ALTG Clinical Trials Newsletter

Transcription

1 ALTG Clinical Trials Newsletter October 2012 President s Message Special points of interest: MAC Elections Next ALTG Group meeting on 15 March 2013 CREST Workshops Inside this issue: General Business 2 NITRO Trial 3 BR26 Trial 3 PACT in NSCLC Study 4 PA in Lung Study 4 Unmet needs in Lung Cancer CHISEL Trial 5 PLUNG 5 SCLC Concept Update 5 ALTG 10/002 Update 6 ALTG 10/003 Update 6 ALTG 10/004 Update 6 4 Welcome to the 11 th ALTG newsletter! The 4 th Australian Lung Cancer Conference was held in Adelaide from August and was an exceptionally successful meeting a tribute to the hard work of the conference Chairs Kwun Fong and Jeff Bowden and the hard working ALF support staff. There were many inspiring talks from the star-studded International faculty, including Pasi Janne, Mark Kris, Federico Capuzzo and Peter Goldstraw among others. ALCC has grown rapidly in size and importance (it has only been held 4 times!) as shown by the ability to attract such International experts and now by the publication of the conference abstracts as a supplement to the September Journal of Thoracic Oncology. Upcoming Meetings 2012 At the ALCC, we held a group meeting of ALTG and a joint Management and Scientific Advisory committee meeting. Several new trials and concepts were discussed including European trials evaluating denosumab and pazopanib in advanced NSCLC that ALTG is likely to have the opportunity to join, a trial in stage III NSCLC basing treatment on PET response to initial combined modality therapy, a TROG lead trial of surgery versus stereotactic RT and a qualitative study of chemotherapy treatment decisions for mesothelioma. This is a time of change for ALTG. My term as President has been completed and I am delighted that the incoming ALTG President is Paul Mitchell. Paul is based at the Austin Hospitals newly opened Olivia Prof Michael Millward ALTG President Newton John Cancer Centre where he is the Cancer Network Director and is a leader in thoracic oncology clinical research. I would also like to welcome onto the MAC Craig Lewis (Medical Oncology), Julian Gooi (Thoracic Surgery), Helen Winter (New Zealand representative) and Shankar Siva (Radiation Oncology). I will remain on the MAC as Past President but there will be a new face on the front of the next newsletter! This is also a time of change for COSA. COSA has long been the peak multidisciplinary cancer body in Australia but is now restructuring and has proposed a new constitution replacing its governing council with an advisory council and a much smaller board. ALTG will be an affiliated organisation and have a seat on the COSA advisory council. Further details of these changes are available on the COSA website ( ). I urge ALTG members who are members of COSA to support these changes at the COSA Annual Meeting to be held in Brisbane from November On behalf of ALTG I would like to congratulate Professor David Ball who has been honoured with the 2012 Tom Reeve Award for Outstanding Contributions to Cancer Care. David has been a leading lung cancer clinician and researcher for over 30 years and a member and supporter of ALTG since its foundation. Well done David! ALTG 11/001 Update 7 ALCC November 2012 Closed SAC Teleconference 2.00pm 3.00pm AEDST The ALTG greatly acknowledges the support from: 8 November 2012 Closed MAC Teleconference 2.00pm 3.00pm AEDST November 2012 COSA s 39th ASM 15 March 2013 ALTG Group Meeting Melbourne TBC

2 Page 2 ALTG General Business ALTG Group Meeting - 15 March 2013 (Melbourne) The next ALTG Group meeting will be held on Friday, 15th March 2013 at the Olivia Newton-John Cancer and Wellness Centre, Melbourne. A tissue collection workshop will be held in the morning with the general membership meeting in the afternoon. A save the date has been sent out to all members and we look forward to seeing you all there! ALTG Management Advisory Committee (MAC) positions A number of ALTG Management Advisory Committee (MAC) positions expired on the 24th August and new members have taken on these positions - President, Paul Mitchell; CT Surgeon, Julian Gooi; Medical Oncologist, Craig Lewis; NZ member, Helen Winter and Radiation Oncologist, Shankar Siva. The Secretary position on the MAC expires in November 2012 if you would like to make a nomination please contact karen@lungfoundation.com.au for an ALTG nomination form. A special thank you to the retiring MAC members for their dedication to the group - Michael Millward, Mary Duffy, Gavin Wright, Ben Solomon, Richard Sullivan and Shalini Vinod. CREST Workshops The Cancer Research Economics Support Team (CREST) is pleased to announce two health