22/002 AURORA

ASPiRATION 2 Liquid (ASPiRATION-2L) will establish a national framework for precision medicine in lung cancer through the implementation of using serial blood-based ctDNA testing (called “liquid biopsy’) to guide treatments following progression on targeted therapies. ctDNA results will be reviewed by an expert tumour molecular board to inform clinical decision making on next line treatment. The option for further ctDNA sampling and review is available for participants should progression recur, which will enable treatment to be tailored based on the tumour’s changing molecular profile.

The ADOPT-Lung study will examine disease free status (DFS) following 12 months of adjuvant durvalumab in addition to neoadjuvant chemotherapy and durvalumab in NSCLC patients who do not achieve a complete pathological response following surgery. ‘Operable’ patients will be given 3-4 cycles of neoadjuvant durvalumab and chemotherapy every 3 weeks, and provided the tumour is satisfactorily removed by surgery (R0 or R1), the patients will be randomised to 12 months of durvalumab given every 4 weeks, or observation. Participants will have CT scans every 12 weeks in the first year, and every 6 months in years 2 and 3. Blood will be collected at the scan visit to measure correlation of DFS with ctDNA clearance.

The aim is to establish the rates of radiation-induced lung disease outcomes, quality of life, and progression-free survival in lung cancer patients treated with Functional avoidance radiotherapy (Arm 1) and Standard radiotherapy (Arm 2)

This project will conduct early stage, small scale research, to assess the potential and feasibility of developing the first Australian Tissue Repository of Airway Cancers for Knowledge Expansion of Resistance (TRACKER) to address issues in translational lung cancer research. Since 2015, immunotherapy has emerged as a promising treatment, however 95% of patients will develop resistance. Conventional tissue sampling and analysis often means the opportunity to study mechanisms of immunotherapy resistance in tissue samples is not maximised. This study aims to establish a clinically annotated biobank of tissue samples from patients with metastatic lung cancer that can be harnessed to advance knowledge in immunotherapy resistance. This will provide a platform for mechanism-driven therapeutic pre-clinical and clinical studies, to enhance personalised medicine approaches.

OCEANiC will investigate whether, following surgery for local or locally advanced EGFR+ NSCLC, patients with tumours containing certain types of genetic signatures can achieve the same disease-free survival with osimertinib treatment alone, as has previously been achieved with osimertinib and chemotherapy. Standard of care treatment is evolving to include osimertinib in addition to chemotherapy, but the OCEANiC trial may provide evidence for similar benefits for using the drug alone, with less toxicity, improved quality of life and reduced health care costs.