TOGA Podcast

In this episode of Conversations in Lung Cancer Research, Dr. Malinda Itchins, Dr. Annie Wong, and A/Prof Stephen Kao discuss the concept of liquid biopsy, its advantages and limitations, and its clinical applications in lung cancer treatment. They explore how liquid biopsy can provide faster diagnosis and treatment options, especially for patients who cannot undergo traditional tissue biopsies. However, they also address the challenges of sensitivity and the need for further research to integrate liquid biopsy into routine clinical practice.This episode is sponsored by: AstraZeneca  Daiichi Sankyo Australia  SOPHiA Genetics  Thermo Fisher Scientific(00:00) Introduction and Acknowledgements(01:16) Meet the Experts(02:10) Understanding Liquid Biopsy(03:01) Advantages of Liquid Biopsy(06:21) Limitations of Liquid Biopsy(09:15) Clinical Scenarios for Liquid Biopsy(13:15) Barriers and Future Directions(19:39) Conclusion and Thank You

In this episode of Conversations in Lung Cancer Research, A/Prof Mel Moore, along with thoracic oncologists Dr. Malinda Itchins and A/Prof Surein Arulananda, delve into the characteristics, detection, and treatment of EGFR exon 20 insertion mutant non-small cell lung cancer. The podcast discusses recent advances, the efficacy of various treatments including small molecule tyrosine kinase inhibitors and monoclonal antibodies, and the potential future of targeted therapies. Special focus is given to the Phase 3 Papillon study and the drug Amivantamab, highlighting the need for next generation sequencing in clinical settings. Key challenges and questions in the field are also addressed, including the impact of co-mutations and optimal therapy sequencing.This episode is sponsored by: Johnson & Johnson(00:00) Introduction and Acknowledgements(00:48) Introducing the Experts(01:29) Understanding EGFR Exon 20 Insertion Mutations(05:04) Challenges with Current Treatments(06:30) Emerging Therapies and Clinical Trials(11:03) Papillon Study Insights(21:27) Future Directions and Unanswered Questions(29:34) Conclusion and Final Thoughts

In this episode of Conversations in Lung Cancer Research, A/Prof Mel Moore interviews Prof Michael Boyer, AM about his extensive career in medical oncology and his current role as CEO of Chris O'Brien Lifehouse. They discuss his early interest in oncology, the influential mentors in his career, and the evolution of lung cancer treatment and research. Michael shares his perspectives on leadership in medical and research roles, the importance of building relationships, and the balance between industry-sponsored and cooperative group research. They also touch upon professional challenges, emotional resilience in oncology, and Michael's vision for the future of his career and the field of oncology. (00:00) Welcome and Introduction(01:04 )Guest Introduction: Professor Michael Boyer(02:25) Michael Boyer's Early Career and Mentorship(07:27) Leadership Roles and Challenges(11:33) Involvement in Clinical Research(21:03) Emotional Aspects of Oncology(29:38) Future of Oncology and Career Advice(33:06) Conclusion and FarewellResources and Links:International Association for the Study of Lung Cancer https://www.iaslc.org/Chris O'Brien Lifehouse https://www.mylifehouse.org.au/Schwartz Rounds https://www.theschwartzcenter.org/programs/schwartz-rounds/

In this introductory episode, Associate Professor Mel Moore, medical oncologist and education chair at TOGA, announces the evolution of TOGA podcasts to 'Conversations in Lung Cancer Research.' The podcast will continue to deliver the latest breakthroughs in lung cancer research while expanding to include deeper dives and engaging discussions with experts in thoracic oncology. Listeners can look forward to unique insights from researchers, clinicians, and key thought leaders shaping the future of lung cancer care.

We have witnessed incredible advances in therapy since ALK was discovered in 2007, starting from the pivotal PROFILE 1001 study of crizotinib in advanced ALK positive NSCLC to present day where we now have five approved targeted agents, with increasing potency, selectivity and CNS activity with each successive generation of drug. Despite these advances in therapy, the emergence of treatment resistance in the TKI still remains one of greatest challenges in the clinic. Our TOGA podcast panel discuss the clinical and genetic factors affecting treatment choice, sequencing and resistance patterns, including oligoprogression and local therapy considerations. Dr Rebecca Tay, Medical Oncologist at Royal Hobart Hospital and ICON Hobart, is joined in this discussion by Professor Ben Solomon, Medical Oncologist at Peter MacCallum Cancer Centre & Board member, Scientific Chair of TOGA and Associate Professor Michael Ng, Radiation Oncologist at GenesisCare St Vincents Hospital Melbourne and Head of Stereotactic Radiotherapy at GenesisCare Victoria. References: CROWN: ascopubs.org/doi/10.1200/JCO.24.00581 Gomez paper denovo oligomet SABR pubmed.ncbi.nlm.nih.gov/31067138/ Kroeze – concurrent systemic therapy + SABR consensus sciencedirect.com/science/article/abs/pii/S1470204522007525 Tsai Curb trial RCT for oligoprogression pubmed.ncbi.nlm.nih.gov/38104577/

In this episode, we discuss the clinical and diagnostic markers when identifying a rare sub type of NSCLC, large-cell neuroendocrine carcinomas (LC-NEC), and provide insights into the management of these patients and future treatment developments. Associate Professor Rachel Wong, Deputy Director Oncology Eastern Health and Medical Oncologist at Epworth East in Melbourne is joined by Dr Patrick Hosking, Senior Histopathologist at Eastern Health Pathology; Dr Mal Itchins, Thoracic Medical Oncologist at Royal North Shore Hospital and Chris O'Brien LifeHouse in Sydney and Dr Sagun Parakh, Medical Oncologist at the Austin Hospital, Lung Cancer Lead. https://www.omico.com.au/our-programs/cancer-screening-program-casp/

