidence around immunotherapy in mesothelioma patients, to be examined in the Phase III ALTG DREAM3R clinical trial, recruiting later this year.
The success of targeted therapies has identified a need for timely, comprehensive genomic profiling of NSCLC tumours at diagnosis. The feasibility and clinical impact of introducing a comprehensive genomic testing platform for metastatic NSCLC patients will be explored in the ALTG ASPiRATION trial that has recently secured MRFF funding and was presented for the first time at the conference.
In an attempt to improve detection of disease in early stage, several countries have implemented lung cancer screening in high risk populations In the local context, as Cancer Australia closed its doors on submissions into the lung cancer screening enquiry and following on from the NELSON study results that showed an unequivocal benefit of lung cancer population screening in high-risk individuals, ALTG respiratory physicians presented data from the International Lung Screen Trial addressing local implementation issues of a screening program.
Those challenges include optimal selection criteria for the screening population, and how to maximise uptake particularly in regional, rural and Aboriginal and Torres Strait Islander populations where the burden of lung cancer is significantly higher. They also addressed speculation over the cost-effectiveness of a lung cancer screening program in the Australian setting.
Presentations also covered the growing awareness of the possible benefits of early referral to palliative care on a patient and carer’s quality of life, in fulfilling psychosocial needs and on survival time.
The ALTG PEARL clinical trial was also presented, as it examines the benefit of early referral to palliative care in malignant pleural mesothelioma patients or Stage IV NSCLC patients. If results of the PEARL clinical trial have a positive impact on patients’ quality of life, it will provide the evidence to change clinical practice and should be readily implemented as the intervention uses an already available, but potentially underutilised, component of the health care system.
With around 10 per cent of the delegates in attendance identifying as consumer advocates, the program afforded great opportunities for delegates to benefit from the consumer perspective when discussing advances in research. This was demonstrated when ALTG consumer advocate and lawyer, Ms Lillian Leigh, took on ALTG President, A/Prof Nick Pavlakis in a lively debate on the stringency of trial eligibility criteria.
With so many potential areas for clinical trials research described at the Annual Scientific Meeting, the ALTG hopes to spend the next few months defining priority research areas and developing new clinical trial ideas.