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Jennifer Holland



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    EP1.11 - Screening and Early Detection (ID 201)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Screening and Early Detection
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.11-23 - Protocol for a Randomized Controlled Trial of FDG-PET-CT in Follow Up of Stage II-IIIA NSCLC Post Treatment (Now Available) (ID 2946)

      08:00 - 18:00  |  Author(s): Jennifer Holland

      • Abstract
      • Slides

      Background

      Early stage Non-Small Cell Lung Cancer (NSCLC) accounts for some 70% of all lung cancer and, although curative treatment may be an option, the 5 year survival remains poor at just over 50%. If cancer recurrence or new disease following initial treatment could be detected earlier, especially whilst still asymptomatic, overall survival may be improved by enabling the earlier use of modern effective salvage therapies. Currently, there is limited evidence, and no consensus in Australia or internationally, on the most effective surveillance strategy following curative treatment. Hence, there is a critical need for a prospective study to examine whether a modern approach to surveillance imaging with PET-CT to detect NSCLC recurrence or new disease earlier and whilst still asymptomatic will not only improve survival but is cost effective.

      Method

      We propose a randomised controlled trial of systematic PET-CT for follow up of patients treated with curative intent for stage II-IIIA NSCLC at hospitals across Australia. Patients will be randomised to either usual care or systematic PET-CT 6 monthly over 3 years and followed for 5 years. Patients with new or recurrent disease will be referred for treatment to their usual clinical team and treatment details collected. The primary outcome of this study will be overall survival. Secondary outcomes include, 1. Detection rate for new tumours and a/symptomatic recurrence 2. Number/type of investigations used in the control arm. 3. Number/type of investigations used in the evaluation of new problems. 4. False positive/negative detection rate. 5. Cost effectiveness analysis. 6. Patient experience. Study design is a 2 arm trial with 1:1 randomisation to routine PET-CT surveillance added to usual care (or usual care alone), commencing 6 months after surgery or curative radiotherapy. The study will be stratified by centre, stage, curative therapy and ongoing smoking status.

      Result

      Section not applicable

      Conclusion

      The study results will define for each stage of disease, whether active surveillance with PET-CT added to usual care prolongs survival compared to usual care. It will also allow for collection of real-word data to understand of what constitutes usual care such that the mortality from the commonest cause of cancer death in our community.

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