Virtual Library
Start Your Search
R.J. Kelly
Moderator of
-
+
MS 22 - The Cost of Lung Cancer (ID 544)
- Event: WCLC 2017
- Type: Mini Symposium
- Track: Epidemiology/Primary Prevention/Tobacco Control and Cessation
- Presentations: 3
- Moderators:R.J. Kelly, T. Sobue
- Coordinates: 10/18/2017, 11:00 - 12:30, Room 502
-
+
MS 22.01 - The Economic Burden of Lung Cancer (ID 7745)
11:00 - 11:25 | Presenting Author(s): Natasha B Leighl
- 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.
-
+
MS 22.03 - Health Disparities and the Costs of Tobacco Related Diseases (ID 7747)
11:25 - 11:50 | Presenting Author(s): Peter Boyle
- 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.
-
+
MS 22.04 - The Economic World of Tobacco Free Investments (ID 7748)
11:50 - 12:15 | Presenting Author(s): Bronwyn King
- Abstract
Abstract:
Global tobacco control is like a gigantic cake, with innumerable slices dedicated to different tobacco control initiatives in different parts of the world. Each slice is vitally important, responsible for advancing our collective cause just that bit further. Each slice is in fact essential as the magnitude of the task simply demands a multitude of efforts and the complexity of the task – not knowing where or when the next breakthrough will occur (or where or when it will be halted due to tobacco industry interference) means that we need to simultaneously commit to a broad range of strategies. Up until a few years ago, there was, however, one slice missing - the slice that involved the finance sector. Never before had the global finance sector, and its almighty power, been leveraged in tobacco control efforts. In fact business as usual for the finance sector saw it working against every other slice of the cake. This situation was largely unintentional, simply a result of ‘doing things the way they had always been done’. Most pension funds invest in tobacco companies. Most banks lend them money. It’s been like that for about a hundred years. Professionally engaging with global finance leaders, asking them to learn about the tobacco epidemic and to reconsider commercial relationships with the tobacco industry, has seen significant changes implemented in the business models of banks, insurers, pension funds and fund managers. Since Tobacco Free Portfolios began in 2012, approximately USD $6 billion has been shifted from investment in the tobacco industry by financial institutions in ten different countries. Several banks have ceased lending money to tobacco companies and several insurers have ceased providing insurance. There is increasing acknowledgement of the significant reputational risk faced by financial organisations if they continue to maintain links with tobacco companies – companies that make products that kill two out of three of their best customers. To proceed with a tobacco-free investment decision, many conditions need to be in place. An open door to the CEOs office; willingness to consider the issue and to learn about something that sits outside the traditional paradigm of the finance sector; a country where public support of tobacco control is strong - where there is awareness of the cost-burden of tobacco, and understanding of the future financial risks associated with tobacco companies, spanning regulation, litigation and scrutiny of supply chains. Some individual finance leaders are more open to the tobacco-free conversation than others but interest is growing rapidly. Tobacco Free Portfolios is working towards a world where the global finance sector is aligned with the global health and governments sectors on tobacco. Our vision is for tobacco-free investment to be the baseline expected standard. With a forecast of one billion tobacco-related deaths this century, tobacco is a problem so profound that it cannot be adequately addressed unless every sector of society contributes to the solution. The changes witnessed in recent years are hopefully the start of a new frontier in truly comprehensive global tobacco control.
Information from this presentation has been removed upon request of the author.
Author of
-
+
MA 09 - The Current Status of Radiation Oncology (ID 666)
- Event: WCLC 2017
- Type: Mini Oral
- Track: Locally Advanced NSCLC
- Presentations: 1
- Moderators:Tomoki Kimura, Yong Chan Ahn
- Coordinates: 10/17/2017, 11:00 - 12:30, Room 316
-
+
MA 09.08 - Receipt of Chest Radiation and Immune-Related Pneumonitis in Patients with NSCLC Treated with Anti-PD-1/PD-L1 (ID 10075)
11:55 - 12:00 | Author(s): R.J. Kelly
- Abstract
- Presentation
Background:
Immune-related pneumonitis (IR-pneumonitis) is a potentially fatal toxicity of anti-PD-1/PD-L1. This study investigates the role of chest radiotherapy (RT) and the development of IR-pneumonitis in NSCLC patients treated with anti-PD-1/PD-L1.
Method:
Between January 2011 and April 2017, NSCLC patients treated with anti-PD-1/PD-L1 either as part of a clinical trial or as standard-of-care at a tertiary academic cancer center, were identified. Patient demographics, treatment, adverse event and RT data including type of RT (SBRT, 2D/3D conformal RT, IMRT, multiple), timing of RT (pre or post PD-1/PD-L1), location of RT (chest/non-chest), and number of courses of chest-RT, were collected in an IRB-approved institutional database. IR-pneumonitis was diagnosed clinically by the treating investigator; patients with confirmed RT pneumonitis, progressive NSCLC, or active infection were excluded. Associations between patient, treatment and RT parameters, and development of any grade IR-pneumonitis were evaluated using Student’s t-test and Fisher’s exact tests.
Result:
Of 184 NCSLC patients identified: median age was 67 years (range: 39-88); 57% (n=105) were male, 75% (n=137) were former/current smokers, 64% (n=118) had adenocarcinoma histology, and 59% (n=109) had advanced NSCLC at diagnosis. Anti-PD-1/PD-L1 monotherapy was received in 74% (n=136, nivolumab: 107, pembrolizumab: 14, durvalumab: 7, other: 8) and combination therapy in 26% of patients (n=48, PD-1/CTLA-4: 13, PD-L1/CTLA-4: 5, PD-1/chemotherapy: 4, PD-1/other: 25, PD-L1/other; 1). Any RT was received by 129 patients (70%), and 96 patients received chest-RT (52%). Thirty-eight (21%) patients developed IR-pneumonitis of any grade. IR-pneumonitis incidence was numerically higher in patients receiving combination therapy compared with monotherapy (29%, n=14/48 vs. 18%, n=24/136, p=0.1). Former/current smokers had a higher incidence of pneumonitis compared with never smokers (25% vs. 12%, p=0.03). IR-pneumonitis incidence was numerically higher in patients receiving chest-RT compared with non-chest/no RT (25%, n=24/96 vs. 16%, n=14/88, p=0.15). Of 129 patients who received any RT, there was a trend towards increased IR-pneumonitis in patients who received chest RT compared with those who received non-chest RT (25%,n=24/96 vs 9%, n=3/33; p=0.08). Overall, there were no significant associations between chest-RT type, chest-RT timing, nor receipt of more than one chest-RT course, and development of IR-pneumonitis (p>0.05).
Conclusion:
IR-pneumonitis incidence is 21% and may be higher than reported in clinical trials. Smoking status is associated with the development of IR-pneumonitis. Receipt of chest-RT was numerically higher, but not statistically associated with, development of IR-pneumonitis after receipt of anti-PD-1/PD-L1 in patients with advanced NSCLC. Radiation parameters did not associate with the development of IR-pneumonitis.
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.
