Kate Johnson

October 14, 2016

LOS ANGELES — Late-breaking results from the FLAME and LANTERN comparison studies, assessing the combination of indacaterol and glycopyrronium in the management of COPD exacerbations, are among the highlights anticipated at CHEST 2016.

The results of these two studies are "a potential game changer," said Neil Freedman, MD, from the NorthShore University Health System in Evanston, Illinois, who is chair of the scientific program committee.

The more than 1300 original research oral and poster presentations will also include late-breaking interim results from the NAVIGATE study of cutting-edge electromagnetic navigation bronchoscopy in the diagnosis of lung cancer.

"This is an expensive technology and it is not clear if it truly makes a difference in outcomes, or which patient groups may benefit the most from its use," Dr Freedman said. "The results of this trial should help guide clinicians as to its benefit, if any, and help them determine when to use it in clinical practice."

In addition, late-breaking results will be reported from the RESPITE trial, in which biomarkers were used to predict response to riociguat, a soluble guanylate-cyclase stimulator, in pulmonary arterial hypertension patients with insufficient response to phosphodiesterase-5 inhibitors.

And results from the RESPIRE 1 trial on the efficacy and tolerability of inhaled ciprofloxacin powder in patients with noncystic fibrosis bronchiectasis will be presented.

Obstructive Sleep Apnea

Sleep will be the subject of around 30 sessions this year, and there will be a special focus on obstructive sleep apnea and continuous positive airway pressure.

Standards of care in obstructive sleep apnea are being re-evaluated in light of results from the SAVE trial and other recent findings, Dr Freedman explained.

"The bottom line is that this may change our approach in terms of how we test and treat a large percentage of patients," he explained. "Those issues will be addressed during several sleep sessions and a postgraduate course."

Pulmonary fibrosis will also be in the spotlight at this year's meeting, said Dr Freedman.

"Until recently we had no treatment beyond lung transplant," he explained; however, pirfenidone and nintedanib were approved to slow disease progression by the US Food and Drug Administration in 2014.

"With these new drugs available, we have the potential to change our management of these patients, although the cost — over a hundred thousand dollars a year — is high, " he told Medscape Medical News.

Hands-on Learning

The opportunity to perform simulated procedures, such as transesophageal echocardiography, endobronchial ultrasound, and flexible laryngoscopy, will be available to meeting attendees.

"Simulation is one of the things that CHEST does extremely well; we are one of the leaders in the field in this area," said Dr Freedman.

Many of the 400 didactic sessions on the agenda will incorporate simulations with high-fidelity simulators, cadavers, and sometimes even live volunteers.

"Our simulation sessions are very popular. These are ticketed sessions that typically sell out fast," he reported.

To target entire care teams, interdisciplinary sessions will be "taught by multiple specialists across the care team, including respiratory therapists and nurses. It's not just physicians lecturing to physicians," Dr Freedman explained. Topics covered range from lung cancer, to COPD, hypoxic respiratory failure, interstitial lung disease, sleep medicine, and pulmonary vascular disease.

"These 2- to 3-hour interdisciplinary sessions were so popular last year that we've actually expanded capacity to try to accommodate everyone," he said.


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