I attended the Canadian Lung Cancer Conference on behalf of Lung Cancer Canada in July of 2022. I came away with a sense of the cutting edge of research and debate in the lung cancer community.
I also had an opportunity to see the humanity of the researchers and oncologists on display. The laughter and intense passionate conversations were a reminder that doctors care. I was disappointed that I didn't see more patients participating. With my red cap and White Ribbon I know I stood out a bit but there is a role for patient engagement in medical conferences of this nature and hopefully that will begin to change.
Here are my notes and thoughts on the conference sessions.
Keynote Speaker- Dr. Federico Cappuzzo (Italy) Virtual
Dr. Cappuzo gave us a sweeping view of history and how far lung cancer diagnosis and treatment has come in the last fifteen years. Astounding.
Medical Oncology Breakout – Chair: Dr. Rosalyn Juergens
TIGIT – Dr. Peter Ellis (ON)
TIGIT is the T-cell immunoreceptor with immunoglobulin and ITIM domain.
This is an exciting new development that shows potential to enhance the effectiveness of PDL-1 checkpoint inhibitors. The CITYSCAPE trial uses tiragolumab and atezolizumab and a recent publication showed a 38% increase in PFS.
Statistical Trial Design for Rare Molecular Subtypes – Dr. Yu Shyr (USA)
Dr. Shyr gave a rapid fire presentation with an intense focus on the challenges of trial design. He highlighted the use of retrospective groups that allowed for robust trials; ways to manage power of trials; the need for a rapid easier endpoints.
Update in Small Cell Lung Cancer- Dr. Janessa Laskin (BC)
This was a hard one for me to listen to. Though there are some developments on the horizon, the fact is that there has been little movement in the treatment, limited stage treatment is relatively successful but extensive stage is a challenge and moves fast.
The growing group of EGFR patients who see SCLC conversion as progression is drawing attention but we don't have clear indications of whether the conventional treatments work for them.
Lunch conversations were just as surprising as the sessions themselves. Meeting the nurse practitioner that facilitates clinical trials in Vancouver at VGH was a highlight. (Getting home and listening to her LCC podcast shed new light on what goes on behind the scenes.)
Afternoon session
I was not expecting the clear fun that was had during the debates. It served to show the humility of science. Examining challenging treatment questions and bringing the best science to the discussion through debate was an interesting way of fostering discussion about difficult questions.
Debate 1: Durvalumab Consolidation for Stage III EGFR Positive NSCLC Post Chemoradiotherapy – Chair: Dr. Nathalie Daaboul (QC)
Yes- Dr. Aliyah Pabani (AB)
No- Dr. Catherine Labbe (QC)
Voting and Discussion with Audience
Again this was a hard one to sit through. This was my treatment. I was a face on the graphs displayed. I was hoping for some clear indication that part of my current situation is as a result of this treatment. To hear that this is controversial gave me some sense that maybe there hadn't been a "mistake" in my treatment.
Debate 2 Surgery vs Radiation in Early Stage Treatment.
I have been following the surgery vs radiation debate in the media but had to step out and miss this debate.
Debate 3: Stage II-III Surgically Managed Early Stage NSCLC- Chair: Dr. Myuran Thana (NS)
Neoadjuvant- Dr. Kevin Jao (QC)
Adjuvant- Dr. Paul Wheatley- Price (ON)
This is a growing group in the lung cancer world. I knew both of these discussants and they were . This was the closest debate showing a clear need for more definitive work in this area. One interesting component is that surgeons are often the ones making this call. They may not have a clear picture of what the benefits might be.
Conclusion
All in all this was a very valuable experience. I was a little overwhelmed by the large numbers of drug reps there. But it shouldn't have surprised me as there are tremendous efforts being made in lung cancer treatments by a wide variety of companies.