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Comparison Between Low and Normal Muscle Mass to Quality of Life in Breast Cancer Patients A Preliminary Study
abstracts Conclusions: This study showed the RDI of fluoropyrimidine in the DOACs group was sufficient compared with the warfarin group. However, major bleeding and thrombosis events, which seemed to be related with low TTR of warfarin, occurred only in the warfarin group. These data may suggest that DOACs are recommended as better anti-coagulation agents than warfarin during chemotherapies using fluoropyrimidine for gastrointestinal cancer.
Chemotherapy Induced Nausea and Vomiting and Quality of Life of Patients On Moderate And Highly Emetogenic Chemotherapy
Eznal Izwadi Bin Mohd Mahidin1, Wan Zamaniah Binti Wan Ishak2 Department of Radiotherapy and Oncology, Hospital Sultan Ismail, Johor Bahru, Johor, Malaysia, 2Clinical Oncology Unit, Faculty of Medicine, University Malaya, Kuala Lumpur
1
Background: Chemotherapy-induced nausea and vomiting (CINV) in cancer treatment are symptoms most feared by patients (pts). The study aim is to analyze the impact of CINV associated to moderately (MEC) or highly emetogenic chemotherapy (HEC) regimes on pts’ quality of life (QOL). Methods: Prospective observational study was done among pts receiving MEC or HEC in University Malaya Medical Center. 88 patients (pts) fulfilled the inclusion criteria. Pts were prescribed standard antiemesis based on national guidelines. Each pt filled up a diary for each cycle from the day before chemotherapy up to day 5 days which included details of emesis history. Pts completed the self-report European Organization for Research and Cancer (EORTC) core Quality of Life Questionnaire (QLQ-C30) before chemotherapy (baseline) and day 5 after each cycles, for 3 consecutive cycles. To estimate the effects of CINV on QOL, the change in scores between the baseline and day 5 HQL assessments was calculated for each domain the QLQ-C30 and compared in 3 subgroups of pts: 1) with both nausea and vomiting, 2) with nausea but no vomiting, 3) with neither nausea nor vomiting. Results: Total of 33 pts (37.5%) develop vomiting during cycle 1, 34 (38.6%) in cycle 2 and 38 (43.2%) in cycle 3. For nausea, 50 pts (56.8%) developed nausea cycle 1, 58 patients (65.9%) in cycle 2 and 3. The incidence of vomiting is higher in female (p-value <0.001) and pts who underwent HEC (p ¼ 0.02). Pts who did not suffer from nausea or vomiting have higher score Global Health Status (GHS) throughout 3 cycles of treatment with p-value <0.05. Emotional functioning score is also found to be higher in the same group of pts during cycle 1 (p ¼ 0.011) and cycle 3 (p ¼ 0.013). Conclusion: The study demonstrated a significant no of pts who underwent MEC or HEC suffered CINV despite the use of standard anti-emetics treatment. We demonstrated that pts who did not suffer from CINV have better QOL.
