1444P - Sarcopenia and acute severe toxicity in sarcoma patients treated with doxorubicin-based chemotherapy

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Complications of Treatment
Supportive Care
Sarcoma
Presenter Aurelie Comte
Citation Annals of Oncology (2014) 25 (suppl_4): iv494-iv510. 10.1093/annonc/mdu354
Authors A. Comte1, O. Huillard2, D. Biau3, A. Babinet3, J. Durand2, V. Dumaine3, F. Larousserie4, V. Audard4, J. Alexandre2, P. Anract3, F. Goldwasser2, P. Boudou Rouquette2
  • 1Medical Oncology Service, Hopital European George Pompidou, 75015 - Paris/FR
  • 2Medical Oncology, Cochin-Port Royal, 75679 - Paris/FR
  • 3Orthopedic Surgery, Cochin, 75679 - Paris/FR
  • 4Pathology, Cochin, 75679 - Paris/FR

Abstract

Aim

Lean body mass (LBM) better than body surface area (BSA), predicts epirubicin's clearance and its toxicity in breast cancer patients (pts) (Prado et al, 2010). Since the dose-intensity of anthracycline-based chemotherapy may be critical in sarcoma pts, we studied whether sarcopenia was associated with the occurrence of acute severe toxicity (AT) in this population.

Methods

Sarcoma pts treated with doxorubicin-based chemotherapy and having a CT scan at the 3rd lumbar vertebrae prior chemotherapy were selected. Skeletal muscle cross-sectional area were measured and sarcopenia was defined using standardized thresholds (Antoun et al, 2010.). Acute severe toxicity was defined as any grade 4 toxicity or febrile neutropenia (FN) or grade≥3 gastrointestinal (GI) toxicity, according to the NCI-CTC occurring at 1st cycle. Sarcopenic and non-sarcopenic pts were compared (χ-2 test or Fischer's exact test for qualitative data).

Results

42 consecutive soft tissue (n=24; 57%) and bone sarcoma (n=18; 43%) pts were eligible (57.1% males, median age 48yrs, range 22-68), and received a median doxorubicin dose of 112 mg at first cycle (range 84-148). 24 pts (57.1%) were sarcopenic at baseline. 13 (54%) of the sarcopenic patients had a normal body mass index (BMI), 11 (46%) were overweight. During the first cycle, AT were hematologic (11 pts 26.2%), FN (8 pts 19.0%), and GI toxicity (6 pts 14.3%). Sarcopenic pts had significantly more ATs (11/24 versus 3/18, p=0.04), more grade 4 hematotoxicity (9/24 versus 2/18, p=0.05), more FN (7/24 versus 1/18, p=0.05). Pts with sarcopenia and BMI< 25 kg/m2 experienced significantly more grade ≥3 GI toxicity (4/13 versus 2/29, p=0.04).

Conclusions

The evaluation of sarcopenia prior to doxorubicin-based chemotherapy in sarcoma patients identifies patients with high-risk of acute toxicity.

Disclosure

All authors have declared no conflicts of interest.