28 November 2019

 
 

Future of early disease identification

The results of NELSON reinforce the importance and value of lung cancer screening. As screening programmes become more widely implemented, new challenges emerge on recognising when CT appearances are benign, when and how to obtain confirmatory tissue diagnosis.

Harry de Koning - Erasmus MC, Netherlands

Following from the announcement of the results of NELSON at the Presidential session of the IASLC 2018 World Conference of Lung Cancer, Professor Harry De Koning will be presenting the implications of NELSON to inform us on results and residual uncertainties for lung screening.

Anand Deveraj - Royal Brompton Hospital, London

Dr Anand Deveraj, a thoracic radiologist that reported and advised on the UK lung cancer screening programme will discuss radiological diagnosis in the era of artificial intelligence and machine learning,

Simon Padley - Royal Brompton Hospital, London

Professor Simon Padley, thoracic radiologist will be presenting the advances in pre-operative biopsy localisation techniques and discuss the merits of pre-theatre localisation versus on-site radiologist (hybrid) theatre presence.

Calvin Ng - Prince of Wales Hospital, Hong Kong

The hybrid theatre re-sets the rules, choices and options for pre-operative localisation and Associate Professor Calvin Ng, will be presenting on the equipment, utility and rationale as surgeon within a hybrid theatre.

Audience discussion and questions:

What is the optimum patient pathways for pre-surgical diagnosis?

Is there any international consensus on best follow up strategies for lung screening?

 

Future of locally ablative treatments I

session chair - Peter Goldstraw, Royal Brompton Hospital, London

The screen detected ground glass opacity and / or lesions that have a low or uncertain malignant potential remain a challenge in surgical management. LCSG 832 have advocated lobectomy as the treatment of choice, but changing histological epidemiology and better understanding of the different malignant potential of adenocarcinoma questions the applicability of LSCG 832 in today’s practice.

Paul Van Schil - University Hospital of Antwerp, BELGIUM

Professor Van Schil was a co-author on the IASLC recommendations for T category coding for sub-solid nodules and will lead the presentation on this session that focuses on the management of sub-solid lesions that are less than 3cm in size. The presentation will discuss the “new” IASLC adenocarcinoma and the relevance with respect to screen and incidentally detected cancers.

Dominique Gossot - Institut du Thorax Curie-Montsouris, Paris

Following on from his successful conference on sub-lobar resections in Paris, Professor Gossot will be discussing the arguments of surveillance versus resection for the management of ground glass lesions less than 3cm.

Hisao Asamura - Keio University School of Medicine, Tokyo

Professor Hisao Asamura is the current TNM 9 staging chair for lung cancer and the Chief Investigator for JCOG 0802. His talk will focus on the rationale of sub-lobar resection in JCOG 0802 and compare the differences in the trial design with the US Alliance of Oncology Trials (formerly CALGB) of segmentectomy versus segmentectomy or wedge resection and prevailing views on the benefits of “anatomic” sub-lobar resection.

Audience discussions and questions:

How can we put patients views in the management pathway for screen detected ground glass lesions?

Do western guidelines also apply to countries like China and Japan where non-smoking lung cancer incidence is high?

 

Future of locally ablative treatments II

session chair - Dr Alessandro Brunelli - Leeds teaching hosptials, leeds

Optimum access (single, multiple keyhole, thoracotomy) and choice of surgical adjuncts (robotics) remain heatedly debated in the surgical arena. This session focus on the emerging developments in single incision surgery and robotics with a debate on where and how experts see the technology developing with respect to number of incisions and accompanying cost of surgical adjuncts.

Joel Dunning - South Tees Hospital, Middlesborough

Mr Joel Dunning is best known for his travels to discover new and emerging operative techniques. As an investigator for the UK VIOLET (VATS versus open surgery) trial, surgical innovator (micro-lobectomy) and robotic surgeon will be presenting a state of art on surgical technology.

Alan Sihoe - The University of Hong Kong Shenzhen Hospital, Hong Kong

Associate Professor Alan Sihoe is an established single port surgeon who writes and lectures internationally on the topic will be presenting an overview of the development of single incision surgery (uniportal and sub-xiphoid) and his views on the future of this technique.

Giulia Veronese - Humanitas Research Hospital, Milan

Dr Giulia Veronese, an experienced robotic thoracic surgeon and Chief Investigator of the ROMAN trial (robotic versus vats surgery) will be presenting her views on the role of robotic surgery for lung cancer in comparison to conventional VATS surgery.

Audience discussions and questions:

Why is the balance changing from less incisions, cheaper surgical adjuncts (VATS) to more incisions and expense with robotics?

 

Future of locally ablative treatments III

Stereotactic ablative body radiotherapy (SABR) is gaining widespread acceptance as a local option for the management of local disease, and the only RCTs to date demonstrate superior efficacy in the elective setting. SABR versus surgery trials have been notoriously difficult to recruit to and in this session, Chief investigators debate the utility of SABR for the primary treatment options for low and high risk patients.

kevin franks - consultant Clinical Oncologist, Leeds Teaching Hospitals NHS Trust

Associate Professor Kevin Franks the Chief Investigator of UK SABRTooth Trial will present an overview of SABR versus surgery trials and discuss the difficulties in the recruitment.

Suresh Senan - Amsterdam University Medical Center, Amsterdam

Professor Suresh Senan, a radiation oncologist, Chief Investigator of ROSEL (SABR versus surgery trial) published jointly with STARS in the Lancet, demonstrating superior survival with SABR compared to surgery for early non-small cell lung cancer. Professor Senan will discuss the role of SABR for elective low-risk patients with lung cancer.

HIRAN C FERNANDO - INOVA FAIRFAX MEDICAL CAMPUS, VIRGINIA COMMONWEALTH UNIVERSITY, VIRGINIA

Professor Hiran Fernando is the Chief Investigator for STABLEMATES (SABR versus surgery), a randomized trial comparing the utility for "high risk" patients with non-small cell lung cancer. He will provide insights on how recruitment is undertaken in the US and the rationale for the approach in the high risk cohort.

Audience discussions and questions:

Why isn’t SABR recommended as first line treatment option in guidelines for early non-small cell lung cancer patients in low risk patients?

 

Future of locally ablative treatments IV

New technologies are emerging in this space for locally ablative treatments. This sessions provides an overview of what is currently in development with a view to clinical application.

Corinne Faivre-Finn - Christie Hospital, Manchester

The Christie Hospital in Manchester is one of the few sites for the provision for MR Linac and proton beam therapies. Professor Corinne Faivre-Finn will be presenting an overview of the new technology and discuss the implementation plans (clinical and research) within the UK and internationally.

Calvin Ng - Prince of Wales Hospital, Hong Kong

Associate Professor Calvin Ng, thoracic surgeon will present the application of electromagnetic navigation bronchoscopy and local ablation of central tumours and future clinical utility of this technology.

Simon Padley - Royal Brompton Hospital, London

Professor Simon Padley, thoracic radiologist will present advances in radiofrequency ablation and discuss it’s place in the management pathway for early local disease.

Audience discussions and questions:

Do we always need tissue diagnosis prior to local ablation?

Currently local ablation treatment options are unique to the interest and development in each site, which technology should we all be looking to acquire?