ESTRO 2025 - Abstract Book

S1366

Clinical - Lung

ESTRO 2025

Results: The systematic review included 21 studies and identified a significant association between high-dose thoracic radiation therapy (RT) and an increased incidence of cardiac adverse events in lung cancer patients. The review revealed that higher dose-volume parameters, notably higher mean heart doses (MHD), were predictive of major cardiac events such as pericardial effusion, arrhythmias, and acute coronary syndrome. The meta-analysis showed a significant 4% (95% confidence interval: 3%-6%) increased probability of the occurrence of cardiac events per additional Gray of MHD, with low heterogeneity among studies (I² = 23%). No publication bias was evidenced. Conclusion: This study underscores the importance of dose-volume parameters as predictors of cardiac adverse events following high-dose thoracic RT in lung cancer treatment. The findings highlight the need for careful consideration of heart dose constraints in RT planning to mitigate the risk of radiation-induced cardiotoxicity, thereby improving the therapeutic ratio for lung cancer patients. Future research should focus on refining these dose constraints and exploring cardioprotective strategies during lung cancer radiotherapy.

Keywords: meta-analysis; cardiotoxicities

2645

Proffered Paper Osimertinib after chemoradiotherapy in unresectable stage III EGFRm NSCLC: chemoradiotherapy regimens and radiation pneumonitis in LAURA (NCT03521154) Terufumi Kato 1 , Hong Jian 2 , Thanyanan Reungwetwattana 3 , Edurne Arriola 4 , Hidetoshi Hayashi 5 , Ki Hyeong Lee 6 , Shuanghu Yuan 7 , James Chih-Hsin Yang 8 , Manuel Cobo 9 , Ahmet Alacacioğlu 10 , Lucy Thompson 11 , Feruza Nasirova 12 , Ellie Grainger 13 , Azura Evans 14 , Ana Bolanos 15 , Suresh S Ramalingam 16 1 Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Japan. 2 Department of Medical Oncology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. 3 Division of Medical Oncology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. 4 Department of Medical Oncology, Hospital del Mar-CIBERONC, Barcelona, Spain. 5 Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan. 6 Department of Internal Medicine, Chungbuk National University Hospital, Cheongju-Si, Korea, Republic of. 7 Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China. 8 Department of Oncology, National Taiwan University Hospital and National Taiwan University Cancer Center, Taipei, Taiwan. 9 Unidad de Gestión Clínica Intercentros de Oncología Médica, Hospitales Universitarios Regional y Virgen de la Victoria, IBIMA, Málaga, Spain. 10 Medical Oncology Clinic, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey. 11 Global Patient Safety, Oncology R&D, AstraZeneca, Cambridge, United Kingdom. 12 Global Medical Affairs, AstraZeneca, Cambridge, United Kingdom. 13 Biometrics, Late-stage Development, Oncology R&D, AstraZeneca, Cambridge, United Kingdom. 14 Late-stage Development, Oncology R&D, AstraZeneca, Macclesfield, United Kingdom. 15 Late-stage Development, Oncology R&D, AstraZeneca, Mississauga, Ontario, Canada. 16 Department of Hematology and Medical Oncology, Emory University School of Medicine, Winship Cancer Institute, Atlanta, Georgia, USA Purpose/Objective: Osimertinib, a third-generation EGFR-TKI, is recommended for EGFRm advanced NSCLC and as adjuvant treatment for resected EGFRm NSCLC. In the Ph3 LAURA study, osimertinib significantly improved PFS by blinded independent central review (BICR) vs placebo (primary endpoint): HR 0.16; 95% CI 0.10, 0.24; p<0.001 in patients with unresectable stage III EGFRm NSCLC without progression during/after definitive CRT. We report new data from LAURA on CRT regimens and RT-related adverse events, e.g. radiation pneumonitis (RP).