economics workshops to be held in October As with all of the CREST workshops, these are free to members of the trials groups. Understanding Health Economics in Cancer Clinical Trials 15 th October, Peter MacCallum Cancer Centre, St Andrews Place Melbourne An introductory level workshop designed to introduce attendees to the basic concepts of economic evaluation methods. Concepts are illustrated using examples from a range of cancer clinical trials. Understanding and applying modeling in economic evaluations of cancer treatments 22 nd & 23 rd October, Centre for Health Economics Research and Evaluation, UTS, Sydney An intermediate level practical workshop, designed to extend attendees knowledge and experience of decision analytic modeling methods used in economic evaluations. Ideal for those who have already attended the introductory CREST workshop, and would like to further their knowledge and practical skills. For further details of these workshops, please contact Alison Pearce (CREST project co-ordinator) by (alison.pearce@chere.uts.edu.au) if you have any questions, or would like to enroll. Membership The ALTG membership currently stands at 344 which has been a great effort. Prospective members can now apply online to become an ALTG member at Please encourage your colleagues, especially those in rural/ regional areas, to become members. Contact: Karen Lather Project Manager - ALTG and Lung Cancer Phone: karen@lungfoundation.com.au State NSW VIC QLD SA WA ACT TAS NT # Members NZ/OS 18 ALTG Clinical Trials Consumer Training Workshop - Update from Haryana Dhillon The ALTG has had increasing consumer involvement in its activities over the past five years. However, we are mindful that our consumer group is small and as a consequence we are at risk of over burdening our generous consumer representatives at the moment. In February, the MAC endorsed a proposal to run a clinical trials consumer training workshop in a effort to expand the number of consumers involved. Preceding the ALCC in Adelaide we ran the ALTG's first Clinical Trials Consumer Training Workshop. With support from Boehringer Ingleheim, we were able to bring together people affected by lung cancer, both patients and caregivers, to tell them more about the ALTG, clinical trials and the work that we do. The aim of the workshop was to introduce the group to people who may be interested in becoming involved in supporting the ALTG's clinical trials work by participating as reviewers, members of research management committees and promotion of the group and its activities. This was attended by ten people interested in the group and we are in the process of following up with them to discuss ongoing involvement. Our attendees were people reflecting the range of thoracic malignancies, from small cell to neuroendocrine tumours; they were at a range of places on the lung cancer journey and shared generously their experience and thoughts. I would like to sincerely thank all the participants for their contribution and Boehringer Ingleheim for their support. Also, generous thanks to Andrew Bowen, Ian Stubbin and Beth Ivimey who each shared their experience and knowledge, skilfully contributing to the workshops success.

3 Page 3 ALTG 06/003 - NITRO Trial A phase III, multi-centre randomised trial of adding nitroglycerin to first line chemotherapy for advanced non small cell lung cancer. The recruitment target is 500 participants. The Nitro trial has been open since May 2009 and there are 29 sites activated, with 218 patients enrolled. Nitro Recruitment The Prince Charles Hospital (27) Royal Perth Hospital (20) Coffs Harbour Hospital (32) Tamworth Hospital (1) Armidale Hospital (1) The Alfred (4) Port Macquarie Hospital (22) Prince of Wales Hospital (11) Nepean Hospital (9) Royal Hobart Hospital (3) Nambour Hospital (13) Bendigo Hospital (5) Royal Prince Alfred Hospital (19) Sir Charles Gairdner Hospital (13) Liverpool Hospital (0) Townsville Hospital (7) Bankstown-Lidcombe Hospital (1) Cairns Base Hospital (2) Tweed Hospital (10) Holy Spirit Northside (0) Newcastle Private Hospital (1) Concord Hospital (1) Gosford Hospital (0) Lismore Hospital (6) St Vincent s Hospital, VIC (1) Queen Elizabeth Hospital (6) Geelong Hospital (1) Warrnambool (0) Christchurch Hospital (2) The trial continues to recruit on average 6 patients per month. Study Chair: Andrew Davidson andrew.davidson@health.wa.gov.au CTC Trial Coordinator: Nick Muljadi nitro@ctc.usyd.edu.au : A/Prof Martin Stockler CTC Clinical Lead Tel: martin.stockler@sydney.edu.au Xanthi Coskinas CTC Assoc. Program Mgr Tel: Xanthi.coskinas@ctc.usyd.edu.au Eric Tsobanis Project Manager Tel: eric.tsobanis@ctc.usyd.edu.au