Abstract 425P
Background
Palonosetron (PALO) is a second-generation 5-hydroxytryptamine 3 receptor antagonist (5HT3RA) that has shown better efficacy than first-generation 5HT3RA (granisetron; GRA) in preventing chemotherapy-induced nausea and vomiting (CINV). PALO is usually administrated repeatedly when the patients have no nausea even though it is expensive as compared with GRA. However, we could reduce medical costs for chemotherapy if 5HT3RA conversion from PALO to GRA in the patient without having CINV is safe and tolerable.
Methods
We prospectively investigated patients receiving highly or moderately emetogenic chemotherapy (HEC or MEC) in combination with PALO for digestive organ cancers in accordance with guideline of Japan Society of Clinical Oncology. Patients assessed as complete response (CR) during the acute phase (0-24 h postchemotherapy) and the delayed phase (24-120 h postchemotherapy) in consecutive treatments were converted their antiemetic agents from PALO to GRA. We evaluated the incidence of CINV and the cost-effectiveness.
Results
Thirty five cases (madian age 73 years, female 51.4%, 18; pancreatic cancer, 8; colorectal cancer, 3; esophageal cancer, 3; gastric cancer, 3; biliary tract cancer) were enrolled at our institution between January 2018 and June 2019. Ten cases were administrated HEC (HEC group) and 25 cases were administrated MEC (MEC group). One case of HEC group and 2 cases of MEC group changed their chemotherapy regimens due to adverse events and progression of disease. Four cases of HEC group (40.0%) and 14 cases of MEC group (56.0%) were assessed as CR in consecutive treatments, thereafter their antiemetic agents were converted from PALO to GRA in the subsequent treatments. All of them continued their chemotherapy without the incidence of nausea and vomiting. Among the cases assessed as CR, we could save 111,935 Japanese yen (1,034.6 USD, range, 13,868-194,152 JPY) per case by conversion of 5HT3RA.
Conclusions
Our data indicated that the conversion of 5HT3RA is safe and also provide economic benefit in patients receiving HEC or MEC. When patients receiving HEC or MEC with PALO were assessed as CR, we should consider conversion of 5HT3RA.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Asahikawa medical University.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
490P - Outcomes of sequential epidermal growth factor receptor tyrosine (EGFR) tyrosine kinase inhibitor (TKI) therapy in patients with advanced non-small cell lung carcinoma (NSCLC)- a real-world institutional experience
Presenter: Yvonne Ang
Session: Poster display session
Resources:
Abstract
498P - An observational retrospective study to evaluate the incidence of acquired EGFR T790M resistance in NSCLC patients with EGFR mutation following progression after at least one prior EGFR TKI treatment in Taiwan: ARISE study
Presenter: Shang-gin Wu
Session: Poster display session
Resources:
Abstract
501P - Clinical characteristics and efficacy in non-small cell lung cancer patients with EGFR exon 20 insertion and EGFR amplification
Presenter: Xin Gao
Session: Poster display session
Resources:
Abstract
502P - Epidermal growth factor receptor tyrosine kinase inhibitor treatment response in advanced non-small cell lung cancer with uncommon mutations: A multicenter observational study
Presenter: Masaki Kanazu
Session: Poster display session
Resources:
Abstract
482P - Interim analysis from a phase IIIb, open-label study of afatinib in EGFR TKI-naïve patients (pts) with EGFR mutation-positive (EGFRm+) NSCLC
Presenter: Filippo De Marinis
Session: Poster display session
Resources:
Abstract
483P - A phase IIIb, open-label study of afatinib in EGFR TKI-naïve patients with EGFR mutation-positive NSCLC: A biomarker analysis
Presenter: Rafael Rosell
Session: Poster display session
Resources:
Abstract
484P - Activity of afatinib in patients (pts) with EGFR mutation-positive (EGFRm+) NSCLC and baseline brain metastases: Pooled analysis of three large phase IIIb trials
Presenter: Maya Gottfried
Session: Poster display session
Resources:
Abstract
491P - Clinical outcomes of leptomeningeal metastases in EGFR-mutant lung adenocarcinoma
Presenter: Chia-I Shen
Session: Poster display session
Resources:
Abstract
510P - Paclitaxel as continuation maintenance therapy in patients with advanced non-small cell lung cancer
Presenter: Suzy Gohar
Session: Poster display session
Resources:
Abstract
496P - Higher osimertinib introduction rate achieved by multiple repeated re-biopsy after acquired resistance to first/second generation EGFR-TKIs
Presenter: Taira Ninomaru
Session: Poster display session
Resources:
Abstract