Abstract 1923
Background
OUTBACK is testing the addition of 4 cycles of adjuvant carboplatin/paclitaxel chemotherapy (chemo) after definitive chemoradiation in locally advanced cervix cancer. We aimed to determine characteristics associated with not starting randomly assigned adjuvant chemo.
Methods
We assessed associations between not starting assigned adjuvant chemo and baseline characteristics of: age; race; country; smoking status; ECOG; BMI; FIGO stage; node involvement; and participants’ self-rated physical, role, emotional, cognitive, social functional status, and financial difficulties (by EORTC QLQ-C30). We also assessed for associations with completion of chemoradiation and grade 3-4 toxicities during chemoradiation. Odds ratios (OR), p-values, and 95% confidence intervals (CI) were calculated with univariable and multivariable logistic regression analyses.
Results
Adjuvant chemo was not started in 105 of 463 (23%) women randomly assigned to receive it. Predictors of not starting adjuvant chemo with a p-value of < 0.05 in univariable analyses, and their effects in multivariable analysis are shown in the table. The odds of not starting chemo were approximately doubled in non-Caucasian women, and those aged >/= 60, even after accounting for other factors.
Conclusions
Adjuvant chemo was less likely to be started in non-Caucasian women, those aged >/= 60, and those with poor self-rated physical function. Further research is required to understand the causes, implications, and methods for mitigating these disparities.
Clinical trial identification
ACTRN12610000732088.
Editorial acknowledgement
Legal entity responsible for the study
University of Sydney.
Funding
National Health and Medical Research Council. In addition, Hospira provided paclitaxel treatment for Australian and New Zealand patients in the study.
Disclosure
L. Mileshkin: Research grant / Funding (self), Provided supply of Paclitaxel for trial patients in Australia and New Zealand: Hospira; Travel / Accommodation / Expenses: Beigene; Travel / Accommodation / Expenses: Roche. K.N. Moore: Advisory / Consultancy, Research grant / Funding (institution): AstraZeneca; Advisory / Consultancy, Research grant / Funding (institution): Clovis; Advisory / Consultancy, Research grant / Funding (institution): Immunogen; Advisory / Consultancy, Research grant / Funding (institution): Tesaro; Advisory / Consultancy: Pfizer; Advisory / Consultancy, Research grant / Funding (self): Merck; Advisory / Consultancy: Aravive; Advisory / Consultancy, Research grant / Funding (institution): OncoMed; Advisory / Consultancy: Samumed; Advisory / Consultancy: Eisai; Advisory / Consultancy, Research grant / Funding (institution): Genentech/Roche; Advisory / Consultancy: Janssen; Advisory / Consultancy: Cue; Research grant / Funding (self): Lilly; Research grant / Funding (self): PTC Therapeutics; Research grant / Funding (institution): Regeneron; Research grant / Funding (institution): Agenus. K. Sjoquist: Advisory / Consultancy, Research grant / Funding (institution): Pfizer; Advisory / Consultancy, Research grant / Funding (institution): Merck; Advisory / Consultancy: Servier; Advisory / Consultancy, Travel / Accommodation / Expenses: Amgen; Travel / Accommodation / Expenses: Ipsen; Research grant / Funding (institution): AstraZeneca; Research grant / Funding (institution): Astellas; Research grant / Funding (institution): Bayer; Research grant / Funding (institution): BMS; Research grant / Funding (institution): Bionomics; Research grant / Funding (institution): Celgene; Research grant / Funding (institution): Medivation; Research grant / Funding (institution): Sanofi; Research grant / Funding (institution): Tilray. W. Small: Honoraria (self), Travel / Accommodation / Expenses: Zeiss; Advisory / Consultancy: Merck. S. Thompson: Honoraria (self): Mevion Medical Systems. W. Huh: Honoraria (self): Antiva; Advisory / Consultancy: Inovio. P.A. Disilvestro: Advisory / Consultancy, Research grant / Funding (institution): AstraZeneca; Advisory / Consultancy, Research grant / Funding (institution): Tesaro; Research grant / Funding (institution): Immunogen; Research grant / Funding (institution): Genentech; Research grant / Funding (institution): AbbVie; Research grant / Funding (institution): Syros; Research grant / Funding (institution): Janssen. D. Rischin: Advisory / Consultancy, Research grant / Funding (institution), Uncompensated: MSD; Advisory / Consultancy, Research grant / Funding (institution), Uncompensated: Regeneron; Advisory / Consultancy, Research