Abstract 5511
Background
Hyponatremia (serum sodium concentration [Na+] <135 mmol/L), is the most common electrolyte disorder in lung cancer patients (incidence 20–44%) with SIADH a frequent cause, particularly in small cell lung cancer (SCLC).
Methods
ASSERT was a prospective, observational, non-interventional study conducted from October 2015 to June 2017 in cancer patients requiring treatment for hyponatremia secondary to SIADH at 18 Italian oncology centres. Management of hyponatremia primarily included water restriction, tolvaptan and hypertonic saline, in accordance with local standard of care/guideline recommendations. The primary endpoint was change in serum [Na+] from baseline visit to end of the first month of the observational period, or earlier discontinuation.
Results
The full analysis set (FAS) included 68 adult cancer patients (lung cancer, n = 48, SCLC, n = 33). Group 1 patients received ≥1 dose of tolvaptan during the observational period; Group 2 patients did not receive tolvaptan. Overall survival (FAS) was significantly higher in Group 1 vs Group 2 (median 123 vs 56 days; p = 0.001), as was mean survival (299.4 vs 74.9 days; p = 0.001). In a linear regression analysis of the relationship between sodium levels and tolvaptan dose intensity for the lung cancer and SCLC cohorts, dose intensity correlated significantly with clinical response after 6 months of treatment in both cohorts (p = 0.005 and p = 0.023, respectively). In the lung cancer cohort, a significantly higher percentage of patients achieved serum [Na+] ≥130 mmol/L in Group 1 vs Group 2 during 6 months of follow-up (Group 1, 87.5% vs Group 2, 62.5%; p = 0.033). These results were similar to those observed in the FAS.
Conclusions
Hyponatremia secondary to SIADH is a potentially modifiable risk factor, which might be implicated in the survival of lung cancer patients. Correction of hyponatremia may be preferentially achieved with pharmacological treatment, rather than the non-pharmacological approaches routinely used in clinical practice.
Clinical trial identification
NCT102573077.
Editorial acknowledgement
Sarah Stowell PhD, CMPP of Ashley Medical Communications, funded by Otsuka Pharmaceutical Europe Ltd.
Legal entity responsible for the study
Otsuka Pharmaceutical Italy Srl.
Funding
Otsuka Pharmaceutical Italy Srl.
Disclosure
R. Berardi: Honoraria (self), Advisory / Consultancy: Otsuka Pharmaceutical. C. Ferrara: Full / Part-time employment: Otsuka Pharmaceutical Italy. M.G. Giustra: Full / Part-time employment: Otsuka Pharmaceutical Italy. R. Evans: Full / Part-time employment: Otsuka Pharmaceutical Europe. All other authors have declared no conflicts of interest.
Resources from the same session
2831 - Interleukin-6 as a Predictive Marker for Early Response to Induction Chemotherapy in Acute Myeloblastic Leukaemia
Presenter: Salah Khallaf
Session: Poster Display session 1
Resources:
Abstract
6014 - Impact of FLT3-ITD mutation on post-transplant outcome of adult AML is modified by the concomitant NPM1 mutation and pre-transplant remission status: A report from Taiwan Bone Marrow Transplant Registry (TBMTR)
Presenter: Su-peng Yeh
Session: Poster Display session 1
Resources:
Abstract
2914 - Efficacy endpoints studied in clinical trials for early-onset leukaemia
Presenter: Dylan Said
Session: Poster Display session 1
Resources:
Abstract
4691 - High triglyceride is a major risk factor of DIC and differentiation syndrome in acute promyelocytic leukemia
Presenter: Tomohiro Yamakawa
Session: Poster Display session 1
Resources:
Abstract
4395 - DREAMM 4: A Phase I/II single-arm open-label study to explore safety and clinical activity of belantamab mafodotin (GSK2857916) administered in combination with pembrolizumab in patients with relapsed/refractory multiple myeloma (RRMM)
Presenter: Suzanne Trudel
Session: Poster Display session 1
Resources:
Abstract
2808 - A Phase 1 Study of HMPL-523, a Selective Oral Anti-Spleen Tyrosine Kinase Inhibitor, in Patients with Relapsed or Refractory Lymphoma
Presenter: Nathan Fowler
Session: Poster Display session 1
Resources:
Abstract
4403 - A Phase 1 Study of HMPL-689, a Selective Oral Phosphoinositide 3-Kinase-Delta Inhibitor, in Patients with Relapsed or Refractory Lymphoma
Presenter: Jonathon Cohen
Session: Poster Display session 1
Resources:
Abstract
3357 - A global patient-driven Facebook study in a very rare sarcoma: Health-related quality of life in Epithelioid Hemangioendothelioma (EHE) patients
Presenter: Marije Weidema
Session: Poster Display session 1
Resources:
Abstract
2475 - Qualitative study of patients’ experiences of living with and beyond a soft tissue sarcoma diagnosis: the impact of sarcoma specialist services
Presenter: Ana Martins
Session: Poster Display session 1
Resources:
Abstract
2640 - Health-related quality of life issues of patients affected by desmoid-type fibromatosis; experiences from two countries
Presenter: Milea Timbergen
Session: Poster Display session 1
Resources:
Abstract