Editor’s Note: This is the first of three articles summarizing highlights from the IASLC Award Lectureships presented during the 2023 World Conference on Lung Cancer. Look for future articles in the coming weeks at ILCN.org.
Each year, the IASLC Lectureship Awards presentations during the World Conference on Lung Cancer feature renowned leaders in thoracic oncology, and this year was no exception. These awards recognize clinicians and investigators who have made significant contributions to the treatment of patients with lung cancer.
During WCLC 2023 in Singapore, these nine lectures took place during one dedicated plenary session on Sunday, September 10. Following is a summary of the highlights from the first three presentations. The session can also be viewed on-demand by registered attendees through December 31.
Tobacco Control and Smoking Cessation
Silvia Novello, MD, PhD, of San Luigi Hospital in Orbassano, Italy, received the IASLC Lectureship Award for Tobacco Control and Smoking Cessation. Dr. Novello was recognized for her work with Women Against Lung Cancer in Europe (WALCE). This nonprofit promotes epidemiology-based communication strategies and awareness initiatives about smoking and lung cancer.
The proportion of people who smoke declined in Europe between 2006 and 2014 but has remained stable since. And recent years have seen the resurgence of cigarettes as a symbol of rebellion and freedom among young people, Dr. Novello said.
“The main reason for teenagers to start smoking is emulation of family, friends, or famous actors or influencers,” she said.
Accordingly, WALCE has designed cinema-focused programs that target young people, including the #smokefreemovie social media campaign, which raises awareness of the negative effects on teens of onscreen smoking. Other projects include live-action web series and short films. WALCE received the Academy Starlight International Cinema Award at the Venice Film Festival for their work.
WALCE has also developed a successful outreach program for adults. “Come Out of the Tunnel, Don’t Burn Your Future,” has hosted 18 events to date. Combined, these events have attracted 16,500 participants, 4,000 of whom received screening via spirometry.
Multimodal Thoracic Surgeons
Next, Alan Sihoe, MBBChir, consultant in cardiothoracic surgery at Gleneagles Hong Kong Hospital, received the Tsuguo Naruke Lectureship Award for Surgery. During his lectureship address, Dr. Sihoe discussed the unique insights today’s thoracic surgeons can bring to discussions about multimodal lung cancer treatment for every stage.
Screening is key to helping clinicians find a balance between overdiagnosis and under-treatment, Dr. Sihoe said.
“We’re seeing, especially here in Asia, that a lot of these screening-detected lesions actually turn out to be malignant,” he said. “As surgeons improve the surgery, the costs of over-diagnosis become less and those of undertreatment become more. We need more of a role in that conversation.”
Surgeons can also offer an important perspective on neoadjuvant therapy, Dr. Sihoe said.
“How many non-surgeons are aware that many patients never make it back for curative surgery after neoadjuvant therapy?” he said. “Even as we congratulate ourselves on the supposed lack of morbidity from neoadjuvant therapy, that’s not necessarily the case.”
Additionally, surgeons even have an important role in treating patients with advanced lung cancer, Dr. Sihoe said.
“Even with stage IV lung cancer, surgery as a local treatment might work better than other modes of local therapy,” he said. “And we’re learning that we can still perform salvage surgery for some patients with quite reasonable long-term outcomes.”
Evolving Expectations
Next, medical oncologist D. Ross Camidge, MD, PhD, of the University of Colorado Cancer Center, delivered the Daniel C. Ihde Lectureship. Dr. Camidge began by asking how the field should evolve before answering his own question: “For a start, we should recognize that our ways of assessing cure post-surgery for early-stage disease by looking at the 5-year survival rate will have to change,” he said. “Those interested in the true cure rate of a radical modality or new staging investigations must find a way of looking at disease-free survival with all of the caveats of surveillance variation.”
In considering advanced disease, Dr. Camidge said that ALK researchers have identified ways in which the entire field can evolve. “Patients with brain metastases are now more appropriately being included rather than excluded from trials,” he said. “And increasingly robust CNS efficacy endpoints are now actively being included in such trials.”
Additionally, the issue of drug toxicity needs more attention from clinicians, Dr. Camidge said. “Prioritizing any degree of progression-free survival benefit over toxicity, especially when some more toxic drugs can also be used in later-line therapies, is already being rethought,” he said. “As a field we can evolve by being more skeptical consumers of how toxicities are presented to us.”
Dr. Camidge concluded with an aspirational goal: “Before we have a cure for all forms of lung cancer, we should strive for perfect cancer control and quality of life for all,” he said. “To achieve this, we will have to evolve our mindset, research environment, and partnerships with patients and regulatory authorities.”
