20/003 ROS1/NTRK ASPiRATION SUBSTUDY

Immunotherapy has improved outcomes in patients with metastatic non-small cell lung cancer (NSCLC) without an actionable driver mutation, when compared to chemotherapy alone. Since 2018 immunotherapy agents were approved for first-line use either as a single-agent immunotherapy (ICI) or in combination as chemoimmunotherapy (CIT) for patients with metastatic NSCLC and programmed death ligand-1 (PDL1) score greater than or equal to 50%. The addition of chemotherapy to immunotherapy is hypothesised to improve the immunogenicity of the tumour micro-environment and induce a more rapid tumour response. However the addition of chemotherapy risks greater toxicity. There remain a limited number of international real-world analyses that assess characteristics influencing treatment selection and none in the Australian setting. There are no descriptive analyses of current practice for this cohort in Australia. This study aims to administer a survey to clinicians in order to understand current clinical practice and treatment decision-making for driver-negative, metastatic NSCLC with PDL1 50% or greater.

This study aims to survey institutions treating lung cancer patients across ANZ regarding key workforce and infrastructure availability. Institutions will also be queried on access to contemporary and novel therapeutics, and other aspects of clinical care such as availability of MDT meetings, smoking cessation and access to clinical trials.

There is a lack of robust evidence in the successful management of night sweats in patients with mesothelioma. As this is both a common and often debilitating symptom of their cancer, improving the evidence base for the pharmacological management of night sweats will be of great benefit to patients.

Cancer Related Fatigue (CRF) is one of the most prevalent, persistent and distressing patient-reported symptoms associated with cancer and its treatment. Physical activity (PA) and psychosocial interventions targeted specifically for CRF have independently been shown to reduce CRF, with more robust evidence supporting PA. Mindfulness Based Stress Reduction (MBSR) is an emerging strategy to address a number of conditions, such as depression and Chronic Fatigue Syndrome. The aim of this study is to determine if a combined PA and MBSR intervention is active in improving CRF in cancer survivors.

An observational cohort study to assess the clinical impact of CGP in metastatic lung cancer patients. The ASPiRATION study is investigating the clinical impact of comprehensive genomic profiling (CGP) on the management of metastatic NSCLC and assessing the feasibility of CGP implementation nationally. When the ASPiRATION study was open to recruitment, standard of care tumour testing for NSCLC patients could only identify changes in three genes: EGFR, ALK & ROS1. Patients enrolled on the ASPiRATION study also had their tumour tested using CGP, often referred to as molecular screening and/or profiling. This technique allows treating clinicians to look at changes in hundreds of genes in a single test. After a patient’s tumour was tested, a report was sent to the referring oncologist with information on (i) Any genetic biomarkers that were identified in the tumour and (ii) The types of treatment that may be suitable. It is hoped this research will determine whether additional molecular screening can be feasibly integrated into Australian clinical practice for patients with metastatic NSCLC. The ASPiRATION study is led by TOGA, in collaboration with Omico (Australian Genomic Cancer Medicine Centre) and the NHMRC Clinical Trials Centre (CTC).

Single arm, open label, phase II trial of vemurafenib and cobimetinib in patients with advanced tumours harbouring BRAF V600 mutations detected by CGP (MoST 12).