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D. De Ruysscher
Moderator of
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Management of brain metastases (ID 2)
- Event: ELCC 2017
- Type: Educational session
- Track:
- Presentations: 4
- Moderators:S. Ekman, D. De Ruysscher
- Coordinates: 5/05/2017, 14:30 - 16:00, Room B
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Local management of brain metastases: The surgeon’s perspective (ID 4)
15:10 - 15:30 | Author(s): M. De Praeter
- Abstract
- Presentation
Abstract not provided
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Molecular characteristics of brain metastases: Are they different? (ID 2)
14:30 - 14:50 | Author(s): S. Ekman
- Abstract
- Presentation
Abstract not provided
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Radiation therapy of brain metastases (ID 5)
15:30 - 15:50 | Author(s): J.D. Zindler
- Abstract
Abstract not provided
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Systemic treatment of brain metastases (ID 3)
14:50 - 15:10 | Author(s): J.C. Yang
- Abstract
- Presentation
Abstract not provided
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Standards for high-dose radiotherapy in lung cancer (ID 15)
- Event: ELCC 2017
- Type: Specialty Session
- Track:
- Presentations: 4
- Moderators:D. De Ruysscher, S. Senan
- Coordinates: 5/06/2017, 11:00 - 12:30, Room W
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ESTRO practice guidelines for lung SABR delivery (ID 62)
11:00 - 11:20 | Author(s): S. Senan
- Abstract
- Presentation
Abstract not provided
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Evidence-based guidelines for delivery of curative radiotherapy in stage III NSCLC (ID 63)
11:20 - 11:40 | Author(s): R. Dziadziuszko
- Abstract
- Presentation
Abstract not provided
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Extra-cranial oligometastatic NSCLC: Techniques, doses and timing (ID 65)
12:00 - 12:20 | Author(s): G. HANNA
- Abstract
- Presentation
Abstract not provided
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Practice guidelines for combining radiotherapy with targeted agents (ID 64)
11:40 - 12:00 | Author(s): D. De Ruysscher
- Abstract
- Presentation
Abstract not provided
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Author of
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Imaging and locally advanced NSCLC (ID 41)
- Event: ELCC 2017
- Type: Poster Discussion session
- Track:
- Presentations: 1
- Moderators:H. Prosch, S. Senan, P. Van Schil
- Coordinates: 5/06/2017, 14:45 - 15:45, Room W
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74PD - Radiation-induced lung toxicity prediction modeling in NSCLC: Importance of baseline toxicity scoring (ID 506)
15:25 - 15:25 | Author(s): D. De Ruysscher
- Abstract
Background:
Validated outcome prediction models with high discriminative power are important for a cost-effective deployment of proton therapy for locally-advanced non-small cell lung cancer (NSCLC). We validated a model predicting lung toxicity 6 months after radiotherapy (RT) treatment.
Methods:
The model published by Appelt et al. (Acta Oncol 2014) was selected from a literature search. It relies on a review of radiation pneumonitis reports and retained the most important predictors, Mean Lung Dose (MLD) as dosimetric factor and 6 factors influencing the patient’s susceptibility: pre-existing pulmonary comorbidity, age>63 years, mid/inferior tumor location and sequential chemotherapy as risk factors, and current smoking and smoking history as protective factors. A dataset of 109 NSCLC patients treated at MAASTRO Clinic using 1.8 Gy fraction doses (two fractions per day) up to 79.2 Gy was studied. The required parameters were retrospectively collected together with the dyspnea endpoint (CTC 3.0 scoring) at baseline and at 6 months after RT. All treatments were performed using 3D-conformal RT techniques as it was the case in the study of Appelt et al. Odds ratios were calculated using logistic regression modelling.
Results:
19.3% of patients presented post RT dyspnea≥2. Our dataset confirmed current smoking and pulmonary comorbidity as prognostic factors for this endpoint, with similar odds ratios (OR = 0.28 (p = 0.02) and OR = 2.95 (p = 0.02), respectively). Tumor location OR was outside of the reported 95% CI. When predicting the change in dyspnea with respect to the baseline score (delta dyspnea≥1, prevalence of 18.6%), the two prognostic factors were not significant anymore (OR = 0.56 (p = 0.27) and OR = 0.47 (p = 0.21), respectively). Both factors exhibited strong correlation with the baseline patient status: worse baseline dyspnea is often a manifestation of existing comorbidities and it determines the probability to stop smoking. MLD was not associated with outcome in any of our models.
Conclusions:
It is crucial to consider delta toxicity endpoints in prediction modeling in order to obtain meaningful models reflecting radiotherapy outcome. Acknowledgement: This project has received funding from the EU under grant agreement no 601826 (REQUITE).
Clinical trial identification:
Legal entity responsible for the study:
KU Leuven
Funding:
EU
Disclosure:
All authors have declared no conflicts of interest.
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Poster Display Session (ID 63)
- Event: ELCC 2017
- Type: Poster Display Session
- Track:
- Presentations: 2
- Moderators:
- Coordinates: 5/07/2017, 12:30 - 13:00, Hall 1
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164P - Heart radiation dose as a risk factor for dyspnea worsening after multimodality treatment for non-small cell lung cancer and pleural mesothelioma: An exploratory analysis (ID 500)
12:30 - 12:30 | Author(s): D. De Ruysscher
- Abstract
Background:
The purpose of our study is to quantify the influence of heart dose on the early and late onset of dyspnea in a cohort of radiotherapy (RT)-treated non-small cancer patients (NSCLC) and malignant pleural mesothelioma (MPM) patients after multimodality treatment, according to the type of surgery.