In this TOGA podcast, we provide an overview of the treatment options for rare subtypes of oncogene driven NSCLC that are now readily identified in the MBS-reimbursed small gene panel including NTRK1, 2,3 and other rare mutations in NSCLC. The importance of testing all patients is discussed as well as what to do when resistance occurs. Associate Professor Steven Kao, Medical Oncologist from Chris O'Brien Lifehouse and Clinical Associate Professor Sydney Medical School, Faculty of Medicine and Health is joined by Professor Wendy Cooper, senior staff specialist in Tissue Pathology and Diagnostic Oncology at Royal Prince Alfred Hospital in Sydney, Anatomical Clinical Stream Lead for NSW Health Pathology, a Clinical Professor at the University of Sydney and a Conjoint Professor at the University of Western Sydney and also Professor Ben Solomon head of the lung Medical Oncology Service and a Group Leader of the Molecular Therapeutics and Biomarkers Laboratory in the Research Division at Peter MacCallum Cancer Centre as well as a Founding Board member of TOGA.

In this TOGA podcast, we provide an overview of the recent neoadjuvant, adjuvant, and perioperative IO data, the options and considerations for treatment and the current reimbursement landscape. Dr Pei Ni Ding, Medical Oncologist from Westmead and Nepean Hospitals Sydney, is joined by Dr Samantha Bowyer, Medical Oncologist from Sir Charles Gairdner Hospital in Perth and Mr Naveed Alam, Thoracic Surgeon from St Vincents, Epworth and Monash in Melbourne. Many emerging treatments are discussed in this podcast, and clinicians are reminded that oncology access programs are listed in the medicines access portal https://www.medicinesap.com/

Do we need to evolve the bar on evidence required for drug reimbursement? The gold standard endpoint for assessing the benefit of anti-cancer drugs has been overall survival (OS) however, more recently, there has been a trend toward using surrogate clinical trial endpoints such as progression free survival (PFS) and event-free survival (EFS). As treatments improve and patients are living longer, using OS as a primary endpoint can mean a longer time until a result is obtained. In this podcast, Dr Rebecca Tay, Medical Oncologist at Royal Hobart Hospital and ICON, discusses the critical role of improvement in quality of life in assessing drugs that are funded on the PBS, the nuances around clinical trial endpoints and the need for surrogate endpoints that accurately predict for OS and a reimbursement system that brings beneficial treatments to patients faster. Professor Nick Pavlakis, Chair of TOGA and Medical Oncologist at Royal North Shore Hospital and Genesis Care and Dr Deme Karikios, Immediate Past Chair of MOGA and Medical Oncologist from Nepean Hospital Sydney join the conversation. https://jamanetwork.com/journals/jama/article-abstract/2817337

Lung Cancer Support Nurse - Lung Foundation AustraliaQuit Centre | HomepageLung Cancer Screening Program: Early Detection Saves Lives (thoraciconcology.org.au)Lung Cancer Optimal Care Pathway

Radiation therapy can be a very effective treatment for lung cancers, with 77% of patients indicating for radiation therapy in their disease trajectory. Yet, only 40% of patients with lung cancer in NSW receive radiation therapy.In this podcast, Professor Shalini Vinod, Assoc Professor Mei-Ling Yap, and Dr Clare Bajraszewski  discuss why radiation therapy is underutilised in lung cancer, what this means for patients, and potential solutions to address this.This episode's host are:Professor Shalini Vinod is a Radiation Oncologist at Liverpool Hospital and a Conjoint Professor at the South Western Sydney Clinical School, UNSW Sydney. She is also on the Board of Directors at TOGA.Associate Professor Mei-Ling Yap is a senior staff specialist Radiation Oncologist at Liverpool and Macarthur Cancer Therapy Centres in Sydney.Dr Clare Bajraszewski is a Radiation Oncologist at Peter MacCallum Cancer Centre at the Bendigo campus.Want to read more about radiation therapy?  Radiation OncologyRadiation Therapy TreatmentsRadiotherapy underutilisation and its impact on local control and survival in New South Wales, AustraliaA Population-based Model of Local Control and Survival Benefit of Radiotherapy for Lung Cancer     

Artificial intelligence (AI) is transforming medicine. Lung Cancer healthcare professionals are interested in the use of AI in radiology, particularly in early diagnosis leading to better patient outcomes. In this podcast we will explore how AI can aid in early detection, accurate interpretation of imaging scans and reduce diagnostic errors. This episode is joined by Associate Professor Michael Franco, a dual trained in medical oncology and palliative care and also the digital health director at Monash in Melbourne. He is featured with Professor Catherine Jones Cardiothoracic Radiologist I-Med Radiology and Clinical Director of Radiology at Redland Hospital, Brisbane and an expert on the Cancer Australia Expert Group for National Lung Cancer Screening Program. And accompanied by Dr Diane Pascoe a Consultant Radiologist and Deputy Director of Medical Imaging at Royal Melbourne Hospital.

In this TOGA Podcast the speakers discuss Antibody Drug Conjugates (ADCs) – An Emerging Treatment Platform in Lung Cancer. The discussion explores the different molecules and mechanisms of drugs currently available, trial results and the subsequent place of ADCs in the Lung Cancer. Furthermore, our guests expand upon the management of patients receiving these drugs. A/Prof Melissa Moore, Medical Oncologist at St Vincent's Hospital Melbourne, is joined in this conversation by fellow medical oncologists A/Prof Tom John from Peter MacCallum Cancer Centre in Melbourne and A/Prof Adnan Nagrial from Westmead Hospital in Sydney.

