Ian, who has been a part of the CRE-PF team since 2017 and a long-term member of the PACT Steering Committee whilst Prof Chambers was Chair sat down with the team to talk about his pulmonary fibrosis clinical trials research and what he hopes to achieve as PACT Chair.
Tell us a bit about yourself and your clinical trials research?
I am a clinician academic, head of the Interstitial lung disease service at the Alfred Hospital, Melbourne and am an Adjunct Clinical Associate Professor in the Central and Eastern Clinical School, Monash University. I completed my advanced training in respiratory medicine at the Alfred and Royal Brompton Hospital in London and then did doctoral research at Monash University Central Clinical School. In 2004, I set up the first dedicated interstitial lung disease service in Australia, at the Alfred.
My experience in clinical trials research dates back nearly 2 decades, when I was a sub-investigator on the first randomised controlled clinical trial in ILD in Australia and one of the first such trials in the world. Since then, I have been a principal investigator in over 25 pharmaceutical clinical trials. I could not have done those studies without the support of many ILD patients at the Alfred, a highly supportive department, and our clinical nurse specialist, Karen Symons. Apart from industry funded research, I have found it very rewarding to also contribute to a number of investigator-initiated interventional trials including the use of ambulatory oxygen in ILD, pulmonary rehabilitation in ILD, danazol to reduce telomere attrition, and whole lung lavage for silicosis.
I have been a part of the CRE-PF since 2017, helping the team to transform PF research and clinical trials in Australia and have been a long-term member of the PACT Steering Committee whilst Prof Chambers was Chair.
What was your motivation to get involved in PF clinical trials and Chair PACT?
Interstitial lung diseases are orphan diseases, as their scarcity causes sufferers to feel relatively invisible within the healthcare system, creates a paucity of experts, and a lack of evidence-based therapies. I saw this firsthand in the 1990’s at the Brompton during my fellowship there. At that time there were no evidence-based therapies for interstitial lung disease, and sadly many patients’ disease progressed, leading to worsening symptoms and quality of life. That experience has been unforgettable and has been my principal motivation to develop a clinical service a bit like the Brompton’s, with sufficient patient numbers to attract clinical trials locally. It was really wonderful when, about 10 years later, two proven anti-fibrotic therapies became available, with local contribution of multiple Australian and New Zealand sites to both drug’s development. Subsequently I have found many patients still miss the opportunity to participate in clinical trials, especially where they live remote to expert centres or attend hospitals insufficiently resourced to run trials. Additionally, ILD clinical trials would benefit from redesign, as they have been relatively lengthy in duration and have required large numbers of patients. My main motivation as chair of PACT is to assist in finding ways to overcome these issues.
What do you see as the priorities for PACT as incoming Chair?
PACT has two stated key missions. In brief, they are to:
- To fast-track discovery science by developing capacity for Australian early phase ILD trials, and to specifically train health professionals in running early phase clinical trial units. We will also boost clinical trial development by shortening and broadening our trials pipeline; for example, to include new ILD trial design approaches;
- Enhance ILD trial accessibility and support translation of research into practice by educating and upskilling the trial workforce, facilitate the establishment of new sites outside of metropolitan areas; and drive the uptake of tele-trials in ILD. PACT will oversee establishment of an ILD tele-trials model, consistent with the National Principles for Tele-trials.
- These priorities have been developed into four major projects for which planning is well underway:
- Project 1. Development of early phase clinical trial units
- Project 2. Upskilling the clinical trial workforce
- Project 3. Shortening and broadening the clinical trial pipeline
- Project 4. Development of clinical trial sites outside of metropolitan areas/tele-trials
Who are the newest PACT team members that have come onboard?
New to the committee is Dr Harry Gallagher from Hamilton in New Zealand. Dr Gallagher is a Respiratory physician and is Head of the Respiratory Department at Waikato Hospital, Te Whatu Ora , New Zealand. Harry completed a clinic fellowship in lung transplant and pulmonary vascular diseases at The Prince Charles Hospital, Brisbane, in 2013. Harry has an interest in promoting interstitial lung disease research in the New Zealand setting. Having Australian and New Zealand committee members is vital as it allows us to identify important clinical questions and design trials from varied experiences and perspectives.
We also welcome Kelcie Hermann to the committee. Kelcie is the General Manager of Clinical Programs, Research and Innovation at Lung Foundation Australia and oversees our strategic partnership and supports our priority initiatives.
Jennifer Walsh has also commenced as the PACT Project Manager. Jennifer has been a CRE-PF Project Manager since its commencement in 2017 and therefore has the experience to continue the great work previously undertaken by Dr Alison Hey-Cunningham.
What do you hope to achieve during your time as PACT Chair?
Apart from working to achieve the key aims already mentioned, I’m hoping that PACT continues to build upon its achievements. We have developed a great resource for patients and clinicians to access information about regionally recruiting clinical trials and I would like to see what we can now do to integrate that effectively into day-to-day clinical practice. I’d also like to continue to shorten the time between trial registration and recruitment, such as making it easier to identify potential clinical trial sites. One of our local strengths of Australia and New Zealand is our truly collaborative network of ILD researchers and I would like to continue to build upon that strength by including those in their early and middle careers in our projects, so as to develop the next generation of ILD researchers.