Incidence of cardiovascular adverse events (AEs) in resected non-small cell lung cancer (NSCLC) patients receiving adjuvant platinum-based chemotherapy: a single institution experience from Wythenshawe Hospital, Manchester, UK
Birley, J. Summers, Yvonne J Taylor, Paul Beanland, L. Lam, C. Califano, Raffaele Cove-Smith, Laura
Birley, J.
Summers, Yvonne J
Taylor, Paul
Beanland, L.
Lam, C.
Califano, Raffaele
Cove-Smith, Laura
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Abstract
Introduction: Adjuvant platinum-based chemotherapy is the
standard of care for patients with resected stage 1b–3 NSCLC
but platinum can cause significant cardiovascular (CV) AEs. Lung
cancer patients often have pre-existing CV co-morbidities which
can preclude them from receiving adjuvant treatment. Even
with careful patient selection, they may develop cardiovascular
morbidity during adjuvant chemotherapy. This audit was
undertaken to identify a specific population who may benefit from
cardio-oncological input.
Methods: We conducted a retrospective analysis of patients treated
with adjuvant chemotherapy at Wythenshawe Hospital, Manchester
between January and December 2018 to determine the incidence of
CV events (CVE). Data was collected via electronic patient records
and chemotherapy prescribing software. Microsoft Excel and SPSS
were used to categorise patients into CV/non-CV event groups.
Patient demographics including age, gender, BMI, comorbidities,
smoking, family history, stage and chemotherapy were statistically
analysed by logistic regression and Fisher’s exact tests. Any cardiac
or vascular event requiring intervention or hospitalisation including venous-thromboembolism (VTE) was recorded. Results: A total of 99 patients were identified. 19% of patients
experienced a CVE, 11% of which were fatal. 42% of CVEs were VTEs,
21% acute AF, 8% acute coronary syndrome and 8% CVA/TIA. Half of
the patients received Cisplatin/Vinorelbine and half Carboplatin/
Vinorelbine. Patients with stage 3 disease had a statistically
significant increased risk of experiencing a CVE but no other patient
subgroup was found to be at specific risk.
Conclusion: Patients with stage 3 disease had a higher incidence of
CVEs, possibly due to selective bias for chemotherapy despite having
high comorbidity risks. The incidence of CVEs was 19%, higher than
those of adjuvant trials but a large proportion of CVEs were VTEs.
Implementation of early cardio-oncological input was recommended
and continuation of VTE prophylaxis during chemotherapy is being
considered.
Description
Date
2020
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Birley J, Summers YJ, Taylor P, Beanland L, Lam C, Califano R, et al. Incidence of cardiovascular adverse events (AEs) in resected non-small cell lung cancer (NSCLC) patients receiving adjuvant platinum-based chemotherapy: a single institution experience from Wythenshawe Hospital, Manchester, UK. Lung Cancer. 2020;139:S44-S