This TOGA Podcast discusses Lung cancer Screening and Moving from Concept to Roll Out. The conversation explores the International Lung Cancer Screening Trial and overseas experience of recruitment, the challenges of reaching different population groups, some of whom stand to benefit most from the LCSP, and what it will mean for healthcare workload. The discussion explores the role of Federal and State jurisdictions in the management of the program. A/Prof Emily Stone, Head of Thoracic Medicine in the Dept of Thoracic Medicine and Lung Transplantation at St Vincent's Hospital Sydney, is joined by A/Prof Gavin Wright Director of Surgical Oncology and a Thoracic Surgeon at St Vincent's Hospital in Melbourne, A/Prof Nicole Rankin, an implementation scientist from The University of Melbourne with expertise in lung cancer and A/Prof Annette McWilliams who is a respiratory Physician at Fiona Stanley Hospital in Perth and clinical lead for the Thoracic Tumour Collaborative for Western Australia. This podcast is produced in support of lung cancer awareness month. Throughout the month of November please help spread awareness of lung cancer. If you want to find out more about lung cancer, get involved or donate towards lung cancer research- please go to TOGA's website at www.thoraciconcology.org.au For more information on the program https://thoraciconcology.org.au/lung-cancer-screening-program/

This TOGA Podcast discusses strategies for enhancing patients' recovery from lung cancer resection in light of new and emerging data for new peri-operative therapies that improve survival. The conversation explores the guidelines available, the changing landscape for the patient with neoadjuvant and adjuvant management options, and the multidisciplinary considerations to optimise the care of patients. Dr Jazmin Eckhaus, a thoracic surgeon from The Austin, Melbourne, is joined by A/Prof Emily Stone, Head of Thoracic Medicine in the Dept of Thoracic Medicine and Lung Transplantation at St Vincent's Hospital Sydney, A/Prof Melissa Moore, a medical oncologist from St Vincent's in Melbourne and Chair of the TOGA Education Committee and Professor Catherine Granger, Head of Physiotherapy Research at The Royal Melbourne Hospital and an Associate Professor of Physiotherapy at The University of Melbourne in Australia. Professor Granger is a cardiorespiratory physiotherapist and clinician scientist with expertise in physical activity and exercise for cancer patients' populations.

This TOGA Podcast discusses the data surrounding air pollution and lung cancer. The discussion delves into Nature and nurture and lung cancer risk and implications for future screening. Associate Professor Tom John, Medical Oncologist from Peter MacCallum Cancer Centre, is joined by Professor Charles Swanton, The Group Leader at the Cancer Therapeutics Laboratory at the London Research Institute and Medical Oncologist from University College in London, Associate Professor Venessa Chin, a Medical Oncologist from St Vincent's Private Hospital, Kinghorn Cancer Centre and Garvan Institute and Dr Tracy Leong, Respiratory Physician from Austin Health, Melbourne and President of the Victorian Branch, and Director of Lung Cancer, for TSANZ.

In this TOGA Podcast, we discuss what defines operability in locally advanced stage III NSCLC. A/Professor Tim Clay, Medical Oncologist from St John of God Subiaco and Rockingham General is joined by Professor Lucy Morgan, Board Chair of the Lung Foundation of Australia and Respiratory Physician from Concord & Nepean Hospitals; A/Professor Phillip Antippa, Cardiothoracic surgeon and the Head of Thoracic Surgical Services at the Royal Melbourne Hospital and the VCCC and also Dr Qurrat van den Blink, Radiation Oncologist from GenesisCare based in Perth (Joondalup) and Albany.

In this TOGA Podcast, Australian medical oncologist, Associate Professor Chee Lee, St George Hospital, Kogarah, is joined by medical oncologist Dr Tristan Barnes, Royal North Shore Hospital, Sydney, and Dr Alex Davis, PhD candidate and medical oncologist at Chris O'Brien Lifehouse, Sydney. They discuss treatment of patients with non-small cell lung cancer with KRAS mutations, the role of co-mutations, and biomarkers that are negative predictors of response. Furthermore, the speakers give an update on current clinical research and approval status of KRAS inhibitors as well as the clinical need for the availability of KRAS inhibitors in Australia.

In this TOGA Podcast, Australian medical oncologist Dr Jenny Lee at Chris O'Brien Lifehouse, Sydney, is joined by medical oncologist Professor Nick Pavlakis, from Royal North Shore Hospital in Sydney and Lisa Briggs, Stage IV lung cancer survivor, Author, Osteopath and Exercise Physiologist who provides her own personal experience after being diagnosed with ALK+ non-small cell lung cancer in 2014. They discuss treatment of patients with non-small cell lung cancer with ALK mutations, the latest updates on ALK targeted therapies, the emergence of resistance, and how the choice of ALK inhibitor should be made between clinician and patient, taking into account potential side-effects, their management and the impact on the particular patient's lifestyle.

