Abstract 358P
Background
Capecitabine (CapX) monotherapy is often employed as a second/third line regimen for various malignancies in the metastatic setting. The use of radical doses of CapX in the palliative setting entails severe toxicities which makes it incompatible with the principles of palliative care. It was a local policy to offer each patient eligible for palliative CapX monotherapy the choice of a standard dose (StD) approach (1-1.25g/m2 bid on Days 1-14 of a 21 day cycle) or a continuous low dose (CLD) approach (0.5g bid daily without a break). Patients were provided information about each regimen's toxicity and efficacy. We recognized a unique retrospective opportunity to compare StD versus CLD.
Methods
After alteast one prior line of chemotherapy, 52 & 44 patients had received CapX monotherapy with StD & CLD, respectively between march 2013 & August 2016 for metastatic malignancies of the gall bladder, pancreas and stomach. Differences in toxicities/discontinuations were assessed by the Fisher Exact Test. For each patient, the date of initiation of CapX, the date of progression and the date of death were noted. The differences in survival outcomes between the two groups was assessed by the Mann Whitney U test.
Results
The incidence of Grade>2 toxicity was significantly higher in the StD compared to the CLD group (68% vs. 3.8%; p < 0.0001). Discontinuations were significantly higher in the StD compared to the CLD group (41% vs. 3.8%; p < 0.0001). The median PFS after initiation of CapX was higher in the CLD than the StD group (123 vs 106 days; z score 2.24, p 0.0251). The median OS after initiation of CapX was higher in the CLD than the StD group (199 vs 166 days; z score 1.98, p 0.047).
Conclusions
While lower toxicities and discontinuation rates were expected in the CLD arm, it was very surprising that survival outcomes too were better in the CLD group. In addition to possible pharmacodynamic advantages of the CLD approach, the better outcomes could also be attributed to better tolerability when compared to the StD approach. Further research would be worthwhile as it could potentially help spare future patients from toxicity while improving efficacy.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Swami Rama Cancer Hospital & Research Institute.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
381P - XKR8 is a promising potential prognostic marker in glioblastoma multiforme patients
Presenter: Kristina Havrysh
Session: Poster display session
Resources:
Abstract
383P - Screening of prognostic molecular biomarker for resectable pancreatic cancer
Presenter: Yonggang Peng
Session: Poster display session
Resources:
Abstract
384P - Prevalence of abnormal microsatellite instability test among ovary and endometrial cancer patients
Presenter: Min Kyu Kim
Session: Poster display session
Resources:
Abstract
385P - Identifying CASP8 polymorphisms associated with breast cancer risk in an Iranian population
Presenter: Alireza Pasdar
Session: Poster display session
Resources:
Abstract
386P - Unusual folding of NaPi2b transporter extramembrane domain 4 during malignant transformation
Presenter: Leysan Minigulova
Session: Poster display session
Resources:
Abstract
387P - 5-years conditional disease free survival and overall survival for breast cancer patients in South Korea
Presenter: Jee hyun Ahn
Session: Poster display session
Resources:
Abstract
388P - To identify circulating tumour cells by machine learning approach
Presenter: Yuebin Liang
Session: Poster display session
Resources:
Abstract
389P - The establishment of patient-derived organoid models and drug response of resectable non-small cell lung cancer
Presenter: Jing-Hua Chen
Session: Poster display session
Resources:
Abstract
395P - Filipinos and lung cancer: An infodemiological assessment using Google trends from 2009 to 2019
Presenter: Lance Isidore Catedral
Session: Poster display session
Resources:
Abstract
396P - Determinants of visiting a referral hospital for cervical cancer screening at Uganda Cancer Institute
Presenter: Collins Mpamani
Session: Poster display session
Resources:
Abstract