Transcript
Announcer:
You’re listening to Clinician’s Roundtable on ReachMD. On this episode, we’ll hear from Dr. Frank Sciurba, who’s the Director of the Emphysema and COPD Research Center and the Pulmonary Function Exercise Physiology Laboratory at the University of Pittsburgh School of Medicine. He’ll be discussing updates on bronchoscopic interventions for patients with COPD, which he spoke about at the 2026 American Thoracic Society Conference. Here’s Dr. Sciurba now.
Dr. Sciurba:
In the last few years, there's been a lot of work ongoing in bronchoscopic interventions for COPD.
Both the Spiration and the Zephyr endobronchial valves are, to this date, the only devices approved by the FDA, although there's been a lot of work in the background. For endobronchial valves, I think familiarity with the inclusion-exclusion criteria is to recognize the importance of setting up a program with support staff. A lot of different types of expertise are critical to making those programs move forward. But when they're established appropriately and patient expectations are set, these can be life changing in the right patient. Other devices are currently moving forward.
One of the patterns we see in COPD is sometimes the first shot at things doesn't necessarily reach significance. And we find out that there's subgroups that, in fact, are the most responsive. And then the trial is generally repeated in those subgroups. That was the case with endobronchial valves when we learned that fissure integrity is really critical for effectiveness.
Targeted lung denervation, which is for non-emphysema dominant or airway-dominant individuals, had a primary outcome of exacerbations and was pretty widely inclusive. In COPD patients, we've learned from a recent publication that, in fact, very hyperinflated patients with low emphysema may be the sweet spot. And so that trial's going to move forward now as a potential airway-dominant trial, with a repeat phase three that we're very hopeful could lead to an approved therapy.
There are two therapies for chronic bronchitis—more for the symptoms—but in COPD patients, one is the CSA cryotherapy, and the other is the galvanized bronchial rheoplasty. Both of those trials have been completed and are being analyzed, and we look forward to those data coming out in peer review and potential presentation to the FDA as to whether those are therapies that are going to improve mainly chronic bronchitis symptoms.
Another emphysema trial was the Apreo lung scaffold or the BREATHE-3 trial. The preliminary phase two data reported was pretty exciting, but now, the phase three trial is in progress, and we'll see where that lands and as to what space that occupies in emphysema-dominant individuals in the future.
So all these things that I've talked about that are emerging, I really hope that they'll be presentations at this year's ATS meeting, allowing the opportunity for experts in the field to engage and have a discussion to really start to give us some guidance as to how these new therapies and new approaches are going to be available to improve the lives of our patients.
Announcer:
That was Dr. Frank Sciurba sharing updates on bronchoscopic interventions in COPD. To access this and other episodes in our series, visit Clinician’s Roundtable on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!