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Capsaicin application for prevention of chemotherapy induced neuropathy from paclitaxel or oxaliplatin, phase II study
Chutima Upachar, Supatra Kidwisala, Achaporn Petchdee, Sorrapong Manyanont, Orasit Sukreeyapongse, Supachat Chompoonuch Department of Medicine, Bhumibol Adulyadej Hospital, Royal Thai Air Force, Thailand Background: Chemotherapy induced neuropathy is well known adverse effect of paclitaxel and oxaliplatin based chemotherapy. Some patients reported improvement of neuropathy after capsaicin gel application. Therefore we conduct 2 phase II study to demonstrate potential benefit of capsaicin application in patient treated with paclitaxel or oxaliplatin based chemotherapy. Methods: After informed consent, Paclitaxel or Oxaliplatin planned patient will be instructed to apply 0.025% capsaicin gel to both palm and sole. Adverse effect, compliance and neuropathy are assessed before each cycle and at one month after last cycle. Due to poor enrollment than expected, both study were early discontinued. Analysis of combined result is planned before analysis of the result and approved by institution review board. At least 29 patients from 36 patients with grade 1 or lower neuropathy according to Common Terminology Criteria for Adverse Events version 4.03 are needed to demonstrate benefit. Result: During Jul 2015 to Oct 2016, 18 patients each from Paclitaxel and Oxaliplatin group were enrolled. Paclitaxel regimen were single agent (89%) or combined with carboplatin (11%). Oxaliplatin regimen were combined with capecitabine (61%) or combined with fluorouracil and leucovorin (39%). Only one patient in paclitaxel group and five patients in oxaliplatin group received capsaicin less than 75% of planned dose. Most reason for received lower than expected dose were disease progression (83%). In combined analysis, 4 patients (11.1%) developed grade 2 of neuropathy at one month after last dose of chemotherapy. Capsaicin related pain were occurred in 4 patients which improved and tolerable after dose reduction. Conclusions: Capsaicin gel application was safe in patient receiving paclitaxel or oxaliplatin. Combined analysis demonstrated potential of capsaicin gel application in prevention of chemotherapy induced neuropathy from paclitaxel or oxaliplatin. (TCTR20150720002 and TCTR20150626002)
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Comparison Between Low and Normal Muscle Mass to Quality of Life in Breast Cancer Patients A Preliminary Study
Andree Kurniawan1, Felix Wijovi2, Helenia Putri2, Devina Adelia Halim2, Olivia Adji Saroso2, Wilson Kores2, Julang Rahman2, Fernando Dharmaraja2, Nata Pratama Hardjo Lugito1 1 Internal Medicine Department, Faculty of Medicine, Pelita Harapan University, Indonesia, 2Faculty of Medicine, Pelita Harapan University Background: Low muscle mass is one of the prognostic factor that may lead to negative outcome and is the major feature of cancer cachexia, including breast cancer. Sarcopenia is associated with reduced quality of life (QoL) and survival. There is limited data reported about this association. The aim of this study is to know the comparison between low muscle mass and Quality of Life in Indonesian Breast Cancer Patients. Methods: The data was collected using cross-sectional Method from October 2018February 2019. Patients who had breast cancer and have underwent chemotherapy are included in this study and evaluated using BR-23 questionnaire, and Bioelectric Impedance Analysis (BIA) to assess their muscle mass with the cut-off of 5.7 kg/m2. the comparison between both lower muscle mass and higher muscle mass to QoL are evaluated using t-test in SPSS version 24.0. Result: From 36 patients with mean age 48.28 þ- 9.8 , median muscle mass is 5.92 ranged from 4.48 to 8.32. Patient with low muscle mass had functional mean of QoL 54.55% þ8.45 and symptoms mean of QoL 85.34% þ- 3.09. while Patient with normal muscle mass had functional mean of QoL 56.02% þ-8.8 and symptoms mean of QoL 86.51þ-12.05. The Association between muscle mass and QoL is defined as p-value of 0.658. Conclusion: Patients with low muscle mass have lower QoL, whereas patient with high muscle mass have better QoL. However, muscle mass association to quality of life is still unclear. Thus, further study with greater sample is needed to confirm the result
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Risk of hepatitis B virus reactivation in patients with solid tumors receiving systemic chemotherapy
Yuka Kobayashi, Yuko Tonoike Nagaoka Chuo General Hospital Background: Hepatitis B virus (HBV) reactivation is known as a risk of chemotherapy in patients with hematopoietic tumors at a rate of 14 to 72%. Screening tests for HBV (HBsAg, HBsAb, HBcAb) are recommended for chemotherapy in patients with solid tumors, however there are a few reports of risk of HBV reactivation and management other than hematopoietic tumors. Patients and Methods: We analyzed 18 HBV-DNA positive patients who received systemic chemotherapy for malignancies between October 2017 and February 2019. Results: The 18 patients included 2 with hematopoietic tumors and 16 with solid tumors. Among them, 4 showed negative for HBsAg before chemotherapy (1 each with breast cancer, neuroendocrine carcinoma, smooth muscle sarcoma, and colon cancer), and other 12 were HBsAg-positive. One of the HBsAg-negative patients developed active hepatitis and was treated with nucleoside. The other 3 presented positive for HBV-DNA in the absence of active hepatitis through the clinical course. 11 of the 12 HBsAg-positive patients showed HBV-DNA positive, and received nucleoside analog without active hepatitis. Most of the attending physicians had not perceived HBV-positivity in the patients before notification by the hepatologists. Conclusion: The treatment of hematopoietic malignancies as well as solid tumors may develop HBV reactivation. HBV screening is recommended according to guidelines before chemotherapy. The intervention of hepatologists in a hospital is necessary for all patients receiving chemotherapy.