grant / Funding (institution), Uncompensated: GSK; Advisory / Consultancy, Research grant / Funding (institution), Uncompensated: BMS; Research grant / Funding (institution): Roche. M.R. Stockler: Research grant / Funding (institution): Astellas; Research grant / Funding (institution): AstraZeneca; Research grant / Funding (institution): Bayer; Research grant / Funding (institution): BMS; Research grant / Funding (institution): Bionomics; Research grant / Funding (institution): Celgene; Research grant / Funding (institution): Medivation; Research grant / Funding (institution): Merck; Research grant / Funding (institution): Pfizer; Research grant / Funding (institution): Sanofi; Research grant / Funding (institution): Tilray. B.J. Monk: Advisory / Consultancy: AbbVie; Advisory / Consultancy: Advaxis; Advisory / Consultancy: Agenus; Advisory / Consultancy: Amgen; Honoraria (self), Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: ChemoCare; Advisory / Consultancy: ChemoID; Honoraria (self), Advisory / Consultancy: Clovis; Advisory / Consultancy: Conjupro; Advisory / Consultancy: Esaias; Advisory / Consultancy: Geistlich; Advisory / Consultancy: Genmab; Advisory / Consultancy: Immunogen; Advisory / Consultancy: Immunomedics; Advisory / Consultancy: Incyte; Honoraria (self), Advisory / Consultancy: Janssen/Johnson & Johnson; Advisory / Consultancy: Merck; Advisory / Consultancy: Myriad; Honoraria (self), Advisory / Consultancy: Roche/Genentech; Honoraria (self), Advisory / Consultancy: Tesaro. All other authors have declared no conflicts of interest.Table: 1052P
Characteristic | Value | Adjuvant chemo not started/ assigned: N (%) | Univariable OR (95% CI) | Univariable p-value | Multivariable OR (95% CI) | Multivariable p-value |
---|---|---|---|---|---|---|
Age | >/= 60 < 60 | 24/70 (34%) 81 / 393 (21%) | 2.01 (1.2-3.5) | 0.01 | 2.30 (1.10-4.81) | 0.026 |
Race | Other White/Caucasian | 43/127 (34%) 62/336 (18%) | 2.26 (1.4–3.6) | 0.0005 | 2.11 (1.13-3.96) | 0.019 |
Nodes involved | Yes No/unknown | 42/225 (19%) 63/238 (26%) | 0.64 (0.4–0.99) | 0.046 | 0.75 (0.42-1.35) | 0.34 |
QLQ-C30 Physical Function | Worst 33.37% Best 66.67% | 5/11 (45%) 59/310 (19%) | 3.55 (1.05–12.0) | 0.04 | 3.66 (1.03-13) | 0.045 |
Chemoradiation | Not completed Completed | 46/114 (40%) 59/349 (17%) | 3.33 (2.01–5.3) | <0.0001 | 3.21 (1.75-5.88) | 0.0002 |
Resources from the same session
1058 - Assessment of CPS+EG, Neo-Bioscore and modified Neo-Bioscore in breast cancer patients treated with preoperative systemic therapy: a multicenter cohort study
Presenter: LING XU
Session: Poster Display session 2
Resources:
Abstract
1156 - The concordance of treatment decision guided by Oncotype and the PREDICT tool in early stage breast cancer
Presenter: Hadar Goldvaser
Session: Poster Display session 2
Resources:
Abstract
3447 - Influence of first treatment delay on survival among breast cancer subtypes
Presenter: Irene Zarcos Pedrinaci
Session: Poster Display session 2
Resources:
Abstract
3505 - Clinical features of early-stage (I-III) triple-negative breast cancer (TNBC) patients with tumors exhibiting low-overall change in molecular profile after neoadjuvant therapy.
Presenter: Nour Abuhadra
Session: Poster Display session 2
Resources:
Abstract
5442 - Meta-analysis in HER2+ early breast cancer therapies and cost-effectiveness in a Brazilian perspective
Presenter: Marcos Magalhaes
Session: Poster Display session 2
Resources:
Abstract
1570 - Anti-mullerian hormone (AMH) levels and antral follicle counts (AFC) may predict ovarian reserves before systemic chemotherapy (SC) in women with breast cancer(BC); a prospective clinical study
Presenter: Cetin Ordu
Session: Poster Display session 2
Resources:
Abstract
2698 - Prognosis of selected triple negative apocrine breast cancer patients who did not receive adjuvant chemotherapy.
Presenter: Giuseppe Cancello
Session: Poster Display session 2
Resources:
Abstract
3104 - Novel Blood Based Circulating Tumor Cell Biomarker For Breast Cancer Detection
Presenter: Chun-Yu Liu
Session: Poster Display session 2
Resources:
Abstract
4631 - Multi-Gene Prognostic Signatures and Prediction of Pathological Complete Response of ER-Positive HER2-Negative Breast Cancer Patients to Neo-Adjuvant Chemotherapy
Presenter: Claudia Mazo
Session: Poster Display session 2
Resources:
Abstract
4632 - Impact of menopause status on breast cancer outcomes and amenorrhea incidence during adjuvant tailored dose dense chemotherapy
Presenter: Andri Papakonstantinou
Session: Poster Display session 2
Resources:
Abstract