In this TOGA Podcast, and on International Women's Day 2023, we celebrate female leadership in medical research. We explore the challenges and success pathways across different career stages for women who work in medical oncology and clinical research. Associate Professor Prunella Blinman, head of the medical oncology department at Concord Hospital and past chair of the Medical Oncology Group of Australia, is joined by Assistant Professor Narjust Florez, Associate Director of the Cancer Care Equity Program and a thoracic medical oncologist at the Dana-Farber Brigham Cancer Center; Professor Lorraine Chantrill, medical oncologist and Head of Service for Medical Oncology across the Illawarra and Area Clinical Director of Clinical Trials; and Dr Rebecca Tay, medical oncologist at Royal Hobart Hospital and former clinical research fellow in lung cancer at The Christie NHS Foundation Trust in Manchester, United Kingdom. https://ascopubs.org/doi/abs/10.1200/JCO.2019.37.15_suppl.10503

Recent studies in NSCLC patients with ALK or EGFR mutations and brain metastases, demonstrated greater benefit from the use of specific targeted therapies. In this Podcast, Associate Professor Paul Mitchell, Medical Oncologist from the Olivia Newton-John Cancer Centre, is joined by Dr Fiona Hegi-Johnson, Radiation Oncologist, Peter MacCallum Cancer Centre in Victoria, and Dr Dasantha Jayamanne, Radiation Oncologist, Genesis Care and Royal Northshore Hospital in NSW to discuss the management of brain metastases in NSCLC. They discuss the current data, the role of stereotactic radiation therapy (SRS, SABR, SBRT) and molecular drivers of ALK and EGFR in the management of these patients. Complex care is also discussed, as are intricacies and clinical considerations behind choosing and implementing care in NSCLC patients with brain metastases.

In this Podcast, Dr Malinda Itchins, Medical Oncologist at Royal North Shore Hospital, Co-Chair of the Advanced Non-Small Cell Lung Cancer Group for TOGA and the Lung Cancer Chair of COSA, is joined by Professor Stephen Fox, Director of Pathology and Head of the Molecular Pathology Laboratory at the Peter MacCallum Cancer Centre in Melbourne Victoria and Professor Michael Millward, Medical Oncologist and Cancer Council Professor of Clinical Cancer Research School of Medicine, University of Western Australia to discuss NGS panels in lung cancer. They discuss the logistics and other considerations behind choosing and implementing NGS panels and the potential future application of this technology in clinical management of NSCLC. Keen to hear more beyond this podcast? Save the date 19 July 2023 for a f2f workshop in Melbourne discussing the various technologies for molecular testing, considerations for implementation and downstream applications. Registration will be part of TOGA ASM 2023 registrations expected to open by April 2023.

In the latest TOGA Podcast, Gavin Wright discusses Lung Cancer Screening and its impact on patient care in Australia, accessibility and practicalities of the MSAC recommendation for the lung cancer screening program. He is joined by A/Prof Emily Stone, Dept of Thoracic Medicine and Lung Transplantation, St Vincent's Hospital Sydney and A/Prof Nicole Rankin, Head, Evaluation and Implementation Science Unit Melbourne University and Ms Paula Nelson Thoracic Liaison Nurse/Lung Cancer Nurse at the Royal Melbourne Hospital.

Welcome to the Thoracic Oncology Group of Australasia Podcast series. Associate Professor Shankar Siva, Radiation Oncologist and current Cancer Council Victoria Colebatch Fellow who leads the SABR program at Peter MacCallum Cancer Centre discusses The Management of Stage III NSCLC in this podcast. Shankar is joined by Associate Professor Rachel Wong, Deputy Director of Oncology - Eastern Health, Adjunct Clinical Assoc Professor - Monash University and Clinical Research Fellow – WEHI and also Professor Drew Moghanaki, Chief of Thoracic Oncology, Department of Radiation Oncology at UCLA, Stanley Lezman and Nancy Stark Endowed Chair in Thoracic Radiation Oncology Research, Co-Director Greater Los Angeles Lung Precision Oncology Program and Co-Director Greater Los Angeles CSP NODES Program also joins us today. Our focus today is on what defines inoperable NSCLC, patient selection and how to manage the toxicities associated with treatment.Thank you to AstraZeneca for sponsoring this podcast.

Welcome to the Thoracic Oncology Group of Australasia Podcast series. In this Podcast, we discuss early NSCLC management and treatment, particularly in light of how immunotherapy will impact surgical and respiratory medicine as the landscape evolves with new data. Dr Melissa Moore Medical Oncologist from St Vincent's Melbourne and the TOGA Education Chair, is joined by Dr Katharine See, Director and Head of the Respiratory Medicine at the Northern Hospital, Melbourne and Mr Naveed Alam, Thoracic surgeon from St Vincent's and Epworth, Melbourne to discuss and review the findings and implications for NSCLC patients. Thank you to Roche for collaborating on this podcast.

For lung cancer patients, the benefits of treatment and potential for cure must always be balanced with risk. Cardiotoxicity is considered a short and long term risk from treatment for lung cancer, but this varies between patients. New radiotherapy techniques, lower doses of radiotherapy and supporting cardiovascular treatments can minimise the risk of cardiotoxicity. Monitoring for cardiac complications is becoming an important aspect of survivorship care, and may require collaboration between medical oncologists, radiation oncologists, GPs and cardiologists. Professor Shalini Vinod, Thoracic Radiation Oncologist from Liverpool Hospital Sydney and Chair of the Liverpool and MacArthur Lung Cancer MDT discusses the challenges with Dr Vicky Chin, Radiation Oncologist from the University of NSW and Dr James Otton, Cardiologist from Liverpool Hospital.

Deme Karikios, Medical Oncologist and Director of Clinical trials at Nepean Cancer Care Centre in Sydney is joined by Wanda Cui, Medical Oncologist from the Peter MacCallum Cancer Centre in Melbourne and Chris Karapetis,  Head of the Department of Medical Oncology and Director of Clinical Research at the Flinders Medical Centre in Adelaide.