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Expectations and challenges for TeamOncology workshops
Chihiro Kondoh1, Yoko Ichinari2, Hajime Morita3, Hisashi Suyama4, Yumi Yoshii5, Mio Ezura6, Yoko Fujisawa7, Hirotoshi Iihara8, Mitsuki Kariya2, Natsumi Matsumoto9, Sanae Nakajima10, Yoichi Osato11, Fumihiro Terasaki12, Mutsumi Yamagami13, Manabu Futamura14, Shigehira Saji15, Naoto T. Ueno16 1 Department of Medical Oncology, Toranomon Hospital, 2Division of Nursing, Gifu University Hospital, 3Division of pharmacy, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, 4Department of Medical Oncology, Tottori University Hospital, 5Oncology Center, Nara Medical University, 6Nova Southeastern University College of Pharmacy, 7Division of Nursing, Chiba University Hospital, 8Department of Pharmacy, Gifu University Hospital, 9Division of pharmacy, Breast and Imaging Center, St. Marianna University School of Medicine, 10Department of Gastroenterological Surgery, Fujita Health University, 11Division of Pharmacy, Tokyo Medical Center, 12 Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center Hospital, 13 Division of Nursing, The University of Tokyo Hospital, 14Department of Surgical Oncology, Gifu University Graduate School of Medicine, 15Department of Medical Oncology, Fukushima Medical School, 16Department of Breast Medical Oncology, The University of Texas, MD Anderson Cancer Center Backgrounds: Promoting team-based cancer care is required. J-TOP (Japan TeamOncology Program) is consisted of multidisciplinary medical staff and we
vi128 | Poster Session
Volume 30 | Supplement 6 | October 2019
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_6/mdz343.048/5582931 by University of Cambridge user on 22 December 2019
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Annals of Oncology
Chemotherapy Induced Nausea and Vomiting and Quality of Life of Patients On Moderate And Highly Emetogenic Chemotherapy
Eznal Izwadi Bin Mohd Mahidin1, Wan Zamaniah Binti Wan Ishak2 Department of Radiotherapy and Oncology, Hospital Sultan Ismail, Johor Bahru, Johor, Malaysia, 2Clinical Oncology Unit, Faculty of Medicine, University Malaya, Kuala Lumpur
1
Background: Chemotherapy-induced nausea and vomiting (CINV) in cancer treatment are symptoms most feared by patients (pts). The study aim is to analyze the impact of CINV associated to moderately (MEC) or highly emetogenic chemotherapy (HEC) regimes on pts’ quality of life (QOL). Methods: Prospective observational study was done among pts receiving MEC or HEC in University Malaya Medical Center. 88 patients (pts) fulfilled the inclusion criteria. Pts were prescribed standard antiemesis based on national guidelines. Each pt filled up a diary for each cycle from the day before chemotherapy up to day 5 days which included details of emesis history. Pts completed the self-report European Organization for Research and Cancer (EORTC) core Quality of Life Questionnaire (QLQ-C30) before chemotherapy (baseline) and day 5 after each cycles, for 3 consecutive cycles. To estimate the effects of CINV on QOL, the change in scores between the baseline and day 5 HQL assessments was calculated for each domain the QLQ-C30 and compared in 3 subgroups of pts: 1) with both nausea and vomiting, 2) with nausea but no vomiting, 3) with neither nausea nor vomiting. Results: Total of 33 pts (37.5%) develop vomiting during cycle 1, 34 (38.6%) in cycle 2 and 38 (43.2%) in cycle 3. For nausea, 50 pts (56.8%) developed nausea cycle 1, 58 patients (65.9%) in cycle 2 and 3. The incidence of vomiting is higher in female (p-value <0.001) and pts who underwent HEC (p ¼ 0.02). Pts who did not suffer from nausea or vomiting have higher score Global Health Status (GHS) throughout 3 cycles of treatment with p-value <0.05. Emotional functioning score is also found to be higher in the same group of pts during cycle 1 (p ¼ 0.011) and cycle 3 (p ¼ 0.013). Conclusion: The study demonstrated a significant no of pts who underwent MEC or HEC suffered CINV despite the use of standard anti-emetics treatment. We demonstrated that pts who did not suffer from CINV have better QOL.
