Abstract 151P
Background
The standard of care for patients with unresectable stage III non-small cell lung cancer (NSCLC) is platinum-based chemotherapy concurrent with thoracic radiotherapy (CRT), followed by durvalumab consolidation if tumor PDL1 expression is ≥1%. CRT is associated with increased risks of developing cardiac dysfunction. Myocardial strain is a measure of myocardial deformation, which is a more sensitive imaging biomarker of myocardial disease than the left ventricular ejection fraction (LVEF). Cardiovascular MRI (CMR) myocardial strain is emerging as an early marker of cardiotoxicity of anticancer treatments.
Methods
We conducted a retrospective analysis of patients with stage III NSCLC treated with CRT at our institution between April 2017 and March 2023. We used a CMR to assess the myocardial strain in all surviving patients with no known cardiac comorbidity. We evaluated the percentage of patients with abnormal myocardial strain, which was defined as having less than 75% of normal myocardium. Additionally, we examined the patients' demographics and clinical characteristics of the cohort.
Results
Of 96 patients with stage III NSCLC treated with CRT, 51 were alive in June 2023. 12 patients were excluded for having known cardiac comorbidity, and 12 declined to participate in the study. 27 patients underwent CMR between May and August 2023 and were included in the analysis. 18 patients (66.7%) had abnormal myocardial strain (Cohort A), versus 9 patients with % normal myocardium >75% (Cohort B). Compared with Cohort B, pts with altered myocardial strain (Cohort A) were more frequently men (22.2 vs 72.2%), and current/former smokers (77.8 vs 100%), p<0.05.
Conclusions
In our cohort of 27 patients with stage III NSCLC treated with CRT who underwent CMR, the percentage of patients with abnormal myocardial strain was high (66.7%). Prospective studies with CMR myocardial strain performed pre- and post-CRT are warranted to explore the sensitivity and specificity of this technology to assess the cardiotoxicity of anticancer treatments, as well as its clinical utility to prevent cardiac dysfunction.
Legal entity responsible for the study
Hospital Ramon y Cajal.
Funding
Has not received any funding.
Disclosure
M. García Pardo de Santayana: Financial Interests, Personal and Institutional, Research Grant, SEOM "Retorno Investigadores" Grant: SEOM; Financial Interests, Personal and Institutional, Research Grant, AECC "Ayuda Clinico Junior" Grant: AECC. P. Garrido Lopez: Financial Interests, Personal, Advisory Board: AbbVie, Amgen, AstraZeneca, Bayer, BMS, GSK, Janssen, Lilly, MSD, Novartis, Pfizer, Roche, Takeda, Daiichi Sankyo, Sanofi; Financial Interests, Personal, Invited Speaker: AstraZeneca, Janssen, MSD, Novartis, Pfizer, Roche, Takeda; Financial Interests, Personal, Advisory Board, Spouse: Boehringer Ingelheim, Gebro, Janssen, Nordic; Financial Interests, Personal, Invited Speaker, Spouse: Boehringer Ingelheim, Janssen; Financial Interests, Personal, Other, Data monitoring committee for INC280I12201 trial in 2020: Novartis; Financial Interests, Personal, Invited Speaker, CACZ885V2201C_CANOPY-N trial: Novartis; Financial Interests, Personal, Other, Lung Cancer Medical Education TASC Committee 2021: Janssen; Financial Interests, Institutional, Invited Speaker: Novartis, Janssen, AstraZeneca, Pfizer, Blue print, Apollomics, Amgen, Array Biopharma; Financial Interests, Personal, Invited Speaker, IO102-012/KN-764 trial: IO Biotech; Financial Interests, Personal, Invited Speaker, JNJ-61186372 (JNJ-372) Clinical Development Program: Janssen; Non-Financial Interests, Personal, Leadership Role, Council member as Women for Oncology Committee ChairPast Fellowship and Award Committee and Press CommitteeFaculty for lung and other thoracic tumours: ESMO; Non-Financial Interests, Personal, Leadership Role, President of the Spanish Federation of Medical Societies (FACME) 2020-2022Past President 2023-2024: FACME; Non-Financial Interests, Personal, Leadership Role, Former President of Spanish Medical Oncology Society: SEOM; Non-Financial Interests, Personal, Leadership Role, Member of the Scientific Committee of the Spanish Against Cancer Research Foundation (aecc) and also Board member: AECC; Non-Financial Interests, Personal, Leadership Role, IASLC Women in Thoracic Oncology Working Group Member: IASLC; Non-Financial Interests, Personal, Advisory Role, Member of the Spanish National Health Advisory Board: Spanish Minister of Health; Non-Financial Interests, Personal, Advisory Role, Assesmment for lung cancer screening evaluation: EUnetHTA; Non-Financial Interests, Personal, Advisory Role: Spanish National Evaluation network (RedETS); Non-Financial Interests, Personal, Advisory Role, scientific advisory group member for clinical immunological, oncology and lung cancer areas: EMA; Non-Financial Interests, Personal, Other, Educational Committee Member: IASLC; Other, Personal, Other, My son is working in the pharma company TEVA as an engineer. I do not have any kind of relationship with TEVA: TEVA. All other authors have declared no conflicts of interest.