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Poster Display session 2

1653 - Impact of concomitant medications on disease free survival (DFS) and overall survival (OS) in patients from the PETACC8 study.

Date

29 Sep 2019

Session

Poster Display session 2

Topics

Tumour Site

Colon and Rectal Cancer

Presenters

Clémence Brun

Citation

Annals of Oncology (2019) 30 (suppl_5): v198-v252. 10.1093/annonc/mdz246

Authors

C. Brun1, J. Taieb2, M. Boulin3, K. Le Malicot4, L.M. Dourthe5, B. AVISSE6, P. Laplaige7, C. Borel8, D. Arsene9, F. Kikolski10, B. Denis11, P. Geoffroy12, R. Coriat13, G. Piot14, C. Lepage1

Author affiliations

  • 1 Hepatogastroenterology Department, CHU Dijon, 21079 - Dijon/FR
  • 2 Department Of Gastroenterology And Digestive Oncology, Hopital European George Pompidou, 75015 - Paris/FR
  • 3 Pharmacy Department, CHU Dijon, 21079 - Dijon/FR
  • 4 Biostatistics, FFCD, Dijon/FR
  • 5 Oncology Department, Clinique Sainte Anne, 67000 - Strasbourg/FR
  • 6 Hepatogastroenterology Department, Centre Hospitalier Pierre Oudot, 38302 - Bourgoin-Jallieu/FR
  • 7 Medical Oncology Department, Polyclinique de Blois, 41260 - La Chaussee St. Victor/FR
  • 8 Medical Oncology Department, Centre Paul Strauss Centre de Lutte contre le Cancer, 67065 - Strasbourg/FR
  • 9 Oncology Department, CHU de Caen, 14033 - Caen/FR
  • 10 Gastroenterology And Hepatology, Hôpital Robert Boulin, 33505 - Libourne/FR
  • 11 Hepatogastroenterology Department, Hôpital Louis Pasteur, 68024 - Colmar/FR
  • 12 Hepatogastroenterology Department, Clinique Saint-Vincent, 51200 - Epernay Cedex/FR
  • 13 Gastroenterology Department And Digestive Oncology, Hôpital Cochin, 75014 - Paris/FR
  • 14 Oncology Department, Clinique des Ormeaux, 76600 - Le Havre/FR

Resources

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Abstract 1653

Background

Impact of comedications and comorbidities upon OS isn’t well described in cancer patients (pts). We aimed to evaluate their impacts on DFS and OS on pts resected from a stage III colon cancer and treated by adjuvant FOLFOX-4 +/- cetuximab in the PETACC8 study.

Methods

Treatments (trts) categories were defined according to the WHO ATC classification system. We focused on 4 medication classes: anticoagulant, cardiovascular, antidiarrheal and antidiabetic trts. We classified the 2559 pts in each category if they took trt at baseline or during study whatever the duration was. Kaplan-Meier method and Cox model were used to compare survival curves. Multivariate analyses were performed on the overall population and according to trt arm.

Results

Only 1% of pts had no comedications. Comedications with anticoagulant, cardiovascular, antidiarrheal and antidiabetic trts were observed respectively in 18%, 40%, 30% and 9% of the cases. Patients with antidiabetic or cardiovascular trts had more comorbidities. For each other comedication categories, baseline characteristics were balanced between pts treated or not. All comedication categories, except antidiarrheals, were associated with a significant decrease of DFS and OS (Table). Dose-intensity was balanced and may not explain survival differences. For pts treated with at least one cardiac, diabetic or anticoagulant trts, severe events were more frequently reported, including 9 early deaths. The use of antidiarrheals is maybe associated to a better exposure to chemotherapy as reflected by a higher rate of grade ≥3 adverse events but also a potential better efficacy. Table. Comedications impact on DFS and OS.Table:

549P

Overall analysisDFSOS
HR [95%CI]pHR [95%CI]p
Anticoagulants
Intake vs no1.33 [1.10–1.62].0031.34 [1.07–1.67].01
Antidiarrheals
Intake vs no0.87 [0.73–1.04].120.78 [0.63–0.96].02
Cardiovascular trts
Intake vs no1.20 [1.03–1.41].021.28 [1.07–1.54].01
Antidiabetics
Intake vs no1.37 [1.07–1.76].011.45 [1.09–1.92].01

Conclusions

Comorbidities related to analyzed ATC classes negatively impact OS and DFS in PETACC8 pts, except antidiarrheal agents which positively impact OS and DFS.

Clinical trial identification

PETACC8; 2005-003463-23.

Editorial acknowledgement

Legal entity responsible for the study

Fédération Francophone de Cancérologie Digestive, Dijon.

Funding

Merck and Sanofi.

Disclosure

J. Taieb: Advisory / Consultancy: Merck; Advisory / Consultancy: Sanofi; Advisory / Consultancy: Roche Genentech; Advisory / Consultancy: Pfizer; Advisory / Consultancy: Amgen. All other authors have declared no conflicts of interest.

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