Abstract 842P
Background
Carboplatin-induced thrombocytopenia (CIT), defined by platelets count < 150.000/μL, frequently requires dose reductions and/or delays of therapy, with impaired dose intensity and potentially worse outcome. No predictive factors of CIT have been established in clinical practice.
Methods
We retrospectively analyzed a cohort of 227 consecutive ovarian cancer patients (pts) treated with carboplatin-based chemotherapy after primary debulking surgery between 2004 and 2020 at National Cancer Institute in Aviano (Italy). Clinicopathological and laboratory characteristics at baseline were tested with uni-/multivariate logistic regression to create a predictive score for CIT. A ROC analysis was performed to identify optimal cut-off values for variables significatively associated with CIT. Known prognostic factors were evaluated in overall survival (OS) with Cox regression model.
Results
Overall, 148 (66.1%) pts had a FIGO stage III and 29 (13%) FIGO stage IV; residual disease was present in 93 (42.1%) pts after surgery. A total of 70 (30.8%) pts experienced haematologic toxicity, 51 (24.1%) with carboplatin dose reduction, among which 22 (43.1%) for CIT. At a median follow-up of 35.9 months, median OS was 74.6 months. Residual tumor after radical surgery (HR 2.15, p = 0.031) and FIGO stage IV (HR 4.82, p = 0.008) significantly showed a shorter OS, by uni-/multivariate analysis. Platelets count (PLT) (OR 0.99, CI 95% 0.98-0.99, p = 0.009) and weight (OR 1.04, CI 95% 1.01-1.07, p = 0.016) were the clinical variables significantly associated with CIT. After ROC-defined cut-off definition, PLT and weight were both statistically significant at multivariate analysis (OR 0.13, p < 0.001 and OR 4.86, p = 0.006, respectively). A score which combined PLT < 295.000/μL and weight > 79.4 kg was implemented and was capable to stratify the population in a low, intermediate and high risk group according to CIT (OR 5.38, p = 0.005 with one of the two conditions, OR 39.75, p < 0.001 with both conditions).
Conclusions
In pts with ovarian cancer receiving a carboplatin-based adjuvant therapy, PLT and weight at baseline are two easy-to-assess parameters to predict CIT risk. Prospective validation is planned to prove the clinical validity and utility of the present score.
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.