BLAST Lower Lobe Study
Research type
Research Study
Full title
Bronchoscopic Lung Ablation with Steam Therapy in Lower lobe Predominant Emphysema
IRAS ID
301069
Contact name
Maria Koufali
Contact email
Sponsor organisation
Nottingham University Hospitals NHS Trust
Duration of Study in the UK
2 years, 3 months, 31 days
Research summary
Emphysema causes destruction of the small airways in the lung, leading to lung over-inflation, difficulty taking up oxygen, and breathlessness. Many patients still have symptoms after maximum medical treatment. Things can often be improved by lung volume reduction procedures. Lung volume reduction surgery and one-way endobronchial valves (designed to deflate parts of the lung) are currently the two main ways of achieving this. A more recently developed treatment is bronchoscopic thermal vapor ablation (BTVA). This uses the energy from steam to cause inflammation in the lung, resulting in scarring and volume loss in the treated area. This reduces the amount of emphysema, and allows the less diseased parts of the lung to function better, resulting in improvements in breathlessness, exercise ability, and quality of life.
Although surgical removal of diseased tissue is an established treatment for emphysema, many centres will not consider patients with lower lobe emphysema for LVRS, based on historical data from early trials. Valves are effective in lower lobe disease, but rely on the absence of something called collateral ventilation. This is where there is air mixing between the different compartments of the lung, which stops the valves from working. A majority of patients with emphysema have a degree of collateral ventilation.
This leaves a group of patients with lower lobe disease who have no access to lung volume reduction therapy. BTVA has the potential to offer these patients a treatment option with meaningful clinical benefits. However, it is currently only licensed for treatment in the upper lobes, and this trial aims to provide evidence of its safety, feasibility, and practicality in lower lobe emphysema. Data will also be collected to record changes in clinical parameters associated with good patient outcomes (lung function, exercise capacity, quality of life).
REC name
South East Scotland REC 02
REC reference
22/SS/0052
Date of REC Opinion
1 Sep 2022
REC opinion
Further Information Favourable Opinion