2022 World Conference on Lung Cancer (ePosters)-EP05.01-012. Avoiding Cardiac Toxicity in Lung Cancer Radiotherapy (ACcoLade) Trial

Pdf Summary

The ACcoLade trial investigated the cardiac toxicity associated with lung cancer radiotherapy. The study analyzed blood and imaging biomarkers in patients receiving thoracic radiotherapy to understand the mechanism of cardiac injury. The blood biomarkers measured were high sensitivity cardiac troponin I (hsTnI) and N-terminal pro-B-type natriuretic peptide (NT pro-BNP). Cardiac CT (CCT) and echocardiography were used to assess coronary artery disease and cardiac structure and function, respectively.<br /><br />The initial results showed that patients with lung cancer had a high prevalence of advanced coronary artery disease before radiotherapy. However, there was no significant change in left ventricular ejection fraction, Agatston score (assessment of coronary artery disease severity), or NT pro-BNP levels over the course of treatment. Cardiac troponin levels increased at the end of radiotherapy. No blood or imaging biomarker predicted future cardiac events.<br /><br />The study also reported on cardiac events during the median follow-up of 52 weeks. Six patients (15.8%) died, but none of the deaths were cardiac-related. One patient had a myocardial infarction 45 days after study enrollment, and another was diagnosed with atrial fibrillation at 101 days.<br /><br />The patient population included a median age of 68.5 years, with a majority having stage III lung cancer. The most common radiotherapy schedule was 55Gy in 20 fractions, and some patients received neo-adjuvant chemotherapy. About one-third of patients had a history of cardiovascular disease, and a significant percentage smoked tobacco.<br /><br />The study concludes that lung cancer patients undergoing radiotherapy have a high prevalence of advanced coronary artery disease. However, no significant changes were observed in cardiac structure and function biomarkers over the course of treatment. The study highlights the need for further research to better understand and prevent cardiac toxicity in lung cancer radiotherapy.

Asset Subtitle

Kathryn Banfill

Meta Tag

Speaker Kathryn Banfill

Topic Locally Advanced Non-small Cell Lung Cancer - Chemoradiotherapy and Radiotherapy

Keywords

ACcoLade trial

cardiac toxicity

lung cancer radiotherapy

blood biomarkers

imaging biomarkers

coronary artery disease

cardiac events

myocardial infarction

atrial fibrillation

research