imPACT – April 2023

Message from the Chair

Welcome to the April issue of imPACT for 2023, the official newsletter of the Pulmonary Fibrosis Australasian Clinical Trials (PACT) network. This month marks the passing of the baton between our former chair of PACT Dan Chambers and me. Dan’s contribution to PACT has been enormous and to commemorate his achievement, this month he is the focus of our Five Minutes with an ILD Researcher feature. Dan and the PACT team have grown PACT into a highly effective platform for engagement between clinical trialists, interested clinicians and referrers, and people with ILD and their families. However, as you will learn in our Five minutes with feature, it is certainly not the only string to Dan’s bow.

I am very pleased to take over as chair of PACT at an extraordinarily busy time for pulmonary fibrosis research in Australia and New Zealand. There is an enormous amount of clinical trial activity arising from local researchers and globally. PACT’s overall mission is to maximise our local capacity to engage in those studies in order to improve the quality of life and outcomes for people living with pulmonary fibrosis. To that end, it is tremendous news that PACT remains an important platform within the newly NHMRC funded Centre for Research Excellence in Pulmonary Fibrosis program, led by Professor Tamera Corte. In this CRE-PF program, PACT has two new components to its agenda. Put broadly, the first is to boost the Australian pipeline for ILD clinical trial development and this will include a range of projects such as supporting the development of early phase clinical trial sites and training trialists around Australia. The second is to widen clinical trial access to those living outside major centres. With the TSANZ annual scientific meeting in Christchurch just finished, it’s worth noting that this aim strongly reflects one of the meeting’s key themes of breaking down health inequality.

With baited breath – the agenda is a busy one! – I am looking forward to keeping you up to date with our progress on these projects and more over the coming years.

Best wishes,

Associate Professor Ian Glaspole

PACT Chair

Message from the CRE-PF

2023 has started with a bang, with March marking the official beginning of the new Centre of Research Excellence for Pulmonary Fibrosis (CRE-PF) program! As I have shared previously, the new CRE program is supported by an NHMRC grant and Australia’s single-biggest philanthropic injection for pulmonary fibrosis research.

With the new CRE, we have expanded our team, welcoming some new investigators from across the coutry. In this issue of imPACT, I’d like to introduce A/Prof Luke Knibbs. A/Prof Knibbs is part of the School of Public Health at the University of Sydney. He has built a research program around understanding the burden of and novel methods for assessing risk factor exposures for disease due to air pollution and aerosol transmission of respiratory pathogens in people with chronic lung disease.

The relationship between air quality and the development or indeed the progression of pulmonary fibrosis is not yet clear. In some early work, we have shown a relationship between exposure to asbestos (Abramson et al. Thorax, 2020) to having pulmonary fibrosis, and an association between proximity of residence to major roads and the progression of disease (publication under review). In the new CRE, A/Prof Knibbs will be furthering this research into gene-environment interactions in pulmonary fibrosis. Work which underpins our three main themes, (1) understanding causes and improving early diagnosis; (2) preventing progression and (3) improving management, moderating symptoms and enhancing quality of life.

I look forward to reporting more exciting news throughout 2023.

Yours sincerely,

Prof Tamera Corte (CIA for CRE-PF)

Trials Update

This year is shaping up to be another big one for pulmonary fibrosis clinical trials with a recent media spotlight on the effects of pulmonary fibrosis on patients and families. This first trials update for the year will run through all our recruiting trials, before we get swept away with the new trials starting in 2023.

Pulmonary Fibrosis and other Lung Disease Trials

For anyone with interstitial lung disease or COPD, SINFONIA offers online singing classes lead by a music therapist. The study examines the effects of singing on breathlessness, wellbeing and symptom management. As well as being accessible to everyone around Australia with internet connection, SINFONIA is also recruiting caregivers which is wonderful to see, as we know what a huge roll caregivers play in looking after family members with lung disease.

The PFOX trial is in the last 6 months of recruitment, enrolling people with pulmonary fibrosis who have low oxygen levels on exertion. The study uses portable oxygen concentrators, which are much lighter than traditional oxygen tanks. The study is looking at how both flowing oxygen and flowing air effects breathlessness, activity levels and quality of life.

The HIIT trial is a physiotherapy-based study for people with fibrotic interstitial lung disease. The study looks at the effects of short bouts of intense exercise regularly interspersed with periods of rest and whether this improves exercise capacity and breathless over the current moderate intensity exercise program.

TELO-SCOPE is another investigator-lead trial looking into genetics and the role of short telomeres in patients with pulmonary fibrosis. The study is examining the effects of the medication Danazol on adults and children with pulmonary fibrosis and short telomeres. The trial has now consented 35 participants and 18 have been randomised to the study drug.

Idiopathic Pulmonary Fibrosis

For people with Idiopathic Pulmonary Fibrosis, we currently have two pharmaceutical trials and one genetic study. The pharmaceutical trials will evaluate the efficacy and safety of: the oral medication Taladegib (Endeavor Biomedicines ENV-101) and intravenous infusion Axatilimab (Syndax SNDX-6352-0506). Endeavor has recently opened sites in Mexico and Canada.

The GRIPF genetic study is recruiting patients with Idiopathic Pulmonary Fibrosis and their family members in order to examine the role of genetic factors in the disease. The similarities and differences in genetic material may provide important information on why some family members develop Idiopathic Pulmonary Fibrosis while others don’t.

Silicosis Trial

The recent media attention on silicosis is drawing important focus to ongoing industry practices that expose workers to deadly silica dust. The Prince Charles Hospital in Brisbane, Alfred Hospital in Melbourne and Royal Prince Alfred Hospital in Sydney are conducting the SHIELD Whole Lung Lavage Observational Cohort Study which may change the standard care for patients with silicosis or silica induced bronchitis.

Information about all current trials is available on the Find a Trial page of our website. We encourage all our patients interested in clinical trials to discuss this with their specialist and get a referral to their local study centre. You can also fill in our online enquiry form to link in with potential studies.

Grants

Stay tuned for information about the 2024 PACT grant-in-aid opportunity! Current grant opportunities relevant to pulmonary fibrosis clinical research and trials include:

• NHMRC Ideas Grants 2023 – support innovative research projects addressing a specific question(s). Closing 3 May 2023.
• MRFF 2023 Chronic Respiratory Conditions Grants – support projects that (1) develop treatable trait-based precision medicine approaches; or (2) clinically validate scalable approaches to medication and therapeutic adherence and/or self-management. Closing 14 June 2023.
• MRFF 2022 Clinical Trials Activity Grants – support clinical trial activity in four streams (1) treatment/management of rare cancers, rare diseases and/or unmet need; (2) reducing inappropriate antibiotic use; (3) reducing inequities for people in regional, rural, and remote communities; (4) comparative effectiveness of two or more health interventions. Closing 28 June 2023.
• MRFF 2023 International Clinical Trial Collaborations Grants – support projects that promote Australian involvement in international collaborative investigator-initiated clinical trials research through the establishment and co-ordination of clinical trial site/s in Australia; and provide high-quality evidence of the effectiveness of novel health treatments, drugs or devices in ‘usual care’ settings, which will support a decision on whether to deliver the intervention in an Australian setting. Closing 7 Feb 2024.