The identification of molecular subtypes of non-squamous NSCLC continues to grow, spurring the development of targeted therapies designed to target these mutations and prevent the growth of the cancer. People with advanced NSCLC that possess one of these ‘actionable' mutations and can access targeted treatments can live for many years with very manageable side effects. However, the technology to identify these actionable mutations in a single test and the targeted treatments are not yet accessible to all people with advanced NSCLC.In this TOGA podcast, we explore access to molecular diagnostics and treatments across ANZ: the past, present, future. Chaired by Professor Nick Pavlakis: Medical Oncologist, Royal North Shore Hospital, Genesis Care and Chair of Thoracic Oncology Group of Australasia ; joined by Dr Laird Cameron: Medical Oncologist Auckland Hospital and Canopy Cancer Care and TOGA Scientific Committee New Zealand representative and Dr Renuka Chittajallu, Medical Oncologist Riverina Cancer Care Centre, Griffith Base Hospital, Genesis cancer care, Kingswood, Director of Clinical Trials, Riverina Cancer Care Centre.In Australia, the TOGA ASPiRATION study is evaluating the impact of providing comprehensive genomic profiling and access to targeted therapies, with the hope that this will provide the evidence for widespread reimbursement for testing and treatments for patients where an actionable mutation is identified.https://thoraciconcology.org.au/aspiration/ 

In this TOGA Podcast, we discuss smoking cessation in the face of smoking-related stigma and nihilism. Dr Henry Marshall, Associate Professor and Clinical Academic Fellow, UQ Thoracic Research Centre and Thoracic Physician, The Prince Charles Hospital Queensland is joined by Professor Christine Paul: Behavioural Scientist at the University of Newcastle and School of Medicine and Public Health Dr. Matt Steliga: Chair of The IASLC Tobacco Control and Smoking Cessation Committee and Surgical Oncologist at Winthrop P. Rockefeller Cancer Institute, Little Rock, Arkansas. The COSA Smoking Cessation in Cancer Patients position statement recommends that brief advice on smoking cessation is everyone's role, but surveys suggest that many healthcare professionals feel they are inadequately trained to conduct these conversations, and in lung cancer, perceived sensitivities around smoking-related stigma may further hamper the delivery of appropriate smoking cessation advice. Despite clear benefits of smoking cessation and the recognition by healthcare professionals that smoking cessation is part of an individualised treatment plan, smoking cessation support for cancer patients may still not be successfully integrated into patient treatment plans. This podcast provides practical advice on how to start the conversations using variations on the “Ask, Advise, Help” model and emphasising brief advice and referral that can be conducted by any healthcare professional.  The podcast also covers why continuing to check in on progress at each visit is important, that stigma-related sensitivities are actually negated by asking about quitting regularly and that tandem pharmacotherapy to combat physical withdrawal and behavioural support (e.g QUITLine counselling) is evidence-based best practice for quitting. Finally, the podcast covers some system-based changes that have had phenomenal results, with over 90% uptake of behavioural support services in both lung cancer and non-cancer cohorts, and a 68% quite rate in a lung cancer cohort, and description of a clinical trial in the Australian healthcare system with a similar intervention. Resources referred to in this podcast:13QUIT for telephone adviceQUIT online referral formClinical Oncology Society of Australia Smoking Cessation Working Group. Smoking Cessation in Cancer Patients: Embedding Smoking Cessation Care in Australian Oncology Health Services. Clinical Oncology Society of Australia. August 2020.https://www.cosa.org.au/media/332692/cosa-smoking-cessation-in-cancer-patients-140820-final.pdf Position Statements | COSA tobacco-cessation-guide.pdf (asco.org) Quitting Smoking At or Around Diagnosis Improves the Overall Survival of Lung Cancer Patients: A Systematic Review and Meta-Analysis - Journal of Thoracic Oncology (jto.org)

Barriers and facilitators and a unique insight into the patient benefits are discussed between Alexandra, patient advocate, teletrials participant and lung cancer survivor, Sabe Sabesan, medical oncologist from the ICON Cancer Centre in Townsville and co-chair of the Australian Teletrial program and the initial teletrials pilot in 2017-2020, and Craig Underhill, medical oncologist from Border Medical Oncology and Haematology in Albury/Wodonga. Incentive funding and harmonising governance requirements for TeleTrials in Australia will help solve many of these issues and continue to transform the way trials are managed. The benefits for patients and their families are clear and positively impact the future of trials in Australia. Resources:          https://wiki.cancer.org.au/australia/COSA:Teleoncologyhttps://www.digitalhealth.gov.au/healthcare-providers/initiatives-and-programs/telehealth                            https://thoraciconcology.org.au/teletrials/ Supported by TakedaDisclaimer: The opinions, beliefs and viewpoints expressed by the various authors and participants contained in this message do not necessarily reflect the opinions, beliefs and viewpoints of TOGA or official policies of TOGA. Dosage & administration of any treatments mentioned during TOGA medical education may differ between Regions. Please refer to your local prescribing information for further details.  

