Abstract 5107
Background
In the phase III RTOG 9802 trial, median overall survival (OS) increased from 7.8 years with radiotherapy alone to 13.3 years (P = .002) with adjuvant procarbazine, lomustine, and vincristine (PCV) following surgery for low grade glioma. Although the PCV regimen improved survival, there were significant toxicities. We hypothesised more frequent toxicities would be observed in clinical practice. We aimed to identify and quantify toxicities in the real world setting in a National Neuro-Oncology centre.
Methods
Patients with low grade glioma who received PCV following radiotherapy from Nov 2014 to Nov 2018 were identified from Institutional databases. Data on toxicities, dose reductions, dose delays and treatment discontinuation were collected from paper and electronic patient records.
Results
A total of 41 patients with low grade glioma were identified. Patients were predominantly male (n = 28) and the median age at diagnosis was 41. Of these, 28/41 patients had a diagnosis of oligodendroglioma and 13/41 had astrocytoma. The majority of patients had tumours with favourable molecular features such as IDH mutations (n = 38) and 1p19q co deletions (n = 23). Only 4 patients completed 6 cycles of chemotherapy without any dose modification or delay. 16 patients completed PCV with dose reductions and dose delays at various levels. The dose intensity was as follows: procarbazine: 69%, lomustine: 71% and vincristine: 68%. Neutropaenia and thrombocytopaenia (table) were the major causes of treatment discontinuation (14/21 patients). Three patients had disease progression during chemotherapy and two patient’s treatment was discontinued due to abnormal LFTs. Three patients opted not to continue chemo due to intolerability in context of grade 3 to 4 fatigue and GI symptoms. At median follow up of 17 months, 9/41 patients have had disease progression.Table: 430P
Our Study % | RTOG 9802% | ||
---|---|---|---|
Patient Completed PCV | 48 | 56 | |
Median Number of Cycles Completed | 3 | 3.5 | |
Thrombocytopenia | G2 (50-75) | 71 | 9 |
G3 (25-50) | 17 | 18 | |
G4 (<25) | 2 | 0 | |
Neutropenia | G2(1-1.5) | 87 | 9 |
G3(0.5-0.1) | 31 | 35 | |
G4(<0.5) | 7 | 8 |
Conclusions
Frequent toxicities are observed with PCV in clinical practice. Our data suggest it might be preferable to adjust doses from the start of chemotherapy to improve tolerability.
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
4242 - HIV, HBV and HCV screening practices in oncology: a cross-sectional interregional survey
Presenter: Isabelle Poizot-Martin
Session: Poster Display session 1
Resources:
Abstract
1267 - Genetic landscape of KEAP1 and NFE2L2 mutated cancers from the AACR GENIE database
Presenter: Mark Zaki
Session: Poster Display session 1
Resources:
Abstract
878 - β-arrestin1 is involved in the Ras-induced malignant transformation
Presenter: Takashi Shibano
Session: Poster Display session 1
Resources:
Abstract
4143 - Incidence of second cancer among PLWHIV: retrospective observational study of a series of 601 patients in the French CANCERVIH network
Presenter: Jean-Philippe Spano
Session: Poster Display session 1
Resources:
Abstract
5145 - A challenging task – Identifying carcinoma of unknown primary (CUP) patients according to ESMO guidelines: the CUPISCO trial experience
Presenter: Chantal Pauli
Session: Poster Display session 1
Resources:
Abstract
1737 - Incidence and Outcome of chronic lymphocytic leukemia with Deletion 17p: An Indian experience; challenges and opportunities
Presenter: Ajay Gogia
Session: Poster Display session 1
Resources:
Abstract
2596 - Driving solo? Investigation into collaborating mutations in SDH-deficient neoplasia
Presenter: Jonathan Killian
Session: Poster Display session 1
Resources:
Abstract
1499 - The potential of a novel antiangiogenic VEGFR1-D2 binding peptide in oncology therapeutics
Presenter: Afsaneh Sadre Momtaz
Session: Poster Display session 1
Resources:
Abstract
1775 - First-in-human phase I study of TAS-117, an allosteric AKT inhibitor, in patients with advanced solid tumors
Presenter: Mayu Yunokawa
Session: Poster Display session 1
Resources:
Abstract
4584 - First-in-human study of ABBV-621 in patients (pts) with previously treated sold tumors: Dose-optimization cohorts
Presenter: Emiliano Calvo
Session: Poster Display session 1
Resources:
Abstract