Virtual Library
Start Your Search
Kevin Nicholas Franks
Author of
-
+
Lunch & Poster Display session (ID 58)
- Event: ELCC 2019
- Type: Poster Display session
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 4/11/2019, 12:30 - 13:00, Hall 1
-
+
126P - Regional retrospective analysis of outcomes of EGFR mutated non-squamous non-small cell lung cancer (NSCLC) patients in West Yorkshire (ID 435)
12:30 - 13:00 | Author(s): Kevin Nicholas Franks
- Abstract
Background
In the UK approximately 10% of all patients diagnosed with NSCLC harbour an Epidermal Growth Factor Receptor (EGFR) mutation. Tyrosine kinase inhibitors (TKI) have been used as first-line treatment for this group of patients since 2009. We performed a retrospective analysis of our regional cohort to assess patient outcomes and document changes in practice over the years.
a9ded1e5ce5d75814730bb4caaf49419 Methods
Electronic paperless notes system (PPM) was used to collect data on 210 patients diagnosed with EGFR mutation positive NSCLC within West Yorkshire from 2009-2018. Information regarding patient characteristics, stage of cancer, treatment, toxicity and outcome was obtained. Descriptive statistics were performed and Graphpad Prism® was used to determine overall survival. Subgroup analyses were performed for exon mutation, performance status, TKI received and year treated.
20c51b5f4e9aeb5334c90ff072e6f928 Results
Of 150 evaluable patients, 114 received first-line TKI, 3 received second-line TKI and 33 received no TKI. Median age was 72 (interquartile range 62-77). 10, 43 and 61 patients had exon 18, 19 and 21 mutations respectively. 93 patients treated with TKI were performance status (PS) 0-2 and 21 PS 3. 49 patients were treated 2009-13 and 65 2014-2018. Of the 33 patients who did not receive a TKI, 14 had no residual disease following another radical treatment modality, 14 were inappropriate for systemic treatment based on PS or EGFR resistance mutation and 2 declined any treatment. Median overall survival for the full cohort was 15.6 months. Statistically non-significant trends towards improved overall survival were seen in patients with PS ≤ 2 versus (vs.) PS 3 (17.8 vs. 9.9 months); exon 19 vs. 21 (19.1 vs. 14.3 months); treatment with Afatinib vs. Gefitinib or Erlotinib (21.3 vs. 12.8 and 13.8 months) and patients treated 2014-2018 vs. 2009-2013 (18.4 vs. 9.9 months). Compared to 2009-2013, in patients treated 2014-2018 Gefitinib use decreased (40 vs. 23) whilst Erlotinib (9 vs. 18) and Afatinib (0 vs. 24) use both increased.
fd69c5cf902969e6fb71d043085ddee6 Conclusions
Our real-world data supports the published literature by demonstrating improved outcomes with TKI treatment in patients with exon 19 mutations, better PS and treatment more recently with second generation TKIs.
b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study
The Leeds Teaching Hospitals NHS Trust.
213f68309caaa4ccc14d5f99789640ad Funding
Has not received any funding.
682889d0a1d3b50267a69346a750433d Disclosure
All authors have declared no conflicts of interest.
cffcb1a185b2d7d5c44e9dc785b6bb25
-
+
Mini Oral session III (ID 65)
- Event: ELCC 2019
- Type: Mini Oral session
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 4/12/2019, 17:45 - 18:45, Room C
-
+
72O - Multi-centre analysis of cardiac events following radical radiotherapy for lung cancer (ID 235)
17:45 - 18:45 | Author(s): Kevin Nicholas Franks
- Abstract
- Presentation
Background
Radical radiotherapy (RRT) plays an essential role in the management of early and locally advanced lung cancer. Recent studies suggest cardiac events post radiotherapy worsen survival outcome for patients. This study aims to identify risk factors which predispose patients to cardiac events post radiotherapy.