Nick Muljadi CTC Trial Coordinator Tel: nitro@ctc.usyd.edu.au ALTG 09/002 - BR26 BR26 is a randomised, double-blind, placebo-controlled trial of PF-804, an orally available, potent, and highly selective irreversible EGFR TKI, in patients with incurable stage IIIB/IV non-small cell lung cancer after failure of standard therapy for advanced or metastatic disease. This multicentre, international phase III trial is being coordinated by the NCIC Clinical Trials Group in collaboration with the NHMRC Clinical Trials Centre and Australasian Lung cancer Trials Group. The study received Central Ethics Committee approval in New South Wales in December 2009, and in Victoria in May Royal Prince Alfred Hospital was the first Australian site to open in May Since then 17 additional sites have opened and 71 patients have been recruited as follows: The Prince Charles Hospital, QLD (3) St. George Hospital, NSW (8) Nambour Hospital, QLD (1) Royal North Shore Hospital, NSW Concord Repatriation General Hospital, NSW (1) Austin Hospital VIC (4) Western Hospital VIC (3) Auckland City Hospital, NZ (9) Peter McCallum Cancer Institute, VIC Geelong Hospital (VIC) Westmead Hospital (NSW) (4) Recruitment is expected to continue through March An interim analysis for overall survival took place in April The results were that the trial had not met the protocol specified stopping point, and therefore recruitment should continue to full accrual. Chris Brown CTC Statistician Tel: chris.brown@ctc.usyd.edu.au Shona Silvester CTC Trial Coordinator Tel: Shona.silvester@ctc.usyd.edu.au Daniel Obando CTC Trial Coordinator Tel: Royal Prince Alfred Hospital, NSW (12) Monash Medical Centre, VIC (5) Royal Adelaide Hospital, SA (5) Sir Charles Gairdner Hospital, WA (5) Prince of Wales Hospital, NSW (4) Calvary Mater Newcastle Hospital, NSW Peninsula Oncology Centre, VIC (7) Study Chair: Professor Michael Millward millward@cyllene.uwa.edu.au CTC Project Manager: Eric Tsobanis BR.26@ctc.usyd.edu.au CTC Trial Coordinator: Shona Silvester BR.26@ctc.usyd.edu.au

4 Page 4 ALTG 04/009 - PACT in NSCLC Study Preferences for adjuvant chemotherapy in non-smallcell lung cancer: What makes it worthwhile to patients and their doctors? The PACT in NSCLC study aims to determine the benefits judged necessary to make ACT worthwhile for patients with resected NSCLC and for doctors, the factors influencing their preferences, and patients preferred and experienced involvement in decision making. The recruitment target is 200 participants The inclusion criteria for this study are as follows: 1. Stage I-III non-small cell lung cancer resected within the last 12 weeks 2. Referred to a participating medical oncologist for consideration of post-operative ACT 3. Able and willing and to complete study questionnaires 4. Written, informed consent The exclusion criteria are: 1. Evidence of distant metastatic disease 2. Previous chemotherapy for lung cancer There are 16 sites activated with 110 patients enrolled: Canberra Hospital (3) Royal Prince Alfred Hospital (0) Royal North Shore Hospital (5) Coffs Harbour Base Hospital (4) Nepean Hospital (12) Port Macquarie Base Hospital (4) St Vincent s Hospital Melbourne (24) Nambour Hospital (3) The Prince Charles Hospital (25) Sir Charles Gairdner Hospital (6) Auckland Hospital (12) Royal Melbourne Hospital (3) Flinders Hospital (4) Christchurch Hospital (0) Concord Hospital (3) Campbelltown Hospital (2) This study continues to recruit on average 3 patients per month, recruitment is expected to end in December Study Chair: Sue-Anne McLachlan Sue-Anne.MCLACHLAN@svhm.org.au CTC Trial Coordinator: Nick Muljadi lung_pt_pact@ctc.usyd.edu.au ALTG 08/001 - Physical Activity in Lung Cancer trial (PAL) The PAL study is a randomised control trial which aims to evaluate the effects of a structured physical activity program on fatigue and quality of life for people with non-resectable lung cancer (NSCLC, SCLC). Participants are randomised to either the usual standard of care or a 2-month physical activity programme, which consists of a combination of home-based and supervised exercise sessions. The supervised sessions also include a behavioural change component to help promote the importance, benefits and maintenance of physical activity. The inclusion criteria for the study are as follows: 1. Non-resectable residual lung cancer (NSCLC, SCLC) Curative intent > 4 weeks post treatment Palliative intent: can be on active treatment 2. Age > 18 years 3. Medically fit to participate in a physical activity program 4. ECOG performance status of <3 5. English proficiency 6. Life Expectancy > 6 months Recruitment The study opened in July 2009 and there are 4 active hospital sites. 