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
397P - Development of prediction model for hepatocellular carcinoma in chronic hepatitis B patients
Presenter: Teerapat Ungtrakul
Session: Poster display session
Resources:
Abstract
398P - Planning for future cancer control programs in Uganda: Projections of top five cancers’ incidence in the next decade
Presenter: Judith Asasira
Session: Poster display session
Resources:
Abstract
399P - Prevalence of colorectal cancer risk factors in apparently healthy adults in Suluhan Village, Bali
Presenter: Cindy Trisina
Session: Poster display session
Resources:
Abstract
400P - Female lung cancer: Emerging issue in Bangladesh
Presenter: Muhammad Rafiqul Islam
Session: Poster display session
Resources:
Abstract
402P - Work-related outcomes among cancer survivors in Singapore
Presenter: Chia Jie Tan
Session: Poster display session
Resources:
Abstract
407P - Focal treatments for metastatic soft tissue sarcoma (mSTS) is associated with improved overall survival
Presenter: Ching Tso Chen
Session: Poster display session
Resources:
Abstract
408P - The Asian sarcoma consortium sarcoma preceptorship program: A program evaluation study utilizing the Kirkpatrick model (Level 1 and 2)
Presenter: Fernando Gracieux Jr.
Session: Poster display session
Resources:
Abstract
409P - Integrated genomic and transcriptomic analysis revealed mutagenic patterns of dedifferentiated liposarcoma and leiomyosarcoma in Chinese patients
Presenter: Yuhong Zhou
Session: Poster display session
Resources:
Abstract
410P - Treatment patterns and outcomes of elderly patients with metastatic soft tissue sarcomas (mSTS)
Presenter: Yu-ju Kuo
Session: Poster display session
Resources:
Abstract
411P - Comparative analysis of protein profiles of prognosis-associated proteins and KIT-related proteins in gastrointestinal stromal tumour
Presenter: Yoshiyuki Suehara
Session: Poster display session
Resources:
Abstract