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B. Mylliemngap
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P1.03 - Chemotherapy/Targeted Therapy (ID 689)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Chemotherapy/Targeted Therapy
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.03-018 - Effectiveness of Supportive Care Drugs in Lung Cancer Patients Undergoing 1st Line Chemotherapy in a Resource Limited Setting (ID 7895)
09:30 - 09:30 | Author(s): B. Mylliemngap
- Abstract
Background:
Lung cancer(LC) chemotherapy is associated with several adverse effects(AEs). Data regarding supportive care medications(SCMs) offered to prevent/treat chemotherapy-related AEs in resource-limited settings and compliance to these therapies is lacking. A prospective observational study was therefore carried out in an attempt to ascertain effectiveness of SCMs in real life setting.
Method:
Consecutive patients with newly-diagnosed LC initiated on first-line chemotherapy at a tertiary referral centre in North India (from July 2014-September 2015) were enrolled. Details of chemotherapy-related AEs including incidence, timing of onset, duration and grades were recorded. Compliance with use of mandatory SCMs prescribed after each chemotherapy cycle was assessed by a structured questionnaire. Patients were also instructed to maintain a symptom diary to record various symptoms, frequency of use of need-based SCMs, visits to local health-care providers and hospitalization(if any) during the inter-cycle period.
Result:
Of 112 patients enrolled, majority were males(83.9%,n=94), current/ex-smokers(82.1%,n=92), had advanced stage [IIIB=33.9%(n=38), IV=46.4%(n=52)] and of non-small-cell type (NSCLC; 72.3%,n=81). A total of 602 chemotherapy cycles were administered with AEs being reported in 580 cycles(96.3%). Diarrhea was the commonest AE(180 cycles,29.9%) developing after a mean (SD) duration of 3.6(2.5) days and lasting for 4(3.3) days. Vomiting(138 cycles,22.9%) beginning after a mean (SD) of 3.5(2.7) days, lasting for 3.8(3.1) days; and constipation(121 cycles,20.1% mean[SD] onset after 2.9[1.7]days, lasting for mean[SD] of 6.5[6 .1]) were the other common AEs. Grade3/4 AEs occurred in 6.7%(39/580) cycles. Compliance to dexamethasone and proton-pump inhibitors prescribed as part of mandatory SCMs was 98.2% and 98.3% respectively. Need based SCMs were required in 479 of the 580 cycles(82.6%) reporting AEs. Need-based SCMs were effective in relieving most symptoms (100% episodes of pain, cough and epigastric pain). Local physician consultation was sought in 18.1% and 15.8% episodes of vomiting and pain respectively. Proportion of patients with grade 3/4 AEs and requiring hospitalization was highest for mucositis(16.1% grade 3/4 and 9.7% hospitalized); followed by vomiting(10.1% grade3/4 and 8.7% hospitalized) and diarrhea(10.6% grade 3/4 and6.7% hospitalized). Hiccups, despite occurring in only 5 chemotherapy cycles(0.9%) did not improve with need based SCMs in 40%. Anemia was observed in 441(73.3% prevalence) chemotherapy cycles and was treated with blood transfusions, erythropoiesis-stimulating agents and intravenous iron supplementation in 47(10.7%), 30(6.8%) and four(0.9%) cycles respectively.
Conclusion:
This study highlights a high prevalence of AEs during LC chemotherapy. However, majority of episodes were grade 1-2 and were controlled with need-based SCMs, without requiring hospitalization or local physician consultation.
