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The impact on comorbidities in deciding the dose for the first
cycle of chemotherapy
Esther Una Cidon
Royal Bournemouth Hospital, UK
OBJECTIVES
METHODS
The treatment of patients
with
cancer
and
comorbidities could be
challenging as these
patients
are
not
represented in clinical
trials. We carried out a
study to evaluate the
relevance
of
the
comorbidities in deciding
the first cycle dose of
chemotherapy and the
patients’ tolerance and
compliance.
We included cancer patients who had at least two
different comorbidities and at least one involving
main organs such as respiratory, cardiac, liver,
cerebrovascular or renal comorbidities. All the
patients included were about to start a first line of
palliative chemotherapy for metastatic colorectal
cancer.
RESULTS
We studied 562 patients who met the inclusion criteria. 395 men / 167
women. 402 older than 65 years. The use of chemotherapy was
modified either in the number of drugs administered or in the schedule
or dosage for the first cycle. Most of these patients received only
monotherapy (59%) and those who received a combination of drugs
received a dose reduction of each drug by 20% if the comorbidities
were under control or by 50% if they were impacting on daily activities.
Generally the tolerance was acceptable with low rate of grade 3
toxicities (8%) especially thrombocytopenia, neutropenia, fatigue,
diarrhoea or mucositis.
In those patients who did not experience any toxicity grade 2 or above,
the dose was increase one step (20-25%) for the second cycle
onwards. By using this method we did achieve good compliance with
the treatment.
We will continue evaluating the PFS and OS in this population.
CONCLUSIONS
18WCGIC
Chemotherapy use and compliance among cancer patients with comorbidities are generally
inferior to healthy population due to the expected toxicities. This could impact on survival.
However, if the compliance is improved, this might have a positive impact on patients’
survival. Our study suggests that by using the first cycle dose reduced chemotherapy and
then reassessing again we have kept compliance. We need further studies to evaluate if this
has got an impact on survival.
195--P
Clinical Other
Esther Una
DOI: 10.3252/pso.eu.18wgic.2016
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