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Capsaicin application for prevention of chemotherapy induced neuropathy from paclitaxel or oxaliplatin, phase II study
Chutima Upachar, Supatra Kidwisala, Achaporn Petchdee, Sorrapong Manyanont, Orasit Sukreeyapongse, Supachat Chompoonuch Department of Medicine, Bhumibol Adulyadej Hospital, Royal Thai Air Force, Thailand Background: Chemotherapy induced neuropathy is well known adverse effect of paclitaxel and oxaliplatin based chemotherapy. Some patients reported improvement of neuropathy after capsaicin gel application. Therefore we conduct 2 phase II study to demonstrate potential benefit of capsaicin application in patient treated with paclitaxel or oxaliplatin based chemotherapy. Methods: After informed consent, Paclitaxel or Oxaliplatin planned patient will be instructed to apply 0.025% capsaicin gel to both palm and sole. Adverse effect, compliance and neuropathy are assessed before each cycle and at one month after last cycle. Due to poor enrollment than expected, both study were early discontinued. Analysis of combined result is planned before analysis of the result and approved by institution review board. At least 29 patients from 36 patients with grade 1 or lower neuropathy according to Common Terminology Criteria for Adverse Events version 4.03 are needed to demonstrate benefit. Result: During Jul 2015 to Oct 2016, 18 patients each from Paclitaxel and Oxaliplatin group were enrolled. Paclitaxel regimen were single agent (89%) or combined with carboplatin (11%). Oxaliplatin regimen were combined with capecitabine (61%) or combined with fluorouracil and leucovorin (39%). Only one patient in paclitaxel group and five patients in oxaliplatin group received capsaicin less than 75% of planned dose. Most reason for received lower than expected dose were disease progression (83%). In combined analysis, 4 patients (11.1%) developed grade 2 of neuropathy at one month after last dose of chemotherapy. Capsaicin related pain were occurred in 4 patients which improved and tolerable after dose reduction. Conclusions: Capsaicin gel application was safe in patient receiving paclitaxel or oxaliplatin. Combined analysis demonstrated potential of capsaicin gel application in prevention of chemotherapy induced neuropathy from paclitaxel or oxaliplatin. (TCTR20150720002 and TCTR20150626002)
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Comparison Between Low and Normal Muscle Mass to Quality of Life in Breast Cancer Patients A Preliminary Study
Andree Kurniawan1, Felix Wijovi2, Helenia Putri2, Devina Adelia Halim2, Olivia Adji Saroso2, Wilson Kores2, Julang Rahman2, Fernando Dharmaraja2, Nata Pratama Hardjo Lugito1 1 Internal Medicine Department, Faculty of Medicine, Pelita Harapan University, Indonesia, 2Faculty of Medicine, Pelita Harapan University Background: Low muscle mass is one of the prognostic factor that may lead to negative outcome and is the major feature of cancer cachexia, including breast cancer. Sarcopenia is associated with reduced quality of life (QoL) and survival. There is limited data reported about this association. The aim of this study is to know the comparison between low muscle mass and Quality of Life in Indonesian Breast Cancer Patients. Methods: The data was collected using cross-sectional Method from October 2018February 2019. Patients who had breast cancer and have underwent chemotherapy are included in this study and evaluated using BR-23 questionnaire, and Bioelectric Impedance Analysis (BIA) to assess their muscle mass with the cut-off of 5.7 kg/m2. the comparison between both lower muscle mass and higher muscle mass to QoL are evaluated using t-test in SPSS version 24.0. Result: From 36 patients with mean age 48.28 þ- 9.8 , median muscle mass is 5.92 ranged from 4.48 to 8.32. Patient with low muscle mass had functional mean of QoL 54.55% þ8.45 and symptoms mean of QoL 85.34% þ- 3.09. while Patient with normal muscle mass had functional mean of QoL 56.02% þ-8.8 and symptoms mean of QoL 86.51þ-12.05. The Association between muscle mass and QoL is defined as p-value of 0.658. Conclusion: Patients with low muscle mass have lower QoL, whereas patient with high muscle mass have better QoL. However, muscle mass association to quality of life is still unclear. Thus, further study with greater sample is needed to confirm the result
