The International Lung GVHD Consensus Conference

GOAL: Synthesize preclinical understanding of the pathogenesis of BOS in the context of allogeneic hematopoietic cell transplant, identify trans latable targets and key priorities for preclinical investigation.

Co-Chairs: Joe Hsu and Sophie Paczesny

08:45 | Opening Remarks

• Prof Antoine Geissbuhler, Dean of the University of Geneva

09:00 | Building on the ATS Research Statement

• Guang-Shing Cheng, Fred Hutch Cancer Cente

09:10 | Airway epithelial / endothelial injury

• Jamie Todd, Duke University

09:30 | Lung specificities of macrophages, cellular immunity, and alloimmune mechanisms

• Julie Boiko, Fred Hutch Cancer Center

09:50  | Viral infections and transplant alloimmunity.

• Louise Bondeelle, University of Geneva

10:10 | Coffee Break

10:30 | Role of infection, microbiome in post-HCT. 

• Matthew Zinter, Univ of California San Francisco

10:50 | Dysbiosis, metabolomics in lung GVHD

• David Michonneau, University of Paris

11:10 | Cell-free DNA in lung transplant. Sean Agbor-Enoh, NIH

11:30 | Coffee Break

• Den Cooke, Johns Hopkins University and Ajay Sheshadri, MD Anderson Cancer Center

12:40 | Lunch

13:30 | Interstitial lung disease

• Bruno Crestani, University of Paris 

13:50 | Lung transplant

• John Belperio, University of California Los Angeles, USA

14:10 | BOS and cGVHD

• Bruce Blazer, University of Minnesota

14:30 | Discussion

14:40 | Are large airways involved in BOS? Anne Bergeron, University of Geneva

15:00 | Prevalence of bronchiectasis after cellular therapies

• David Epstein, Stanford University

15:20 | Non-cystic fibrosis bronchiectasis novel treatments and future directions

• Alan Barker, Oregon Health Sciences University

15:40 | Discussion

15:50 | Coffee Break

16:10 | Murine models of OB and transplant pulmonary fibrosis

• Joe Hsu, Stanford University

16:30 | BOS lung organoids

• Carla Kim, Harvard University

16:50 | Ex vivo human lung samples BOS vs. CLAD

• Patrick Mellors, Dartmouth University

17:10 | Discussion

• Sophie Paczesny, Medical University of South Carolina, USA and Joe Hsu, Stanford University

GOAL: To derive a consensus revision of the HCT-BOS definition based on up-to-date evidence

Co-Chairs: Guang-Shing Cheng and Anne Bergeron

08:00 | From BO to BOS: Defining Lung GVHD

• Anne Bergeron, University of Geneva

08:05 | Historical context of the lung chronic GVHD definition and response criteria

• Steve Pavletic, NIH

08:15 | Considerations of practice heterogeneity on the landscape of cGVHD and lung disease

• Daniel Wolff, University of Regensburg

08:25  | The diagnostic framework and introduction of working proposal

• Guang-Shing Cheng, Fred Hutch Cancer Center

08:30 | Basics of PFTs: spirometry, lung volumes, DLCO, and current interpretative strategies

• Jane Turner, McMaster University

08:45 | Patterns of airflow obstruction, small airways disease, and reversibility relevant to clinical BOS

• Gerald Weinhouse, Dana Farber, Cancer Institute/Harvard University

09:00 | Alternatives to conventional PFTs

Paul Robinson, University of Queensland, Australia
 

09:15 | Gaps, controversies, recommendations and discussion

• Guang-Shing Cheng, Fred Hutch Cancer Center

09:30 | Chest imaging correlates of airflow obstruction / small airways impairment, including CXR, CT, MRI

• Okka Hamer, Universityof Regensburg

09:50 | Novel approaches to chest imaging and e.g. MRI, qCT

• Greg Yanik, University of Michigan

10:10 | Gaps, controversies, recommendations and discussion

• Husham Sharifi, Stanford University 

10:30 | Coffee Break

10:45 | Pro/Con Debate: Exclusion of infection and the need for bronchoscopy

• Clare Sander, Cambridge University Hospital and TBD

11:05 | Requirements for clinical context (e.g. other cGVHD) and the need for histology

