21/008 Lung Cancer Screening

Lung cancer patients expect to feel breathless, and little is done to implement therapies to address this symptom. Without management breathlessness negatively impacts physical function, social and psychological wellbeing. Despite there being evidence-based interventions to support people there remains a gap in implementation. This project will investigate existing datasets and co-design a study to determine current practice and potentially lead to implementation research or clinical trials to improve the translation of research evidence to manage breathlessness in lung cancer patients.

The Victorian Lung Cancer Registry is a Clinical Quality Registry established in 2011 and housed in the Clinical Registry Unit, Monash University. With governance oversight and nationally-based opt out ethical consent, the VLCR has recruited 44 hospitals from 19 health services representing over 85% of Victorian lung cancer diagnoses and registered 11,000 lung cancer patients providing both a Quality Indicator Report and an Annual Report to stakeholders with the objective of driving Quality Improvement through gap analysis and local on-site innovation.

LUCAP is a patient-focused research group who are developing a national clinical quality data platform for lung cancer that collects, analyses and reports on information such as how quickly people get lung cancer tests, what sort of tests are done and how quickly people get treatments. When large datasets are analysed, this real world data can provide an indication of quality of advances in lung cancer care. Reports from this platform for individual lung cancer service providers can be compared against a set of national standards to inform of unwanted variation in care, and provide compelling evidence for this to be addressed. The platform can further extend to support innovative research in lung cancer care and treatments.

Previous work has demonstrated that patients with metastatic disease, including mNSCLC, who experience long periods of disease stability have unique survivorship challenges. It is unclear whether such survivorship needs are addressed by community clinicians. The aim of this study is to facilitate and enhance communication between hospital-based cancer care teams, primary care clinicians and patients via the implementation of a multi-disciplinary team (MDT) consultation including both the patient’s GP and the patient to identify the survivorship concerns of individual long-term responder patients with mNSCLC and formulate a tailored survivorship care plan.

Cancer-related cognitive impairment is a well-recognised problem in cancer patients. However, there is little data that has assessed cognitive function in patients with metastatic disease, warranting further attention as a growing number of people are living with metastatic NSCLC. To understand whether cognitive function is a problem for people who have received, chemotherapy, immunotherapy or targeted therapies, COGNITION aims to investigate self-reported cognitive symptoms in patients living beyond the first 3 months of diagnosis with stage IV NSLC.

Radiation therapy (RT) is indicated for 77% of lung cancer patients. A common adverse event, affecting at least 20% of patients, is radiation-induced lung injury. To minimise radiation-induced lung injury, Professor Keall’s team has invented and pioneered ventilation imaging based on computed tomography (CT) which has been developed into a medical device (CIA). This medical device uses CT scans routinely acquired for planning RT to compute a CT ventilation map showing high functioning and low functioning lung regions. VitAL aims to investigate whether the use of CIA can be used to direct radiation away from the healthy, high functioning regions towards the low functioning regions, thereby reducing toxicity and improving the patient’s quality of life.