Welcome to the Thoracic Oncology Group of Australasia Podcast series. Today Rachel Roberts-Thomson, Medical Oncologist from Queen Elizabeth Hospital in Adelaide, discusses Improving Outcomes in EGFR-Mutated Non-Small-Cell Lung Cancer . Rachel is joined byVenessa Chin from St. Vincent's Hospital in Sydney & Angeline Low who has her own personal experience with EGFR lung cancer .EGFR mutations are identified in approximately 15% of NSCLC patients. Efficacious, PBS-reimbursed first line treatments are available, but resistance to treatment and progression remains a concern. In this podcast, options for treatment post-progression are discussed, including accessible treatment and sequencing options and the role of patient preferences and clinical trials.In collaboration/partnership/supported with/by Roche.Disclaimer: The opinions, beliefs and viewpoints expressed by the various authors and participants contained in this message do not necessarily reflect the opinions, beliefs and viewpoints of TOGA or official policies of TOGA. Dosage & administration of any treatments mentioned during TOGA medical education may differ between Regions. Please refer to your local prescribing information for further details.  Note: SRS is Stereotactic radiosurgery

The first TOGA Podcast for 2022 is about the need for a national clinical quality registry in lung cancer. A/Professor Emily Stone, the Deputy Chair of TOGA, is a Respiratory Physician, Senior Staff Specialist and Head of Thoracic Medicine within the Department of Thoracic Medicine and Lung Transplantation at St Vincent's Hospital Sydney. She is a conjoint Senior Lecturer at the University of New South Wales and the Chair of the St Vincent's Hospital Lung Cancer Multidisciplinary Team. Emily is joined by Professor Rob Stirling, Respiratory Physician from the Alfred and Monash University who is the lead for the Victorian Lung Cancer Registry (VLCR) and also Professor Fraser Brims, Respiratory Physician from Sir Charles Gairdner Hospital and Curtin University Medical School and Institute of Medical Health.The high burden of disease and poor outcomes in lung cancer necessitate provision of optimal and timely care to ensure the best possible outcomes for people with lung cancer. A national clinical quality registry will reduce unwarranted variation in care by benchmarking performance and evaluate strategies designed to improve care, such as the expected lung cancer screening program. Registries are not just about collecting data.  Examples of varied care in lung cancer and a vision of what a clinical quality process should look like for lung cancer is explored in this podcast, together with an urgent call to action to demand funding for a national Clinical Quality Registry for lung cancer.

Welcome to the Thoracic Oncology Group of Australasia Podcast series. Today Mal Itchins, Medical Oncologist from Royal North Shore Hospital discusses ALK therapy choices & considerations when treating ALK NSCLC. Mal is joined by Steven Kao, Medical Oncologist from the Chris O'Brien Lifehouse and Lisa Briggs who has her own personal experience with ALK lung cancer having been diagnosed in 2014, when only limited treatment options were availableWe have seen rapid transformation in treating ALK lung cancer with emerging therapies and new indications over the last decade. We discuss how to choose one treatment over another, optimizing sequencing as well as addressing potential side effects associated with each of the options. Patient preferences, needs and wants are also considered.Two of the associated TOGA trials, ASPiRATION and ALKternate are exploring how molecular testing can monitor emerging mutations and influence treatment decisions, as well as exploring liquid biopsy to search for emerging mechanisms of resistance.https://thoraciconcology.org.au/clinical-trials/Thank you to Pfizer for sponsoring this Podcast.Disclaimer: The opinions, beliefs and viewpoints expressed by the various authors and participants contained in this message do not necessarily reflect the opinions, beliefs and viewpoints of TOGA or official policies of TOGA. Dosage & administration of any treatments mentioned during TOGA medical education may differ between Regions. Please refer to your local prescribing information for further details.

In this TOGA Podcast and in recognising Lung Cancer Awareness month 2021, Mel Moore, TOGA Education Chair and Medical Oncologist at St Vincent's Hospital Melbourne, discusses the importance of treating lung cancer patients with respect, dignity and withholding the often associated judgement. The internal guilt and the pain caused by a diagnosis of lung cancer is amplified by the stigma that exists in society today, including the medical profession. The societal view that lung cancer is self-inflicted and therefore deserved, leads to stigma. Perceptions about the course and outcome of lung cancer as an illness also contribute to this stigma, and to therapeutic nihilism in the medical community. The unconscious bias and its impact on lung cancer patients is discussed as well as the high levels of emotional distress that contribute to depression and anxiety for those diagnosed. It's time to challenge the stereotype and address the existing nihilism to ensure research, treatment and care is not negatively impacted on the basis of existing prejudice. Briony Scott, Governance Chair at TOGA with her own personal experience with lung cancer, Suzanne Chambers Executive Dean of Health Sciences at ACU and Stewart Dunn, Professor of Psychological Medicine at University of Sydney, join Mel in the conversation.

In this Podcast, Briony Scott discusses the stigma often associated with a diagnosis of lung cancer with Danielle and Terri – both diagnosed with lung cancer and managing the impact on their lives. They also explore self-stigma, family implications, cultural and social behaviours and systemic beliefs.

Drugs that target cancer gene mutations or rearrangements have improved outcomes for patients with many different cancers, including lung cancer, melanoma, and others . The challenge is being able to identify these genomic changes in a timely and efficient manner. Next-generation sequencing (NGS) based tumour comprehensive genomic profiling (CGP) that detects a wide range of genomic aberrations is one method being utilized to match patients to relevant targeted therapies against several oncogenic drivers, particularly for lung cancer. Several in-house as well as commercial testing panels are now available that help Medical Oncologists understand the cancer genomic profile of their patients. This information helps inform whether there these patients are likely to respond to a targeted agent, either as standard of care or as part of a clinical trial.In this Podcast, we will discuss some of the challenges that exist in being able to identify these molecular changes. The value of comprehensive genomic profiling for lung cancer patients in Australia will be discussed including the TOGA ASPiRATION study, an observational cohort study to assess the clinical impact of CGP in metastatic lung cancer patients. Professor Nick Pavlakis, TOGA Chair and Senior Staff Specialist in the Department of Medical Oncology at Royal North Shore Hospital and conjoint Professor in the Faculty of Medicine University of Sydney, is joined by Professor Stephen Fox, Head of the Molecular Pathology Laboratory, also currently Director of Pathology at Peter MacCallum Cancer Institute and Professorial Fellow in the Department of Pathology, The University of Melbourne.https://thoraciconcology.org.au/aspiration/Thank you to Roche for sponsoring this Podcast.

