Early pulmonary function changes associated with brigatinib initiation.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 9538-9538
Author(s):  
Terry L. Ng ◽  
Amber Johnson ◽  
Andrea Abeyta Osypuk ◽  
Derek Smith ◽  
Kimberly R. Jordan ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Standard Dose ◽  
Effector Memory ◽  
Effector Memory T Cells ◽  
Activated Neutrophils ◽  
6 Minute Walk Test ◽  
Function Testing ◽  
Background Phase ◽  
Minute Walk ◽  
Alternative Drugs

9538 Background: Phase I-III studies reported symptomatic pulmonary toxicity within the first week of initiating brigatinib in 6% patients post-crizotinib and 3% in TKI naive patients with standard dosing (90mg QD for 7 days then 180mg QD as tolerated). A prospective observational study of pulmonary function testing (PFT) on initiating brigatinib was conducted. Methods: Patients PS≤2, with resting O2 sats on RA ≥90% and Hg ≥10 g/dL, without significant heart/lung disease or steroid use initiating brigatinib 90 mg QD were eligible. PFT with DLCO, Borg dyspnea and 6-minute walk tests were performed at baseline (prior to brigatinib), and on day 2 (D2), 8 (D8), and 15 (D15) of brigatinib. D15 analyses were initially as clinically indicated but became mandatory if DLCO had not returned to baseline by D8. Peripheral blood was collected at baseline, D2 and D8 for CyTOF analysis. The primary endpoint was the incidence of Early Onset Pulmonary Events (EOPEs), defined as a DLCO reduction of ≥ 20% from baseline. An interim analysis was performed on the first 10 patients due to a higher than expected incidence of DLCO reduction. Results: D2 and D8 measurements were captured in all 10 patients, D15 in 7 patients. Ninety percent (9/10) of patients experienced DLCO reduction with nadir occurring on D2 in 4/9 and on D8 in 5/9 patients. Median DLCO nadir was −13.33% from baseline (range: −34.44 to −5.00). Three patients (30%) met EOPE criteria, all on D8, all without symptoms. Brigatinib was not held and all 10 patients escalated to 180mg on D8. Despite continued dosing, 4/9 patients recovered DLCO to baseline or above by D15 (2/3 EOPEs cases), 2/9 recovered above nadir but below baseline by D15 (1/3 EOPE case), and 3/9 did not have improvement from nadir values but no D15 assessment was performed. Dyspnea and 6-minute walk test did not correlate with DLCO changes. Patients who experienced an EOPE had significantly higher levels of activated neutrophils (pERKhi) at baseline. On the day of the EOPE event, patients who met EOPE criteria had significantly higher levels of activated neutrophils and fewer activated CD4+ effector memory T cells. Conclusions: Modest DLCO reduction occurred in 90% (9/10) patients during the first 8 days of brigatinib-dosing without associated symptoms. When rechecked on D15, DLCO improved in 100% patients (6/6) despite continued dosing and standard dose escalation at D8. Patients unlikely to tolerate even this modest, short-lived change should consider shallower step-up dosing or alternative drugs. CyTOF analysis suggests levels of pretreatment neutrophils may be a biomarker for developing EOPEs. Clinical trial information: NCT03389399 .

scholarly journals Glucose Intolerance in Patients With Cystic Fibrosis: Sex-Based Differences in Clinical Score, Pulmonary Function, Radiograph Score, and 6-Minute Walk Test

2011 ◽  
Vol 56 (3) ◽  
pp. 290-297 ◽  
Author(s):  
B. Ziegler ◽  
C. L. Oliveira ◽  
P. M. E. Rovedder ◽  
S. J. Schuh ◽  
F. A. Abreu e Silva ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pulmonary Function ◽  
Glucose Intolerance ◽  
Clinical Score ◽  
Walk Test ◽  
6 Minute Walk Test ◽  
Minute Walk

scholarly journals Possibilities in short-term pulmonary rehabilitation in preoperative preparation of patients with lung cancer against the background of COPD

2021 ◽  
pp. 66-72
Author(s):  
N.A. Shefer ◽  
◽  
E.B. Topolnitskiy ◽  
E.S. Drozdov ◽  
G.Ts. Dambayev ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Surgical Treatment ◽  
Pulmonary Function ◽  
Pulmonary Rehabilitation ◽  
Walk Test ◽  
Physical Status ◽  
Short Term ◽  
6 Minute Walk Test ◽  
Functional Indices ◽  
Minute Walk