73 of a planned 140 participants have been randomised; 33 from Concord Hospital, 20 from Royal Prince Alfred Hospital, 10 from Westmead Hospital, and 10 from Prince of Wales Hospital. Study A/Prof Janette Vardy (PI) janette.vardy@sydney.edu.au Dr Haryana Dhillon (PI) haryana.dhillon@sydney.edu.au ALTG 09/006 - Unmet Needs In Lung Cancer Patients and Carers This study titled "Caring for thoracic cancer caregivers: exploring psychological and supportive care needs" and involves interviewing bereaved carers of people with lung cancer to discuss their experience. The aim of the study is to identify intervention points for improving support of patients and carers during the lung cancer disease trajectory. The study has recruited 34 current caregivers to people with lung cancer and 9 bereaved carers from Concord Repatriation General, Royal Prince Alfred, and Prince of Wales Hospitals. Study recruitment and data collection have been completed. The final analysis is underway and we expect to submit this manuscript before the end of this year. The results have been presented at the Clinical Oncological Society of Australia's Annual Scientific Meeting, the Australian Lung Cancer Conference and they Sydney Cancer Conference. Haryana Dhillon (Co-PI) Haryana.dhillon@sydney.edu.au Melanie Price (Co-PI) Melanie.price@sydney.edu.au Janette Vardy (Co-PI) janette.vardy@sydney.edu.au

5 Page 5 TROG CHISEL (ALTG 09/005) This phase III trial is a TROG study endorsed and co-badged by ALTG. Patients with T1 and T2A N0 non-small cell lung cancer are randomized to hypofractionated stereotactic ablative radiotherapy (either 54 Gy in 3 fractions or 48 Gy in 4 fractions) versus conventionally fractionated radiotherapy 66 Gy in 33 fractions. Randomisation is 2 to 1 in favour of the experimental hypofractionated arm. The aim is to recruit 100 evaluable patients. Eight sites have been activated and 26 patients randomized: Princess Alexandra (12 patients), Peter Mac Moorabbin (6) Peter Mac East Melbourne (7), Alfred (1) Peter Mac Bendigo (0), Peter Mac Box Hill (0), RPAH (0), RNSH (0). Additional sites in Hobart, Perth, Newcastle and New Zealand are hoping to join the study in The outcome of a funding application for NZ sites was unfortunately unsuccessful. Patients randomized to the control arm do not need to be treated at a centre credentialed to deliver the experimental treatment; if centres do not have the technical capability of delivering the hypofractionated treatment their patients can be referred to a linked site if randomized to the experimental arm; if randomized to conventional treatment, it can be given at the base site. No serious adverse events attributable to treatment have been reported. Funding has been obtained from CA for $260,000 per year for 3 years and a request to extend funding until the end of 2013 has been approved by Cancer Australia. Funding provides $500 capitation per patient and $800 to pay for any PET scans required to confirm recurrence. Publication: Kron T, Clements N, Aarons Y, Dunn L, Chesson B, Miller J, Roozen K, Ball D. Radiochromic film for individual patient QA in extracranial stereotactic lung radiotherapy. Radiation Measurements. 2011;46(12): Any further enquiries regarding this Trial should be directed to the principal investigator, David Ball, at david.ball@petermac.org or the central trial coordinator, Bev McClure at bev.mcclure@petermac.org ALTG 10/001 PLUNG The PLUNG-GP trial is a randomized Phase III trial comparing high dose palliative radiotherapy (HDPRT) with concurrent chemotherapy + HDPRT (C-HDPRT) in patients with good performance status, locally advanced or small volume metastatic NSCLC who are not suitable for radical chemo-radiotherapy, either due to tumour extent or patient factors The optimal treatment approach for this group of patients is unknown and clinical practice varies throughout Australia. The PLUNG trial compares a widely employed high doses palliative radiotherapy regime (36Gy/12F) with a concurrent chemotherapy and high dose palliative radiotherapy regime (40Gy/20F + Vinorelbine + Cisplatin) which has been investigated in preceding Phase I and II trials conducted under the auspices of the Trans Tasman Radiation Oncology Group (TROG). The objectives of the trial are to determine which regime is superior in terms of symptom relief and improvement in quality of life. The study aims to recruit 130 patients and has received funding from Cancer Australia. The study has now received ethics approval to open at the Princess Alexandra Hospital, Brisbane and we hope to open the study at other sites shortly. For anyone who is interested in this study please