448P - Prevalence of thyroid dysfunction, diabetes, and impact of palliative chemotherapy in advanced metastatic cancer patients: Prospective data from LMIC

Background

Globally, about 27% of people over 65 years and 8-18% of cancer patients have diabetes(DM). They share certain risk factors (e.g., smoking, obesity, etc.) which might contribute to their associations. Likewise, thyroid disorders(TD) are potentially common around 11% incidence in India. Recent evidence suggests various late complications in cancer survivors; among them, DM and TD often remain neglected. There is a paucity of data for adult survivors, especially in the Indian/LMIC context. This study is valuable for determining how cancer and cancer-directed therapy are related to endocrine disorders, thus guiding us in planning optimum cancer therapeutics.

Methods

Histopathological proven advanced metastatic cancer patients (n=100) visiting AIIMS Rishikesh who had not received prior systemic treatment were enrolled in a prospective observational study. Participants received standard cancer-directed therapy and studied their endocrine profile before and after 3month of therapy. Breast cancer patients were not included in the study.

Results

This study included a total of 100 patients, 51% males and 49% females. Ovary (31%), lung (23%), and urinary bladder (11%) were the most common sites. The majority received Paclitaxel /Carboplatin (34%) and Capecitabine-Oxaliplatin (11%). Initial prevalence of DM and hypothyroidism was 6% and 10%, respectively. About 12% had prediabetes which did not worsen even after prolonged use of steroids as an adjunct to chemotherapy. Also, in the study population, the incidence of new-onset DM and hypothyroidism after therapy was 2% and 3%.

Conclusions

Screening for DM and TD should be routinely practiced to improve life quality in cancer survivors. The adjunct steroids might improve treatment tolerance and compliance by reducing therapy-related side effects, but new-onset DM incidence was not increased. Further larger-scale studies are warranted to establish an association of endocrine disorders with cancer and their implications on cancer therapy as well as survivorship.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.