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Risk of hepatitis B virus reactivation in patients with solid tumors receiving systemic chemotherapy
Yuka Kobayashi, Yuko Tonoike Nagaoka Chuo General Hospital Background: Hepatitis B virus (HBV) reactivation is known as a risk of chemotherapy in patients with hematopoietic tumors at a rate of 14 to 72%. Screening tests for HBV (HBsAg, HBsAb, HBcAb) are recommended for chemotherapy in patients with solid tumors, however there are a few reports of risk of HBV reactivation and management other than hematopoietic tumors. Patients and Methods: We analyzed 18 HBV-DNA positive patients who received systemic chemotherapy for malignancies between October 2017 and February 2019. Results: The 18 patients included 2 with hematopoietic tumors and 16 with solid tumors. Among them, 4 showed negative for HBsAg before chemotherapy (1 each with breast cancer, neuroendocrine carcinoma, smooth muscle sarcoma, and colon cancer), and other 12 were HBsAg-positive. One of the HBsAg-negative patients developed active hepatitis and was treated with nucleoside. The other 3 presented positive for HBV-DNA in the absence of active hepatitis through the clinical course. 11 of the 12 HBsAg-positive patients showed HBV-DNA positive, and received nucleoside analog without active hepatitis. Most of the attending physicians had not perceived HBV-positivity in the patients before notification by the hepatologists. Conclusion: The treatment of hematopoietic malignancies as well as solid tumors may develop HBV reactivation. HBV screening is recommended according to guidelines before chemotherapy. The intervention of hepatologists in a hospital is necessary for all patients receiving chemotherapy.
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Expectations and challenges for TeamOncology workshops
Chihiro Kondoh1, Yoko Ichinari2, Hajime Morita3, Hisashi Suyama4, Yumi Yoshii5, Mio Ezura6, Yoko Fujisawa7, Hirotoshi Iihara8, Mitsuki Kariya2, Natsumi Matsumoto9, Sanae Nakajima10, Yoichi Osato11, Fumihiro Terasaki12, Mutsumi Yamagami13, Manabu Futamura14, Shigehira Saji15, Naoto T. Ueno16 1 Department of Medical Oncology, Toranomon Hospital, 2Division of Nursing, Gifu University Hospital, 3Division of pharmacy, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, 4Department of Medical Oncology, Tottori University Hospital, 5Oncology Center, Nara Medical University, 6Nova Southeastern University College of Pharmacy, 7Division of Nursing, Chiba University Hospital, 8Department of Pharmacy, Gifu University Hospital, 9Division of pharmacy, Breast and Imaging Center, St. Marianna University School of Medicine, 10Department of Gastroenterological Surgery, Fujita Health University, 11Division of Pharmacy, Tokyo Medical Center, 12 Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center Hospital, 13 Division of Nursing, The University of Tokyo Hospital, 14Department of Surgical Oncology, Gifu University Graduate School of Medicine, 15Department of Medical Oncology, Fukushima Medical School, 16Department of Breast Medical Oncology, The University of Texas, MD Anderson Cancer Center Backgrounds: Promoting team-based cancer care is required. J-TOP (Japan TeamOncology Program) is consisted of multidisciplinary medical staff and we
vi128 | Poster Session
Volume 30 | Supplement 6 | October 2019
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_6/mdz343.048/5582931 by University of Cambridge user on 22 December 2019
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Annals of Oncology