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
51P - Enhancing the anti-breast tumour activity of STING through a novel sting transcriptional regulator
Presenter: Hanchu Xiong
Session: Poster display session
Resources:
Abstract
52P - Reverse Warburg effect-related mitochondrial activity and 18F-FDG uptake in invasive ductal carcinoma
Presenter: Byung Wook Choi
Session: Poster display session
Resources:
Abstract
53P - Phase II study of atorvastatin in combination with radiotherapy and temozolomide in patients with glioblastoma (ART): Final analysis report
Presenter: Abdullah Altwairgi
Session: Poster display session
Resources:
Abstract
54P - Association between Parkinson’s disease and brain tumours: A nationwide population-based cohort study
Presenter: Joo-hyun Park
Session: Poster display session
Resources:
Abstract
55P - Toxicity profiles of treatment with modern fractionated radiotherapy, contemporary stereotactic radiosurgery, or transsphenoidal surgery in non-functioning pituitary macroadenoma
Presenter: Kevin Sheng-Po Yuan
Session: Poster display session
Resources:
Abstract
56P - Hippocampal avoidance in WBRT for metastases: Comparative neurocognitive and dosimetric assessment
Presenter: Vibhay Pareek
Session: Poster display session
Resources:
Abstract
57P - Multidisciplinary brain metastasis clinic: Is it effective and worthwhile?
Presenter: Annu Rajpurohit
Session: Poster display session
Resources:
Abstract
58P - Functional status as a determinant prognostic factor for overall survival in adult patients with medulloblastoma treated with chemotherapy and radiotherapy
Presenter: Juan Ayala Alvarez
Session: Poster display session
Resources:
Abstract
59P - Pattern of care in high-grade gliomas after recurrence
Presenter: Nandini Menon
Session: Poster display session
Resources:
Abstract
60P - Five fractions plus “SRS” boost combined with temozolamide for newly diagnosed and recurrent glioblastoma multiforme (GBM)
Presenter: Azhar Rashid
Session: Poster display session
Resources:
Abstract