Abstract 142P
Background
We carried out a multicenter study to validate the results from a unicentric study that demonstrated increased risk of diarrhea and/or enterocolitis (DiEnt) in patients(pts) with colorectal cancer (CRC) treated with capecitabine plus oxaliplatin (CAPOX) and concurrent use of angiotensin receptors blockers (ARB).
Methods
Retrospective cohort of pts that received at least 1 cycle of CAPOX from 5 centers in Brazil and Argentina. Clinical data were retrieved from medical charts. The primary endpoint was grade (G) ≥ 3 DiEnt as described by the Common Terminology Criteria for Adverse Events version 5.0. Unadjusted logistic regression was used to evaluate risk factors for ≥ G3 DiEnt (use of ARBs or angiotensin-converting enzyme inhibitors [ACEi], age, performance status, Age-adjusted Charlson Comorbidity Index [A-CCI], tumor sidedness, presence of ileostomy, treatment intent [curative vs palliative], use of proton pump inhibitors, center and estimated clearance creatinine [ECC - Cockcroft-Gault equation]). A multivariable logistic regression analysis was performed to adjust for confounders, with variables with P < 0.05 deemed significant.
Results
From April/2010 to December/2023, 362 pts were included. 79 pts (21%; 95% confidence interval [CI]: 17 – 26%) had G3 ≥ DiEnt, mostly in the first three cycles (85%). Age ≥ 65 years, right-sided tumors, A-CCI, ECC, center and use of ARBs or ACEi were associated with ≥ G3 DiEnt in univariate analyses. In multivariable analysis, age ≥ 65 years (odds ratio [OR]: 3.16; 95% CI, 1.59 to 6.27) and ECC (OR: 5.4; 95% CI, 25 to 13.83) were independently associated with ≥ G3 DiEnt. Use of ARBs or ACEi was not significant (OR: 1.59; 95% CI, 0.85 to 2.98; P=0.15). Six out of 11 pts who used olmesartan had ≥ G3 DiEnt.
Conclusions
In CRC pts treated with CAPOX, age ≥ 65 years or ECC < 60ml/min, but not use of ARBs/ACEi, were independent risk factors for ≥ DiEnt. Olmersartan should be avoided, if possible, during CAPOX as nearly half of pts taking it had ≥ G3 DiEnt.
Legal entity responsible for the study
Fundação Antonio Prudente.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.