The aim of the study is to investigate the influence exerted by short-term outpatient pulmonary rehabilitation on functional indices and the course of the perioperative period for patients with lung cancer against the background of COPD Material and methods. According to the study design, lung cancer patients with planned surgical treatment were distributed between groups according to the COPD severity (stages II-IV). At the outpatient stage, evaluation of the pulmonary function and 6-minute walk test were performed. The results of the test and the functional indices were registered with further establishment of the pulmonary rehabilitation procedure complex for the patient. The exercises were performed at home and designed for the duration of two weeks. The complex included cycles of breathing, strength and aerobic exercises with individually adjusted intensity depending on the severity of clinical COPD manifestations and the baseline physical status. Upon completion of the training course, the patients underwent repeated spirometry and the 6-minute walk test. The results obtained were registered and analysed with subsequent surgical treatment of the patients. Results. Minimal changes in functional indices upon completion of the course were registered in patients with COPD stage II, which prevented achievement of statistical significance. Therewith, patients with COPD stages III and IV who had undergone the course of exercises were noted to show statistically reliable improvement of pulmonary function (FEV1) and improvement of the overall physical status, which is testified to by enhanced tolerance to externally imposed physical loads (p<0.01). Apart from that, decreased HR values (p<0.01)) growth of SpO2 values (p<0.01) and decreased shortness of breath (p<0.01) were registered in these groups after the 6-minute walk test. No statistically significant differences in relation to the number of postoperative complications or the term of in-hospital stay were revealed between the groups in the postoperative period. Conclusion. Performance of a pulmonary rehabilitation course during the preoperative period reliably improves functional indices in patients with COPD stage III and IV, which may be of crucial significance for determination of functional operability at the outpatient stage

Comparison of pulmonary function tests (PFTs) and 6-minute walk test (6MWT) in patients with lymphangioleiomyomatosis (LAM)

2020 ◽  
Author(s):  
Rémi Diesler ◽  
Vincent Cottin ◽  
Ségolène Turquier ◽  
Mouhamad Nasser ◽  
Kais Ahmad ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Pulmonary Function Tests ◽  
Walk Test ◽  
Function Tests ◽  
6 Minute Walk Test ◽  
Minute Walk

scholarly journals Association of Chronic Cough and Pulmonary Function With 6-Minute Walk Test Performance in HIV Infection

2014 ◽  
Vol 65 (5) ◽  
pp. 557-563 ◽  
Author(s):  
Monica Campo ◽  
Krisann K. Oursler ◽  
Laurence Huang ◽  
Matthew Bidwell Goetz ◽  
David Rimland ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Pulmonary Function ◽  
Test Performance ◽  
Chronic Cough ◽  
Walk Test ◽  
6 Minute Walk Test ◽  
Minute Walk

scholarly journals Higher Levels of Circulating Fibrocytes Are Associated with Lower Oxygen Saturation in Adults with Sickle Cell Disease

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 2710-2710
Author(s):  
Joshua J. Field ◽  
Borna Mehrad ◽  
Marie Burdick ◽  
Kaushik Shahir ◽  
Debora Nischik ◽  
...  
Keyword(s):  
High Resolution ◽  
Pulmonary Function ◽  
Oxygen Saturation ◽  
Lung Disease ◽  
Pulmonary Function Testing ◽  
Cell Disease ◽  
Lower Oxygen ◽  
Function Testing ◽  
Minute Walk ◽  
Circulating Fibrocytes