a9ded1e5ce5d75814730bb4caaf49419 Methods
All patients who received RRT (including Stereotactic Body Radiotherapy (SBRT), radical fractionated radiotherapy and chemoradiotherapy) for lung cancer between 01/01/2010 to 30/12/2016 at 2 UK institutions have been included. Patients were excluded if they had multiple courses of radiotherapy to the chest. Individual patient clinical information has been retrieved from hospital electronic database. Patient and cancer demographics have been collected. Pre-existing cardiac conditions, Charlsons’ Co-morbidity index and Qrisk 3 scores were calculated. Post radiotherapy cardiac events were identified rom electronic patient records and time to cardiac events were calculated.
20c51b5f4e9aeb5334c90ff072e6f928 Results
600 patients have been identified so far and processed. Median follow up is 31 months. Of all patients, 29% had pre-existing cardiac conditions. 52 patients experienced cardiac events following radiotherapy, of which 37% were ischaemic events. Of patients who experienced an ischaemic event, 58% did not have a known pre-existing cardiac condition. 71% of cardiac events post RRT occurred in the first 2 years following RT. Proportionally, patients who underwent radical fractionated radiotherapy and concurrent chemoradiotherapy had the highest incidence of cardiac events. Patient characteristics of those who experienced cardiac toxicity are summarized in the table below
fd69c5cf902969e6fb71d043085ddee6 ConclusionsTotal = 52 (10%) Ischaemic events 19 (7 events lead to death – Grade 5) Pericardial(effusion) events 8 Arrhythmic events 13 Cardiac failure events 12 Pre-existing cardiac diagnosis Patients who had ischaemic events 8/19 (4 previous MI, 2 IHD, 1 arrythmia and 1 valve abnormality Patients who had pericardial events 1/8 (arrhythmia) Patients who had arrhythmic events 6/13 (2 previous MI, 2 IHD, 1 CCF, 1 CCF and arrhythmia) Patients who had CCF events 9/12 (2 previous MI, 5 IHD, 2 valvular abnormality) Sex Male = 33 Female = 19 Age Median = 73 Smoking Never smoked 0 Ex-Smoker <10 PY 0 Ex-smoker <20 PY 9 Ex-Smoker 20-40PY 15 Ex-Smoker >40 PY 9 Current Smoker 19 Charlson Score Median = 6 RT indication Adjuvant RT 4 (12.5% of all Adjuvant RT) SBRT 19 (8.7% of all SBRT) Concurrent ChemoRT 10 (14.5% of all Concurrent ChemoRT) Sequential ChemoRT 0 Radical Fractionated RT 19 (15.6% of all Radical Fractionated RT) Tumour Location Left Upper Lobe(LUL) 12 (8% of all LUL tumours) Left Lower Lobe(LLL) 11 (17% of LLL tumours) Right Upper Lobe(RUL) 16 (9% of RUL tumours) Right Middle Lobe(RML) 1 (3% of RML tumours) Right Lower Lobe(RLL) 12 (17% of RLL tumours)
A clinically significant proportion of patients developed cardiac toxicity following radical radiotherapy for lung cancer. Cardiac events occur much sooner after lung cancer radiotherapy than radiotherapy for breast cancer or lymphoma. Work is ongoing to identify greater number of patients and combine local data with data from national registry to aid analysis.
b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study
The authors.
213f68309caaa4ccc14d5f99789640ad Funding
Yorkshire Cancer Research.
682889d0a1d3b50267a69346a750433d Disclosure
All authors have declared no conflicts of interest.
cffcb1a185b2d7d5c44e9dc785b6bb25Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
-
+
Treatment related pneumonitis in lung cancer patients (ID 12)
- Event: ELCC 2019
- Type: Multidisciplinary Interactive session
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 4/11/2019, 08:00 - 08:50, Room W
-
+
The radiation oncology perspective (ID 30)
08:00 - 08:50 | Presenting Author(s): Kevin Nicholas Franks
- Abstract
- Presentation
Abstract not provided
Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
