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
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