ESMO Congress 2023 | OncologyPRO

Abstract 348P

Background

Chemotherapy for early breast cancer (BC) increases the risk of chronic opioid use. Factors associated with new opioid use after (neo)adjuvant chemotherapy for BC are poorly understood.

Methods

We analyzed Elevance Health administrative claims and Cancer Care Quality Program data between 2017-2022. BC patients who underwent surgery and (neo)adjuvant chemotherapy were included. Patients that had claims for either opioids or for medications used to treat neuropathic pain before BC diagnosis were excluded. Long-term use was defined as opioid drug claims lasting at least 3 months within 1 year of follow-up. We explored factors associated with this outcome via logistic regressions, with additional stratification to adjuvant/neoadjuvant groups.

Results

Among 3,353 BC patients, 156 (4.56%) were prescribed long-term opioids during the first year following chemotherapy. Young age, advanced stage, mastectomy (vs. lumpectomy), and higher comorbidity score were associated with long-term opioid usage (Table). Of patients aged ≤ 45 (N=442), 8.6% had long-term opioid claims, while patients aged 65-75 (N=653), 2.45% had such claims. When analyzing specific comorbidities, significant associations with opioid use were found for chronic obstructive pulmonary disease (COPD), liver disease, and peptic ulcer in patients treated with neoadjuvant chemotherapy. Rheumatic disease and congestive heart failure were associated with opiod use in patients treated with adjuvant chemotherapy. Table: 348P

Factors associated with long term opioid use

	OR	Confidence interval	p value
Age	0.66	0.55-0.78	1.40E-06*
Lymph node +	1.51	1.02-2.24	4.13E-02
Social determinant index	1.07	0.91-1.26	4.17E-01
Charlson's comorbidity	1.4	1.21-1.64	1.29E-05*
Stage II (ref stage I)	2.16	1.33-3.52	1.93E-03*
Stage III (ref stage I)	1.35	0.72-2.54	3.52E-01
Mastectomy (ref lumpectomy)	2.41	1.52-3.81	1.77E-04*
Mastectomy and lumpctomy (ref lumpectomy)	5.72	3.33-9.8	2.34E-10*
Radiotherapy	0.64	0.43-0.96	2.87E-02*
Hormonal	0.71	0.5-1	5.27E-02
Anti HER2	0.91	0.63-1.31	6.09E-01
Immunotherapy	2.29	0.75-6.97	1.45E-01
Taxans	1.09	0.59-1.99	7.87E-01

Conclusions

This study offers valuable real-world insights into the prevalence and potential risk factors for chronic opioid use during the first year following chemotherapy for BC. Young age, mastectomy and higher comorbidity index were associated with chronic opiod use in this cohort.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

E. Granot-Hershkovitz, S. Amar-Farkash, K. Rosenberg-Katz: Financial Interests, Personal, Full or part-time Employment: Elevance Health. D. Aran: Financial Interests, Personal, Other, Consultant: Carelon Digital Platforms, Link Therapeutics, CytoReason. All other authors have declared no conflicts of interest.