Inflammation plays an important role in pathogenesis, development and progression of lung cancer. Widespread literature exists on the prognostic impact of tumor-related factors, whereas host-related factors have not been deeply evaluated to date. Inflammatory indicators could play a vital role in assisting Medical Oncologists to identify which patients are considered at a higher probability of unfavourable prognosis and probably worse toxicity, justifying an appropriate management plan in advance.In this podcast Stephen Clarke, Professor of Medicine from the University of Sydney joins Associate Professor Kellie Charles, Head of Pharmacology at the University of Sydney Australia, who were part of the team that discovered that cancer-related inflammation altered chemotherapy pharmacokinetics, toxicity and survival, to discuss the issue.Thank you to Novartis for sponsoring this Podcast.

Delays in diagnosis are one of the main factors associated with reduced survival rates for lung cancer patients. Clinical guidelines have been implemented in some countries to standardize the diagnosis process, better define the time from diagnosis to the beginning of treatment, and to improve clinical results in lung cancer. In Australia, periods of 14 days from the initial referral of the GP to the first specialty consultation, and also from diagnosis to the first treatment are recommended. However, previous reviews showed an average time of 27 days for lung cancer diagnosis, with time distributions below those recommended by international guidelines (ranging from 6 to 45 days). Across all three modalities, a treatment delay of four weeks is associated with an increase in the risk of death.In this TOGA Podcast, we will discuss some of the challenges associated with treatment delay and how we can improve these for lung cancer patients in Australia. Dr Mal Itchins, is a thoracic medical oncologist at Royal North Shore Hospital, GenesisCare, and North Shore Private; Professor Wendy Cooper,  Staff Specialist in Tissue Pathology and Diagnostic Oncology at Royal Prince Alfred Hospital and Mr Phillip Antippa a specialist Cardiothoracic surgeon and the Head of Thoracic Surgical Services at The Royal Melbourne Hospital and the Peter MacCallum Cancer Centre, join us in the conversation.Thank you to Novartis for sponsoring this TOGA Podcast.Reference:ASPiRATION is an observational cohort study to assess the clinical impact of comprehensive genomic profiling in metastatic lung cancer patients. Find more information here: https://thoraciconcology.org.au/aspiration/

Welcome to the Thoracic Oncology Group of Australasia Podcast series. This TOGA Podcast focuses on thriving with lung cancer and overcoming the challenges associated with long term survivorship and lung cancer. The past decade has seen significant advances in the management of metastatic NSCLC with the advent of multiple targeted therapies, immunotherapy approaches and combination approaches and associated improvements in survival outcomes for patients. There is an emerging cohort of patients with advanced NSCLC who experience long periods of disease control whilst on these treatments. Traditionally survivorship has referred to the care of or issues for patients following curative treatment of early-stage disease. However, due to the recent advances described here, there is a compelling need to begin addressing the issues faced by long term metastatic disease 'survivors'. In this Podcast, we welcome Lillian Leigh, a long-term survivor of lung cancer, Dr Sarah Heynemann, Oncology Fellow from the Chris O'Brien Lifehouse and Mary Duffy, Lung Cancer Clinical Nurse Consultant (CNC) in the Lung MDT at Peter MacCallum Cancer Institute about the issue's patients face and how to support long term survivors of lung cancer.

Cigarette smoking is by far the greatest cause for lung cancer. But the proportion of lung cancer in patients who have never smoked before is on the rise. In this podcast, Melissa Moore and Lucy Morgan discuss the increase in lung cancer diagnoses for young women who have never smoked before. 

Welcome to the Thoracic Oncology Group of Australasia Podcast series. This TOGA Podcast focuses on Small Cell Lung cancer (SCLC) – a type of lung cancer with the poorest prognosis of any lung cancer. SCLC patients make up about 13% of new lung cancer diagnoses that are characterized by early & rapid spread with only modest progress in its treatment over the last decades. Immunotherapy continues to radically change the way we treat many types of lung cancer and today we explore what these treatments mean for the SCLC patient and the practical implications of using immunotherapies in the clinic. We also discuss future combinations and novel agents in clinical trial development.Our guests today include Dr Steven Kao, Medical Oncologist from the Chris O'Brien Lifehouse in Sydney Australia, Associate Professor Stephen Liu, Director of Thoracic Oncology & Director of Developmental Therapeutics at the Lombardi Comprehensive Cancer Centre of Georgetown University and also Dr Rebecca Tay, a Medical Oncologist from the Royal Hobart Hospital in Tasmania, having recently completed a Clinical Research Fellowship at the Christie NHS Foundation Trust in Manchester.Thank you for joining us and also thank you to Roche for sponsoring this Podcast.Useful link: https://www.frontiersin.org/articles/10.3389/fonc.2020.01074/full Disclaimer: The opinions, beliefs and viewpoints expressed by the various authors and participants contained in this message do not necessarily reflect the opinions, beliefs and viewpoints of TOGA or official policies of TOGA. Dosage & administration of any treatments mentioned during TOGA medical education may differ between Regions. Please refer to your local prescribing information for further details.