Abstract Background: In patients with sickle cell disease (SCD), tissue injury due to vaso-occlusion can result in fibrosis and organ dysfunction. Fibrocytes are circulating bone marrow-derived cells that can home to damaged organs, differentiate into fibroblasts and myofibroblasts and contribute to scarring. Fibrocytes have been implicated in the pathogenesis of pulmonary fibrosis in several animal models, including a mouse model of SCD. A preliminary study of patients with SCD suggests that the concentration of circulating fibrocytes is increased compared to controls. To build upon these findings, we tested the hypothesis that in adults with SCD higher levels of fibrocytes are associated with measures of lung disease. Methods: In a prospective cohort study of steady state adults with SCD, peripheral blood fibrocytes were measured and subjects underwent a pulmonary assessment that included pulmonary function tests, resting pulse oximetry, a 6-minute walk test, 2-D echocardiography, and high-resolution chest CT. A control group of healthy, African Americans also provided fibrocyte measurements and had pulmonary function testing. Fibrocytes were identified as collagen-1+ CD45+ cells using quantitative flow cytometry. For statistical analyses, fibrocyte values were log-transformed. Continuous and dichotomous variables were tested with Pearson’s correlation and Mann-Whitney U, respectively. Results: The cohort was comprised of 47 adults with SCD and 19 healthy African American controls. Sixty percent of the SCD subjects were HbSS or HbS-β-thalassemia0. Mean age (SD) of SCD cases was 35 years (±11) and 70% were female. Twenty-seven percent of SCD cases had asthma and 41% had a significant smoking history. Sixty-four percent of SCD cases had ground glass opacities on CT of the lung, 34% had bronchiectasis and 20% had evidence of pulmonary fibrosis. Compared to controls, patients with SCD had lower forced expiratory volume in 1 second (p<0.001), forced vital capacity (p<0.001), and pre- and post-bronchodilator 25-75% forced expiratory flow (FEF25-75%) (p=0.006). Fibrocyte levels also trended higher in patients with SCD compared to controls (median 1.2 x 106 vs. 8.5 x 105, p=0.07). Within patients with SCD, most fibrocytes expressed the chemokine receptor CXCR4 and smaller subsets expressed CCR2 or CCR7. Increased levels of fibrocytes in patients with SCD were associated with lower oxygen saturation (p=0.01) and higher reticulocyte counts (p=0.01). Lower oxygen saturation and higher reticulocyte counts were also associated with each other, independent of fibrocytes (p=0.007). Fibrocytes expressing CXCR4, a chemokine that mediates homing to the lungs, were associated with lower post-bronchodilator FEF25-75% (p=0.04). There was no association between fibrocyte levels and other measures of pulmonary function testing, degree of fibrosis on high-resolution CT, or abnormalities on 2-D echocardiogram or 6-minute walk. Conclusion: In adults with SCD, higher fibrocyte levels were associated with lower resting oxygen saturation and FEF25-75%, a measure of lung obstruction. Significant lung pathology was observed in a high percentage of SCD patients. The associations between fibrocyte levels, hypoxia and a measure of pulmonary dysfunction suggest that fibrocytes contribute to this lung disease. Higher reticulocyte counts in patients with increased fibrocytes may be due to the association of both reticulocyte count and fibrocyte level with hypoxia. Ongoing longitudinal studies may better define the relationship between fibrocytes and evolving lung disease. If additional evidence is found in these longitudinal studies, fibrocytes could be a therapeutic target to prevent chronic pulmonary disease in adults with SCD. Disclosures Field: NKTT: Consultancy, Research Funding. Strieter:Novartis: Employment.

scholarly journals Electromyographic Manifestations of Fatigue Correlate With Pulmonary Function, 6-Minute Walk Test, and Time to Exhaustion in COPD

2015 ◽  
Vol 60 (9) ◽  
pp. 1295-1302 ◽  
Author(s):  
G. Boccia ◽  
D. Dardanello ◽  
N. Rinaldo ◽  
G. Coratella ◽  
F. Schena ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Time To Exhaustion ◽  
Walk Test ◽  
6 Minute Walk Test ◽  
Minute Walk

scholarly journals Desaturation during Six-Minute Walk Testing Predicts Major Morbidity Following Anatomic Lung Resection among Patients with COPD

Healthcare ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 16
Author(s):  
Christopher Towe ◽  
Katherine Wu ◽  
Alina Khil ◽  
Yaron Perry ◽  
Stephanie Worrell ◽  
...  
Keyword(s):  
Lung Function ◽  
Pulmonary Function ◽  
Lung Resection ◽  
Multivariable Analysis ◽  
Pulmonary Function Testing ◽  
Oxygen Desaturation ◽  
Chronic Obstructive ◽  
Major Morbidity ◽  
Function Testing ◽  
Minute Walk

Background: Pulmonary function testing (PFT) is commonly used to risk-stratify patients prior to lung resection. Guidelines recommend that patients with reduced lung function, due to chronic lung conditions such as Chronic Obstructive Pulmonary Disease (COPD), should receive additional physiologic testing to determine fitness for resection. We reviewed our experience with six-minute walk testing (SMWT) to determine the association of test results and post-operative complications. Methods: Consecutive adult patients undergoing segmentectomy, lobectomy, bilobectomy or pneumonectomy between 1 January, 2007 and 1 January, 2017 were identified in a prospectively maintained database. Patients with poor lung function, as defined by percent predicted forced expiratory volume in 1 s (FEV1) or diffusion capacity of carbon monoxide (DLCO) ≤60%, had results of SMWT extracted from their chart. Association of test result to post-operative events was performed. Results: 581 patients had anatomic lung resections with predicted post-operative FEV1 or DLCO values ≤60%, consistent with a diagnosis of COPD. Among them, 50 (8.6%) had preoperative SMWT performed. Patients who received SMWT were more likely to have a FEV1 or DLCO less than 40 percent predicted (24/50 (48.0%) vs 166/531 (31.3%), p = 0.016). Post-operatively, patients who had SMWT performed had higher rates of pneumonia, but similar rates of major morbidity. The post-exercise oxygen saturation and the amount of desaturation correlated with the occurrence of major morbidity. In multivariable regression, oxygen desaturation was an independent risk factor for the occurrence of major morbidity, and desaturation was an excellent predictor of major morbidity by receiver operating characteristic curves analsysis. Conclusions: Among patients with elevated risk, oxygen desaturation during SMWT was independently associated with the occurence of major morbidity in multivariable analysis, while pulmonary function testing was not. SMWT is an important tool for risk-stratification, and may be underutilized.

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