• Catherine Lee, Fred Hutch Cancer Center

11:25 | Gaps, controversies, recommendations and discussion

• Ajay Sheshadri, MD Anderson Cancer Center

11:45 | Summary of Revision Part 1

Guang-Shing Cheng, Husham Sharifi, Ajay Sheshadri

12:00 | Lunch

13:00 | Consideration of preexisting lung disease and the impact of aging on lung function

• Hemang Yadav, Mayo Clinic

13:15 | The impact of growth on lung function

• Shiv Shanthikumar, University of Melbourne

13:30 | Specific pediatric considerations for lung function testing chest imaging, and invasive diagnostic testing

• Stella Davies, Cincinnati Children’s Hospital

13:45 | Recommendations for minimum diagnostic criteria if no diagnostic testing can be obtained. Kirsten Williams, Emory University

14:00 | Discussion

14:15 | Pro/Con: Is bronchiectasis a consequence of BOS, or its own lung GVHD entity? 

• Mark Barash, Medical College of Wisconsin and Louise Bondeelle, University of Geneva

14:35 | Mixed physiology and non-parenchymal restriction

• Jeff Sturek, University of Virginia

14:50 | Organizing pneumonia and Interstitial lung disease entities

• Julie Lai, Stanford University

15:05 | Pro/Con: Should CLAD-RAS criteria be applied to HCT Lung GVHD? 

• Saskia Bos, University of Leuven and Anne Bergeron

15:25 | Recommendations and discussion: Include non-BOS as

• GVHD, and which entities? Jeff Sturek and Anne Bergeron

15:45 | Coffee Break

• Chair: Daniel Wolff
• Panelists: Yves Chalandon, Danielle Stahlbaum, Stella Davies,
• Paul Carpenter, Najla El-Jurdi

• Guang-Shing Cheng and Anne Bergeron

GOAL: Establish an ideal clinical trial design and identify clinical trial readiness gaps for Lung GVHD after HCT

Co-Chairs: Guang-Shing Cheng and Anne Bergeron

• Guang-Shing Cheng

08:10 | Why we need BOS-specific clinical trials

• Anne Bergeron, University of Geneva

08:15  | Guidelines versus the reality

• Helene Schoemans, University of Leuven

08:30 |  FDA-approved cGVHD agents and BOS trials: a pulmonologist’s perspective

• Anne Bergeron, University of Geneva

08:45 | Antifibrotics and the Pulmonary Drug pipeline

• Katrin Hostettler, University of Basel

09:00 | Alternative therapies (e.g. ECP) and cGVHD drug pipeline.

• Daniel Wolff, University of Regensburg

09:15 | Q&A / Panel Discussion

• Chair: Daniel Wolff and Steve Pavletic

09:30 | The logistics of establishing multicenter / international collaborations US/EU

• Incyte, Sanofi, Therakos, Dr. Jason Chien, Patient Representatives, FDA/EMA/NIH representatives

10:15 | Coffee Break

10:30 | Innovative trial designs in interstitial lung diseases: adaptive, umbrella, basket

• Toby Maher, University of California Los Angeles

10:45 | Continuous lung function measures as endpoints for lung GVHD

• Ted Gooley, Fred Hutch Cancer Center

11:00 |  Response criteria: aligning with the updated Lung GVHD Definition

• Guang-Shing Cheng, Fred Hutch Cancer Center

11:15 | Biomarkers for Lung GVHD: how do we get there, and how do we test? 

• Sophie Paczesny, Medical College of South Carolina

11:30 | Rare disease disease trial design: stratification and statistical concerns

• Sylvie Chevret, University of Paris/Hopital St. Louis

11:45 | Q&A / Discussion

12:00 |  Lunch

13:00 | Brainstorming Breakouts: 1. trial design; and 2. agents to test; 3. gaps in clinical trial readiness

13:45 | Small group reports and discussion

• Guang-Shing Cheng and Anne Bergeron