Background Epidermal growth factor receptor (EGFR) mutations identify a unique biological subtype of non-small cell lung cancer (NSCLC). Treatment outcomes for EGFR-mutant locally advanced NSCLC patients have not been well-described. Methods We retrospectively examined outcomes after combined modality therapy including thoracic radiation therapy (RT) in 123 patients with locally advanced NSCLC and known EGFR mutation status. Outcomes were compared using Kaplan-Meier analysis, the log-rank test, and multivariate Cox regression models. Results All 123 patients underwent thoracic RT; 25% had tumors with EGFR mutations, and 94% had stage III disease. Overall 81% received chemotherapy concurrent with RT and 55% underwent surgical resection. With a median follow-up of 27.5 months, overall survival was significantly higher in patients with EGFR-mutant versus wild-type tumors (2-year estimate: 92.6% versus 69.0%; p=0.04). Two-year relapse-free survival (41.4% versus 35.8%; p=0.33) and distant recurrence rates (63.7% versus 61.7%; p=0.39) did not differ significantly by genotype. The 2-year locoregional recurrence rate (LRR) was significantly lower in EGFR-mutant versus wild-type patients (17.8% versus 41.7%; p=0.005). EGFR-mutant genotype was associated with decreased risk of LRR on multivariable analysis (HR=0.44; 95% CI, 0.19-1.00; p=0.05), but not OS, after adjusting for surgery and other potential confounders. Conclusion We observed that EGFR-mutant patients with locally advanced NSCLC treated with RT had lower rates of LRR than EGFR wild-type patients, raising the hypothesis that EGFR mutations may confer sensitivity to RT and/or chemotherapy. The association between mutation status and overall survival after combined modality therapy was less robust. Our data may serve as a useful baseline estimate of outcomes by EGFR genotype for future prospective studies.

Aims To determine the proportion of older medical patients who have an adverse drug event (ADE) during admission to hospital and assess the association with hospital length of stay (LOS). Methods A retrospective evaluation of eligible patients, aged greater than 65 years, consecutively admitted to a medical ward at the Royal Brisbane and Women's Hospital, Australia. Patient medication charts, medical notes and laboratory results were reviewed using an ADE trigger tool to identify potential ADEs during admission. A clinical panel examined and confirmed any true ADEs and the corresponding causative agents. LOS was compared between patients who did and did not have an ADE. Results A total of 164 patients were recruited over 30 days. The trigger tool identified a total of 69 triggers from 40 patients (24.3%) with a potential ADE during admission, of which 12 patients (7.3%) had a true ADE. The main drug categories implicated included cardiovascular, anti‐infective and haematological agents. The group of patients with an ADE had a longer median (25th, 75th percentile) LOS when compared to patients without an ADE: 6.5 (3.75, 11) versus 4 (2, 7) days (p = 0.043). Conclusion Approximately 7% of older in‐patients experience an ADE, which has a significant association with an increase in their LOS. To minimise patient harm, undesirable high‐risk drugs should be avoided and vigilant monitoring must occur if they need to be prescribed. An adequately powered, multi‐site study is required and preventative strategies should be further explored.

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