1873P - Thalidomide for the treatment of chemotherapy-induced night sweats in patients with pancreatic cancer

Background

Night sweats are a common symptom in cancer patients during chemotherapy, with severe episodes significantly impacting daily functioning, psychological status, and quality of life (QoL). Current treatments often show limited effectiveness, necessitating novel therapeutic exploration.

Methods

Pancreatic cancer patients with chemotherapy-induced night sweats (CINS) received 100mg thalidomide daily. Symptom severity was assessed using Common Terminology Criteria for Adverse Events (CTCAE, version 5.0), the Hot Flash-Related Daily Interference Scale (HDSS) and an expert-based method. QoL and sleep quality were measured by EORTC QLQ-C30 questionnaire. Responses to thalidomide were evaluated by Sweating Evolution Questionnaire (SEQ) and Traditional Chinese Medicine (TCM) criteria, with laboratory tests performed pre- and post-treatment.

Results

45 patients were enrolled. Baseline assessments indicated 88% of patients had Grade 2 CINS by CTCAE. Using expert-based method, 18% had mild, 56% moderate, and 26% severe symptoms. HDSS scores further delineated symptom severity. The upper body (64%) was identified as the most prevalent site. 56% of these patients (19/33) needed at least one change of clothes daily, while 18% (6/33) required five or more clothes-changes. 85% of these participants(29/34) achieved the optimal effect of "cured”, while the optimal effect of other 5 participants was “effective”. The mean duration to achieve optimal effect of “effective” or “cured” was 5.0±2.9 days. The overall mean duration of thalidomide therapy was 10.7 days. Thalidomide treatment resulted in a marked improvement in patients' quality of life and sleep quality. Notably, thalidomide administration correlated with a significant increase in monocyte counts (post:8.9 ± 8.6/μl vs pre:5.4 ± 4.9/μl, p=0.002), a decrease in B lymphocyte count (post: 92.1 ± 50.5/μL vs pre: 115.6 ± 66.0/μL, p=0.029)and a decline in the proportion of B lymphocytes (post: 6.7 ± 2.9% vs pre: 8.0 ± 3.5%, p=0.048).

Conclusions

Thalidomide demonstrated efficacy in managing CINS and showed significant benefits in improving the QoL and sleep quality for pancreatic cancer patients, with immunological changes indicating possible immunomodulation mechanisms.

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.