contact either Margot Lehman (margot_lehman@health.qld.gov.au) or Assoc Prof Michael Michael (Michael.michael@petermac.org). Small cell lung cancer Concept Development Group Update A small cell lung cancer (SCLC) concept development group was formed in Q The Group has met via teleconference and face-to-face to discuss future SCLC trials for the ALTG. The working group comprises of medical and radiation oncologists interested in SCLC. The Group is currently working on the following concept: Temozolomide and PARP (Poly ADP ribose polymerase) inhibitor as second line chemotherapy for SCLC). The concept outline and schedule of assessments have been developed and now the Group is currently seeking funding to support this trial. Any further enquiries regarding this Trial should be directed to the CTC Clinical Lead A/Prof Martin Stockler, at martin.stockler@sydney.edu.au

6 Page 6 ALTG 10/002 - A PILOT STUDY TO DEVELOP A CLASSIFICATION ALGORITHM FOR IDENTIFYING PATIENTS WITH ADENOCARCINOMA OF LUNG SUITABLE FOR INDIVIDUALIZED THERAPIES The primary objective is to retrieve archived slides and tissue blocks of 100 cases of lung adenocarcinoma diagnosed at SVH. Detailed histological classification, EGFR CISH testing and EGFR/KRAS mutational analysis will be performed. This information will then be correlated with clinical parameters. The results of this pilot study may inform the development of a protocol for a larger scale study to develop and validate a classification algorithm to include histopathology, EGFR GCN as detected by CISH, in addition to EGFR mutation analysis. Progress to date: * Ethics approval obtained * Top up funding ($17,000) obtained from a SVH Research Endowment Fund grant * 100 archived slides and tissue blocks identified and retrieved. * Detailed histological subtyping completed for 100 cases. * Slides have been prepared for in-situ hybridization and mutation testing * EGFR, KRAS and BRAF mutation testing completed (Alex Dobrovic, PMCC) * S-ISH EGFR GCN testing completed * Lung cancer fellow appointed at SVH * Currently undergoing analysis and manuscript preparation Sue-Anne McLachlan SVH sue-anne.mclachlan@svhm.org.au Other Investigators: Prue Russell, Gavin Wright, Matt Conron, Alex Dobrovic, ALTG ALTG 10/003 - Implementing standardised PET procedures for scanning, data collection and reporting in patients with NSCLC across Australia s ALTG sites: A feasibility study. The work has shown that sites would accept a standardised protocol. The work to obtain a NHMRC grant to support this standardization has met with the difficulty of a lack of identified interested principle investigator. The lack of academic nuclear physicians across Australia and the high work load of those already involved in the ALTG have caused the project to stall. The TROG group where PET scans post irradiation might be investigated may lead to state sites attempting a standardised protocol. It is suggested that co operative trial groups support the funding of more academic nuclear physicians so as to improve the predictive management of patient s care. Contact Andrew Davidson Andrew.Davidson@health.wa.gov.au ALTG 10/004 - Limiting the functional decline of patients with advanced non-small cell lung cancer. The functional decline that is seen in patients with lung cancer is a complex issue. It is well recognised by treating clinicians that patients with advanced NSCLC decline physically over time but has been poorly studied to date. Phase 1 (40 participants) of this study looked at this in detail and showed that patients with advanced stage disease have clinically significantly lowered physical function at commencement of treatment and participants function continued to decline over time. The aim of this project (phase 2) is to pilot test a home based exercise program, designed to lessen the functional decline and its impact on patients. The home exercise program is based on pulmonary rehabilitation principles. The objective is to assess the feasibility and acceptability of the pilot intervention in ten participants to further refine the model before undertaking a larger randomised control trial. Functional and QOL assessment measures are carried out prior to beginning treatment. Participants then begin the 8 week exercise program while undergoing treatment and are then followed up at 2 months, 4 months and 6 months. Recruitment of 10 patients at Peter MacCallum Cancer Centre has been completed with final data collection to be completed by September Preliminary results are presented; 31 patients met inclusion criteria and were approached to take part in the study with11 patients (7 males) consenting. Patients who completed the intervention (n=10) from baseline to T2, resulted in only 10% having demonstrated a clinically meaningful functional decline on the 6 minute walk distance test (-50m). Preliminary data suggests that advanced stage NSCLC patients can remain active during the treatment phase to help lessen the functional decline associated with cancer treatments and the disease process. Strategies to increase uptake into the program need to be explored to improve the feasibility of the program in a clinical setting. Study contacts: Dr Linda Mileshkin (PI). linda.mileshkin@petermac.org Andrew Murnane (Study Coordinator) andrew.murnane@petermac.org