Lung cancer screening works. Earlier detection of lung cancer presents a vastly different prognosis. Stage I disease has a median 5 year survival of greater than 65%, whereas metastatic disease has a 5 year median survival rate of 15-20%. It is time to shift the perception of a lung cancer diagnosis to that of a treatable cancer with a potential cure, through a combination of early-stage detection, and effective communication that newer treatments offer better survival and QoL. The recently released Cancer Australia Report on lung cancer screening has been presented to the Health Minister and is awaiting actions. Dr Emily Stone, Respiratory Physician from St Vincent's Hospital in Sydney, interviews Professor Kwun Fong, Thoracic and Sleep Physician at The Prince Charles Hospital, Brisbane. Both are long time advocates and researchers in early screening for lung cancer and they discuss the challenges of implementing a lung cancer screening program.

Australia has one of the highest incidence rates of mesothelioma in the world.Mesothelioma is a form of cancer that most often affects the thin linings of the organs in the chest (pleura) and abdomen (peritoneum). Mesothelioma is closely linked with asbestos exposure either at work or among family members of workers and people living in neighbourhoods near asbestos factories and mines. The risk is lifelong.TOGA, the Thoracic Oncology Group of Australasia, is working to positively change the outcome for patients with mesothelioma through an innovative clinical trials program and by providing medical education & awareness.In this Podcast, we talk with Professor Anna Nowak, Pro Vice Chancellor at UWA, Medical Oncologist and Director of the National Centre for Asbestos Related Diseases and Medical Oncologist Dr Steven Kao from the Chris O'Brien Lifehouse with a special interest in predictive and prognostic factors in mesothelioma, about emerging treatments for mesothelioma patients and the DREAM3R trial.In a successful partnership spanning US, Australia and New Zealand, TOGA investigators are collaborating with PrECOG and NHMRC CTC and have opened a Phase III trial called DREAM3R investigating the addition of immunotherapy to chemotherapy in patients with newly diagnosed malignant pleural mesothelioma. Australia has one of the highest incidence rates of mesothelioma in the world, and new promising therapies are desperately needed. The DREAM3R trial follows on from the exciting Phase II clinical trial results in PrECOG's PrE0505 trial https://rb.gy/q44it3 and the Australian DREAM trial https://rb.gy/lrkhvo that both showed early promising results with the chemotherapy and durvalumab combination. More information on the DREAM3R trial can be found here: https://rb.gy/2h9f5v and https://rb.gy/rkznyt' Further trial information available here:https://rb.gy/2h9f5v and https://rb.gy/rkznyt

The first virtual TOGA Preceptorship enabled 38 Preceptees involving Fellows, Advanced Trainees, Nurses and Patients to come together and discuss the landmark papers in lung cancer and the latest in treatment.A multidisciplinary group including Medical Oncology, Radiation Oncology, Respiratory, Nursing, Palliative Care and Surgery were involved and available to share expertise.Hear from two of the Preceptors - Prunella Blinman and Shankar Siva, and three Preceptees – Anna Lawless, Abhijit Pal and Melanie Rabbets, about their experiences, their learnings, what they are looking forward to in future research and how the Preceptorship has impacted their career choices.

Dorothy Keefe, CEO of Cancer Australia and Mark Scott discuss the COVID impact on diagnosing and treating lung cancer patients – a 4 week delay in diagnosis makes a difference. The red flag symptoms of lung cancer need increased education, especially for the younger, non-smoking women, who are not always aware that a lung cancer diagnosis is possible. GP awareness and early screening is also important here. We are very good at treating breast cancer, colorectal cancer and prostate cancer – we need more focus to reach this point with lung cancer. Developing a specific thoracic oncology research group will enable such a focus, especially a multidisciplinary, patient centric group such as TOGA.Cancer Australia: Investigating Symptoms of Lung Cancer

Remarkable advances in screening, diagnosing and treating lung cancer are discussed in this Podcast. Associate Professor Nick Pavlakis, Medical Oncologists from Royal North Shore Hospital Sydney and Dr Emily Stone, Respiratory Physician from St Vincent's Hospital Sydney join TOGA for a conversation about public health measures to ensure the survival increase we are seeing for patients with lung cancer continues to accelerate into this decade.Sponsored with a Takeda Educational Grant.

Lung cancer is the leading cause of cancer related deaths in Australia, and lung cancer in never smokers is still the seventh leading cause of death. Lung cancer kills more women every year than breast, ovarian and uterine cancers combined even though many seem to think that the only cancer women ever get is breast cancer! More young women are being diagnosed every year who have never smoked – around 1/3 of new diagnoses fit this category for women.Thankfully this statistic is declining.Higher awareness, earlier screening and targeted treatments have played a role in better outcomes for lung cancer patients, as has the identification of driver mutations that can cause some lung cancers.Alexandra's story is inspiring. Diagnosed with lung cancer 8 years ago, her treatments have varied due to the discovery of a rare mutation called ALK and she is now involved in an innovative clinical trial using a targeted agent for patients with the ALK gene rearrangements. In this Podcast, Mark Scott talks with Alexandra about her challenges in diagnosis, searching for the best treatments available, living in a regional area and what it's like to be involved in lung cancer clinical trials. Alexandra is redefining survival rates for those with lung cancer and bringing new hope for patients all around the world.

Join us for a conversation with internationally recognized Medical Oncologists and researchers, Professor Ben Solomon & Associate Professor Tom John as they discuss the increased survival benefits for patients with oncogene driven lung cancer and how novel treatments are contributing.Oncogenes discussed include EGFR & osimertinib; ALK & brigatinib, alectinib, lorlatinib; ROS1 & crizotinib, entrectinib; KRAS & sotorasib; G12C; Exon20 insertions & poziotinib, amivantamab, RET & selpercatinib, pralcetinib. Also discussed – the importance of the move beyond single gene testing to panels and NGS is important to maximise turn-around times and the efficient utilization of clinical samples.