Methods:
In 121 patients with multimodality-treated NSCLC and MPM the maximal dyspnea score (CTCAE 4.0) before RT and at an early (≤6 months) and a late (7-12 months) time point were obtained. Included patients needed to be clinically and radiologically progression-free 9 months after the end of RT. The difference (Δ) between the maximal dyspnea at ≤ 6 months and the pre-RT dyspnea or the maximal dyspnea at 7-12 months and the pre-RT dyspnea was calculated.
Results:
Our results show that 44% (50/113) of patients developed an early worsening of at least 1 point in their dyspnea score (Δdyspnea ≥1) after the end of RT. As independent predictors of an early worsening, we identified the MHD (for Δdyspnea ≥1: OR = 1.032, p = 0.04) and the dyspnea score before RT (for Δdyspnea ≥1: OR = 0.40, p = 0.0001; for Δdyspnea ≥2: OR = 0.35, p = 0.05). At a later timepoint, only the dyspnea score before RT (OR: 0.40, p = 0.001) was identified as predictor of for Δdyspnea ≥1.
Conclusions:
Our results, albeit exploratory, suggest that heart dose may play a role in the early worsening of the dyspnea in a heterogeneous cohort of multimodality treated RT patients.
Clinical trial identification:
Legal entity responsible for the study:
KUL UHasselt-ZOL-Jessa
Funding:
This study is part of the Limburg Clinical Research Program (LCRP) UHasselt-ZOL-Jessa, supported by the foundation Limburg Sterk Merk, province of Limburg, Flemish government, Hasselt University, Ziekenhuis Oost-Limburg and Jessa Hospital. This work was partly funded by the European Union’s Seventh Framework Programme for research, technological development and demonstration under grant agreement no 601826 (REQUITE). CB is supported by the Cancer foundation Limburg and a grant from ‘Kom op tegen kanker’. AB is supported by a grant from the Stichting tegen kanker/Fondation contre le cancer (CA/2014/354) and by Kom op Tegen Kanker (Stand up to Cancer, The Flemish Cancer Society).
Disclosure:
All authors have declared no conflicts of interest.
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80TiP - A feasibility trial evaluating the addition of nivolumab to standard first-line chemo-radiotherapy in locally advanced stage IIIA/B NSCLC: The ETOP 6-14 NICOLAS trial (ID 455)
12:30 - 12:30 | Author(s): D. De Ruysscher
- Abstract
Background:
Sequential or concomitant chemo-radiotherapy is the treatment of choice for stage III NSCLC. One attempt to improve the long-term survival is an immunotherapeutic strategy. The monoclonal antibody nivolumab targets and inhibits PD-1, an immune receptor on activated T-cells and responsible for abrogating anti-cancer immune response. The role of immune-checkpoint inhibitors is currently being evaluated in this indication as monotherapy or in combination with chemotherapy as well as after completion of chemo-radiotherapy but it has not yet been assessed in combination with radiotherapy. While anecdotal data of concurrent therapy suggests an acceptable toxicity profile, a formal prospective assessment is required before embarking on trials comparing concurrent versus sequential checkpoint inhibitors and radiotherapy.
Trial design:
NICOLAS is a phase II feasibility trial evaluating the administration of nivolumab concomitantly with standard first-line chemo-radiotherapy for locally advanced stage IIIA/B NSCLC. Additional inclusion criteria include adequate organ function and performance status 0-1. Chemotherapy consists of three cycles of cisplatin plus vinorelbine, etoposide or pemetrexed. Radiotherapy to the chest will be delivered either sequentially to or concurrently with chemotherapy. The initial nivolumab dose is 240 mg Q2W for eight cycles in the sequential, and 360 mg Q3W for four cycles in the concurrent chemo-radiotherapy schedule, followed by 480 mg Q4W for maximum one year for both regimens. A total of 43 patients will be recruited into the trial. The primary endpoint is grade > =3 pneumonitis observed up to 6 months after radiotherapy. The goal is to reject a 6-month pneumonitis-free rate of < =67%, tested at a rate of 85%, with 85% power and 5% one-sided alpha. An interim analysis will be performed after 21 patients have completed a 3-month follow-up on nivolumab treatment. Safety is closely monitored by the ETOP IDMC at their regular meetings every three months. NICOLAS is sponsored by ETOP with financial support of Bristol-Meyers Squibb. Accrual is ongoing and as of January 2017, 18 patients have been enrolled.
Clinical trial identification:
EudraCT: 2014-005097-11
Legal entity responsible for the study:
European Thoracic Oncology Platform (ETOP)
Funding:
Bristol-Meyers Squibb
Disclosure:
R.A. Stahel: Honoraria as consultant at advisory boards from Abbvie, Astra Zeneca, BMS, Boehringer Ingelheim, Eli Lilly, MSD, Pfizer and Roche and as speaker from Astellas, Astra Zeneca, Lilly, MSD, Novartis and Roche. R.M. Huber: Honoraria as consultant at advisory boards from BMS. All other authors have declared no conflicts of interest.
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Standards for high-dose radiotherapy in lung cancer (ID 15)
- Event: ELCC 2017
- Type: Specialty Session
- Track:
- Presentations: 1
- Moderators:D. De Ruysscher, S. Senan
- Coordinates: 5/06/2017, 11:00 - 12:30, Room W
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Practice guidelines for combining radiotherapy with targeted agents (ID 64)
11:40 - 12:00 | Author(s): D. De Ruysscher
- 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.
