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Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

2069 - The concordance with antiemetic guideline for pediatric, adolescent and young adult patients with cancer using a large-scale administrative database.

Date

22 Oct 2018

Session

Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

Presenters

Seiko Bun

Citation

Annals of Oncology (2018) 29 (suppl_8): viii603-viii640. 10.1093/annonc/mdy300

Authors

S. Bun1, S. Kunisawa2, N. Sasaki2, K. Fushimi3, K. Matsumoto4, A. Yamatani5, Y. Imanaka2

Author affiliations

  • 1 Healthcare Economics And Quality Management, Kyoto Univercity, 606-8501 - Kyoto/JP
  • 2 Healthcare Economics And Quality Management, Kyoto Univercity, Kyoto/JP
  • 3 Health Policy And Informatics Section, Tokyo Medical and Dental University Graduate School, Tokyo/JP
  • 4 Children's Cancer Center, National Center for Child Health and Development, 157-8535 - Tokyo/JP
  • 5 Pharmacy, National Center for Child Health and Development, 157-8535 - Tokyo/JP
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Resources

Abstract 2069

Background

In the field of adult patients, the risk factors for discordance with antiemetic guideline (GL) are reported to be hematological malignancy, older age, and the use of low emetic risk chemotherapy. However, there are scarce reports in the field of pediatric or adolescent and young adult (AYA) patients. Therefore, we assessed the concordance with antiemetic GL in the field of pediatric and AYA patients who received chemotherapy.

Methods

Using the Diagnosis Procedure Combination system in Japan, we identified patients with cancer aged 30 years or younger from July 2010 to March 2016. Patients’ data included age, gender, diagnosis, anticancer drugs, and antiemetic drugs. We assessed the concordance with antiemetic GL of ASCO in patients of each emetic risk category. Furthermore, we assessed the risk factors for discordance with antiemetic GL, using logistic regression.

Results

A total of 21,106 patients who underwent chemotherapy were included. We classified patients into the following 6 age categories: 0-2 yo (n = 2,480), 3-5 yo (n = 1,983), 6-11 yo (n = 2,782), 12-17yo (n = 3,495), 18-23 yo (n = 3,941) and 24-29 yo (n = 6,425). The median age was 16 (0-29) years old. The rate of concordance with GL in each emetic risk category was 18.2% in high risk (18 yo >, n = 2,531), 51.1% in high risk (18 yo ≤, n = 4130), 32.1% in moderate risk (n = 7,188), 52.0% in low risk (n = 5,806), and 51.6% in minimum risk (n = 1,451). In multivariate analysis, risk factors for discordance with antiemetic GL were high emetic risk chemotherapy, lower age (0-2 yo), hematological malignancies, and brain tumor.Table: 1802P

Risk factors for discordance with antiemetic guideline

Odd ratio95% CIP Value
Age category0-2 yo1.711.55-1.89<0.05
3-5 yo1.161.04-1.29<0.05
6-11 yo1.121.02-1.24<0.05
12-17yo1.491.37-1.63<0.05
18-23 yo1.131.04-1.23<0.05
Emetic risk categoryHigh2.272.0-2.55<0.05
Moderate1.431.27-1.60<0.05
Low0.980.87-1.110.79
Diseasenon-malignancy0.750.52-1.110.15
Brain tumor1.461.31-1.62<0.05
Hematorogical malignancy1.281.20-1.37<0.05
Breast cancer0.530.42-0.67<0.05
Ovarian/Cervical cancer0.390.34-0.44<0.05

Conclusions

Our study identified substantial room for improvement in antiemetic practice and risk factors for discordance with antiemetic GL in pediatric and AYA patients. These identified risks are different from those in adult patients. Further investigation of the causes of this discordance is warranted, especially considering the unique background of this field.

Clinical trial identification

Legal entity responsible for the study

Kyoto University.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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