Abstract 32P
Background
International guidelines recommend a combination of NK1, 5-HT3 receptor antagonists, and dexamethasone (DEX) as standard antiemetic therapy for patients treated with a doxorubicin and cyclophosphamide (AC) regimen. However, DEX has been associated with several side effects, including diabetes, osteoporosis, and immunosuppression. Additionally, pneumocystis pneumonia, a rare but fatal condition, has been reported, predominantly in patients undergoing the dose-dense AC (ddAC) regimen.
Methods
We recruited 30 patients with Stage I-III breast cancer who received the ddAC regimen. Patients were administered prophylactic olanzapine (OLZ) 5 mg/day on days 1 to 4 in addition to the standard three-drug combination antiemetic regimen, with DEX omitted on days 2 and 3. Nausea/vomiting and drowsiness were evaluated using a 4-point Likert scale questionnaire previously employed in the J-FORCE study, which assessed the efficacy of OLZ 5 mg in high-emetic-risk regimens. The primary endpoint was complete response (CR) rate in the delayed phase (24-120 hours post chemotherapy administration) of the first cycle. Secondary endpoints included the total control (TC) rate of nausea and vomiting, complete control (CC) rate, degree of daytime sleepiness, and quality of life as assessed by EORTC QLQ-C30 Ver.3.
Results
Among the participants, 22 patients (73%) received ddAC as neoadjuvant chemotherapy and 8 (27%) as adjuvant chemotherapy. Median age at the start of treatment was 56 years. CR rates were 73% and 63% in the acute and delayed periods, respectively. TC and CC rates in the acute period were 60% and 73%, whereas those in the delayed period were 36.6% and 63%, respectively. In both periods, 40% of patients experienced moderate or severe sleepiness. Mean scale scores for nausea on the EORTC QLQ-C30 remained within the Minimally Important Difference score level throughout the 4th cycles of treatment.
Conclusions
This prospective pilot study suggests that the addition of OLZ 5mg allows the omission of steroids without a worsening of CINV in patients with ddAC.
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.
Resources from the same session
602P - COLUMBUS 7-year update: A randomized, open-label, phase III trial of encorafenib (Enco) + binimetinib (Bini) vs vemurafenib (Vemu) or Enco in patients (Pts) with BRAF V600-mutant melanoma
Presenter: Andrew Haydon
Session: Poster Display
Resources:
Abstract
603P - An individualised postoperative radiological surveillance schedule for IDH-wildtype glioblastoma patients (HK-GBM Registry)
Presenter: Jason Chak Yan Li
Session: Poster Display
Resources:
Abstract
604P - Cabozantinib versus placebo in patients with radioiodine-refractory differentiated thyroid cancer who progressed after prior VEGFR-targeted therapy: Outcomes from COSMIC-311 by BRAF status
Presenter: Marcia Brose
Session: Poster Display
Resources:
Abstract
606P - BRAF and NRAS mutations are associated with poor prognosis in Asians with acral-lentiginous and nodular cutaneous melanoma
Presenter: Sumadi Lukman Anwar
Session: Poster Display
Resources:
Abstract
607P - Single institutional outcomes of radiotherapy and systemic therapy for melanoma brain metastases in Japan
Presenter: Naoya Yamazaki
Session: Poster Display
Resources:
Abstract
608P - The efficacy of immune checkpoint inhibitors and targeted therapy in mucosal melanomas: A systematic review and meta-analysis
Presenter: Andrea Teo
Session: Poster Display
Resources:
Abstract
609P - The association between thyroid function abnormalities and vitiligo induced by pembrolizumab regarding prognosis in patients with advanced melanoma
Presenter: Moez Mobarek
Session: Poster Display
Resources:
Abstract
610P - Analyzing the clinical benefit of the evidence presented at these congresses and utilizing a standardized scale to quantify it will significantly enhance our understanding of the studies showcased, allowing for more objective evaluation and interpretation
Presenter: Charles Jeffrey Tan
Session: Poster Display
Resources:
Abstract
611P - ESMO-magnitude of clinical benefit scale (MCBS) scores for phase III trials of adjuvant and curative therapies at the 2022 ASCO annual meeting (ASCO22)
Presenter: Thi Thao Vi Luong
Session: Poster Display
Resources:
Abstract
612P - Is the juice worth the squeeze? Overall survival gain per unit treatment time as a metric of clinical benefit of systemic treatment in incurable cancers
Presenter: Vodathi Bamunuarachchi
Session: Poster Display
Resources:
Abstract