7 Page 7 ALTG 11/001 MASTERY The MASTERY study is a proposed ALTG multicentre randomised phase II clinical trial of sunitinib or placebo as maintenance therapy in malignant pleural mesothelioma. Currently, there is no standard second-line or maintenance therapy for this disease. A previous single arm phase II study of sunitinib as second line therapy for mesothelioma showed activity, with 12% partial response and 65% stable disease as best response. On the basis of this, the MASTERY trial has been designed to evaluate the use of maintenance sunitinib in patients with ECOG PS 0-1 following response or stable disease at the completion of platinum and pemetrexed first-line therapy. Patients will be randomised to either oral sunitinib 37.5mg daily continuous therapy, or identical placebo, following determination of stable disease or partial response at the end of chemotherapy. The primary endpoint is progression-free survival. Secondary endpoints include objective radiological response, quality of life, toxicity and adverse events, change in serum mesothelin, and overall survival.biospecimens will be taken for exploratory endpoints, including VEGFR polymorphisms. A draft protocol was developed at the 2011 Flims clinical trials workshop and a proposal submitted to Pfizer Australia and Pfizer International. Unfortunately Pfizer are unable to provide funding to conduct the study but would be agreeable to supply study drug should funding be received from competitive sources. An NHMRC grant application was submitted in the 2012 round and results will be announced in late Study Chair: Anna Nowak anna.nowak@uwa.edu.au Australian Lung Cancer Conference (ALCC) 2012 The ALCC was held in Adelaide at the Adelaide Convention Centre on the August The conference had a record 497 delegates, 9 International Speakers and 111 abstracts submitted. A post conference report will be available online at alcc.net.au in November. A big thank you to everyone that attended and to all that volunteered to make this Conference a huge success! There were delegates that came from Texas, Nepal, Philippines, China and India. An Evaluation Survey was ed to all delegates in September, if you have not done so already could you please go online and complete this survey as it will assist us for the 2014 ALCC. If you are interested in being the local organiser for the 2014 ALCC please contact Glenda Colburn (Glenda@lungfoundation.com.au) to express your interest.

8 We re on the Web! The Australasian Lung cancer Trials Group (ALTG) is Australia and New Zealand's lung and thoracic cancer clinical research group. The ALTG is a multidisciplinary organisation dedicated to reducing the incidence, morbidity and mortality of lung and other thoracic cancers and improve the quality of life of these patients, carers and families in Australia and New Zealand through the coordination and facilitation of high quality clinical research. The ALTG collaborates with a number of organizations including the NHMRC Clinical Trials Centre (CTC) and Peter MacCallum Cancer Centre. Both of these groups are leaders in Australia for the design, conduct, analysis and publication of oncology clinical trials, including working with both Australia and international collaborative groups. The specific objectives of the ALTG are: To facilitate participation in the development, conduct, evaluation, reporting of clinical trials in lung and thoracic cancer. To promote the use of clinical trials in evaluating new treatments and management approaches for lung and thoracic cancer. To contribute to the translation of clinical trial findings into clinical practice. Business Address: Australasian Lung cancer Trials Group c/o The Australian Lung Foundation 44 Brookes Street Bowen Hills QLD 4006 Mailing Address: Australasian Lung cancer Trials Group c/o The Australian Lung Foundation PO Box 847 Lutwyche QLD 4030 Telephone: 61 (0) Fax: 61 (0) karen@lungfoundation.com.au The ALTG is generously supported through unrestricted educational grants from the following companies: