Lung cancer

Lung cancer conference: Associate Professor Nick Pavlakis on the steps to improving care


The 8th Biennial Australian Lung Cancer Conference 2020 was held in Melbourne recently. The Limbic spoke to Associate Professor Nick Pavlakis, president of the Australasian Lung Cancer Trials Group (ALTG) for his perspective on some of the discussion.

Equity and access  

“There was a lot of discussion with patient groups about equity and access to clinical trials. It highlighted a few things that are important at the national level,” he said.

“Patients are very keen to go on trials. There are currently some historical conventions that dictate sometimes quite restrictive criteria for people to get on trials, and if we listen to patients, they are saying they really want to be part of trials and can we re-look at this.”

“The answer is not simple because some of those strict rules are provided by organisations such as the FDA or the TGA and so are not alway under our control. We did emphasise to the patients that the scientific community certainly has made attempts to be more inclusive and to try and get people from the ‘real world’ into the trials.”

The multidisciplinary team

“One of the hallmarks of our meeting is that it is representative of thoracic oncology, medical oncology, radiation oncology, palliative and supportive care….,”  Associate Professor Pavlakis said.

However the MDT is only as good as the infrastructure that supports it and the important work of nurse coordinators and lung cancer nurses.

A petition calling for federal government funding for 15 specialist lung cancer nurses was launched at the conference and will be presented to the House of Representatives in March 2020. It says the Federal Government currently funds 98 specialist breast and 62 prostate cancer nurses but no lung cancer nurses.

Associate Professor Pavlakis said a lung cancer diagnosis was emotionally challenging.

“Then you are worried about where you are going for the next treatment and what that treatment is going to do to you… and the likelihood of surviving is higher in those other cancers than in lung. You actually need to have more lung cancer nurses.” 

Clinical trials 

Associate Professor Pavlakis gave two examples of trials that were discussed at the conference and highlight Australia’s contribution at an international level.

He said DREAM3R is a pivotal trial, led by Australia, involving 450 mesothelioma patients from the US and Australia. The phase 3 randomised trial is testing the addition of immunotherapy durvalumab to chemotherapy as first line treatment.

As well, government funding has been announced recently to partner with Roche in the ASPiRATION study which will evaluate the routine use of comprehensive genomic sequencing in all newly diagnosed lung cancer patients.

“It’s about finding all the targets and then getting all the people found to have a target onto a targeted therapy.”

He said there was no point in having therapies if you couldn’t find the patients.

“… and this program is going to find the patients. It will completely change the landscape in terms of offering clinical trials. There will be impetus for trials coming to Australia and that has been a handicap for us in the past,” he said.

“It’s a paradigm shift for Australia.”

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