Lung cancer

What’s on the respiratory medicine agenda for 2023?

Lung health is again set to be a major public policy battleground in 2023, with vaping, silica dust and air pollution all on the reform agenda this year.

TSANZ president Professor John Upham says all three issues are in the society’s sights for the next 12 months, given the harm of non-action on each.

With vaping in particular, it was clear the Commonwealth’s requirement for a prescription to purchase nicotine-containing cigarettes was failing, Professor Upham said.

“The reality is the vast majority of vaping going on in the community is completely unregulated. People just buy them from the corner store,” he said.

He said TSANZ was lobbying the governments to improve policing on sale of the devices and introduce mandatory labelling to list their ingredients.

On the topic of silica dust exposure, there was “nervousness” among respiratory physicians that the progress of the past few years might stall without real reform to the artificial stone benchtop industry.

As for lung cancer, Peter Mac oncologist Associate Professor Tom John said 2023 promised to be an exciting year for clinicians, with a number of new drugs in development.

“In metastatic lung cancer, the up and coming agents at the moment are the antibody drug conjugates, of which there are quite a few now being developed,” he told the limbic.

Professor John said there was a hope the therapies would have fewer side effects than existing alternatives, while also being “semi-targeted” because of their mechanism directly giving the cytotoxic agent into the cell.

“We will be seeing a lot more of those trials this year, including a few in combinations. Some of these might be game changes in terms of how we manage metastatic lung cancer going forward,” he said.

On a similar vein, a number of agents were now being trialled for KRAS-mutant lung cancer, some of which could potentially be used in combination for chemotherapy in the future. This was of particular interest given some of the newer G12C inhibitors appeared to avoid the problem of liver toxicity, he added.

And in EGFR mutant lung cancer, overall survival data was anticipated for release in the high-profile ADAURA trial, which evaluated the targeted therapy Osimertinib as an adjuvant treatment for patients with stage III disease following surgery.

“People have been waiting for that data before it becomes adopted as standard of care so that will be one to watch,” Professor John said.

The limbic will be reporting from the TSANZ SRS 2023 meeting in Christchurch from 25-28 March  and the Australian Lung Cancer Conference 2023 on the Gold Coast 15-17 Feb.

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