Neoadjuvant debate to feature at TOGA’s first in-person ASM

Lung cancer

By Geir O'Rourke

18 Jul 2022

Dr Melissa Moore

Neoadjuvant immune therapy and the fallout from the disappointing decision on lung cancer screening are set to lead the agenda at the Thoracic Oncology Group of Australasia’s (TOGA) annual scientific meeting this week.

The meeting to be held in Sydney will be TOGA’s first ever in-person conference since the group formed as a breakaway venture from the Australasian Lung Cancer Trials Group (ALTG) in July 2020.

An online-only option is still available, but the “overwhelming majority” of those who have registered so far are coming face-to-face, says meeting convenor Dr Melissa Moore.

“I think there is an appetite for everyone to be able to get together after so long,” she tells the limbic.

“And what I’m excited about is that it’s a very multidisciplinary program, so it won’t all just be medical oncology.”

Building on one of the highlights of this year’s ASCO conference, a major topic would be neoadjuvant immune therapy, Dr Moore said.

The list of international speakers is headed by Professor Ming Tsao, a consultant thoracic pathologist and researcher at the University of Toronto, who will give an update on pathological and biomarker assessment of NSCLC specimens after NA IO.

On top of that, a breakfast symposium will be held on the topic, chaired by TOGA secretary Professor Michael Boyer.

“Is neoadjuvant better, is adjuvant better? We don’t have the answers at the moment,” Dr Moore said.

“I think it is going to be quite complex and a lot to tease out as to the best setting in which to use immunotherapy in the curative setting, whether it’s pre-op, post-op. And it would create potential changes to referral pathways.

She added: “Obviously it’s a bit hypothetical at this point as none of this is PBS listed yet, but the companies working on these agents will likely be seeking reimbursement and the difficulty is going to be in what setting is it used.”

Lung cancer screening

The decision by the Medical Services Advisory Committee (MSAC) to defer its recommendation on a national lung cancer screening program is likely to be another hot topic at the TOGA meeting, Dr Moore said.

“One of our international speakers is going to be speaking about lung cancer in non-smokers, so it feels crazy that we don’t have our own screening program in high-risk patients but the rest of the world is now talking about the possibility of screening lower-risk individuals,” she said.

“It’s disappointing as the data is pretty clear.”

Other international speakers will include Professor Eric Lim from the UK, who was a lead researcher on the VIOLET trial examining outcomes from video assisted thoracoscopic surgery (VATS).

And Dr Charu Aggarwal, Associate Professor for Lung Cancer Excellence at the Penn Centre for Precision Medicine in Pennsylvania, will discuss plasma-based genotyping in NSCLC.

Despite the ongoing spread of COVID-19, Dr Moore said the conference organisers were committed to a face-to-face meeting.

Nevertheless, mask wearing would be encouraged, while large open ballrooms had deliberately been chosen for the conference venue to minimise transmission risk.

“There is still certainly some risk. My feeling though is that COVID-19 is going to be with us for years to come and there are benefits to meeting in-person, particularly for the next generation coming through,” she said.

“The advanced trainees have had very little opportunity to get together and interact with one another and leaders in the field, it’s important for their career development and to  inspire people to get involved in lung cancer research.”

Further details are available here.


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