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Paul Welsh
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P2.17 - Treatment of Locoregional Disease - NSCLC (Not CME Accredited Session) (ID 966)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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P2.17-22 - Cardiac Biomarkers in CART Study (CARdiac Toxicity in Lung Cancer Patients After Chemo-Radiotherapy). (ID 14165)
16:45 - 18:00 | Author(s): Paul Welsh
- Abstract
Background
Lung cancer has the highest incidence and mortality. Chemo-radiation (CRT) can achieve curative outcomes, but there is limited knowledge of the associated toxicity. The results of the RTOG 0617 study highlighted the impact of cardiac toxicity. Further investigation of cardiopulmonary toxicity is required.
a9ded1e5ce5d75814730bb4caaf49419 Method
This is a single centre, prospective observational study in which NSCLC patients undergoing RRT with or without chemotherapy were invited to participate. Evaluations include clinical assessment, cardiac MRI and ECG. Biomarker results are available for lattermost patients. Evaluations performed at baseline, during treatment, 6 weeks and 6 months after treatment.
4c3880bb027f159e801041b1021e88e8 Result
11 patients underwent translational blood sampling. Key details are given in table 1. Change in biomarker results is shown in figure 1. In this limited sample the change did not reach statistical significance. This study showed that 3/11 patients achieved hsTnT > 14 (suggestive of myocardial damage) during study period. 8/11 patients had NTproBNP > 125 (suggestive of increased heart failure risk) at some point on study. 3/11 demonstrated an NTproBNP levels > 400, a recognised cut off warranting cardiac echo.
Table 1 Patient
Baseline
Co-morbidities
Baseline ECG result
Treatment
Baseline NTproBNP, pg/ml
(maximum change post-baseline)
Baseline hsTnT, pg/ml
(maximum change post-baseline)
Hospital admission within 6 months (reason)
Status at 6 months
22
Normal
RRT
22
(+ 4%)
6.7
(+38%)
No
Alive
24
IHD, DM, COPD, RA
T-inversion, II, III, aVF
CRT
625
(+101%)
11.2
(+105%)
Yes (COPD, NSTEMI)
Alive
26
Normal
CRT
89
(+79%)
6.2
(+67%)
Yes (Chest pain)
Alive
27
CHOLES, HPT
Normal
RRT
81
(+80%)
5.5
(+47%)
Yes (Unknown)
Alive
28
HPT
Normal
RRT
32
(+106%)
7.1
(-20%)
No
Alive
29
IHD, DM, CHOLES
Sinus Bradycardia,
Ist Degree AV Block
RRT
Missing
(NA)
Missing
(NA)
No
Alive
30
COPD, HEPB
Sinus Bradycardia
CRT
113
(+148%)
7.6
(-16%)
No
Alive
31
AF
Normal
RRT
58
(+15%)
7.2
(+101%)
No
Alive
32
IHD, CHOLES, HPT
Normal
RRT
624
(+10%)
4.9
(+39%)
No
Alive
33
IHD, HPT
Normal
CRT
91
(+220%)
7.6
(+12%)
No
Alive
34
Normal
CRT
509
(-45%)
4.7
(-37%)
Yes (N+V, chest pain)
Dead
Table 1. Listing of comorbidities, treatment, hospital admissions, ECG results and baseline biomarkers. Abbreviations: RRT (radical radiotherapy), CRT (concurrent chemo-radiation), COPD (exacerbation of COPD), NSTEMI (non-elevated ST segment myocardial infraction), N+V (nausea and vomiting), IHD (ischaemic heart disease), DM (diabetes mellitus), HPT (hypertension), CHOLES (hypercholesterolemia), AF (atrial fibrillation), RA (rheumatoid arthritis), HEPB (Hepatitis B), NTproBNP(N-terminal pro-B-type natriuretic peptide), hsTnT (high sensitivity Troponin-T)
Cardiac biomarkers and their changes indicate that further investigation may be required in some to exclude cardiac ischaemia and heart failure risks before or following treatment.
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