Evaluation of chemotherapy benefit in patients who continue to smoke: Preliminary experience.

Abstract

e12534 Background: The smoking continuation during chemotherapy treatments affects positive results. As reported for instance by Mazza et al. in the review "Taking care of smoker cancer patients: a review and some recommendations" (Ann Oncol. 21(7):1404-9, 2010), nicotin seems to inhibit the potential of cisplatin in determining tumor cell death (Int J Oral Maxillofac Surg 2007; 36: 739–744), while some new anti-cancer drugs can give an excellent response only in people who have never smoked (Proc Natl Acad Sci U S A 2004; 101(36): 13306–13311). Methods: It is an observational monoistitutional analysis. The analysis covered 886 patients undergoing chemotherapy at the Veneto Oncology Institute of Padua during an observation period of six years (from 2006 to 2011). We have been taken into account all patients included in the Onco-AIFA national register for the monitoring of innovative anticancer drugs, focusing on the three big killer diseases: colon and rectum cancer (40% of the sample analyzed), lung cancer (36%) and breast cancer (24%). The Kaplen-Meier method was used to analyze the overall survival data. Results: Among the information collected, the aspect of smoking was taken into account: it was possible to extract the data for about half of the patients (n = 473), 48% of whom were non-smokers, 31% were smokers and the remaining 21% ex-smokers. Although there are three types of cancer that have three different natural histories, the study revealed that being a smoker or ex-smoker is a determinant of the OS of patients: in particular non-smokers showed a median survival of 27 months, ex-smokers of 18 and smokers of 13 (p <0.001). Conclusions: It should be noted then, that in the entirety of the sample smoking continuation reduces survival. Therefore, in addition to an increased risk, there is a reduced benefit in terms of clinical conditions and response since tobacco reduces the effects of anticancer chemotherapy. That being so, although the data are still preliminary, every effort must be made to ensure that a patient stops smoking during chemotherapy treatments as it has been demonstrated that the ex-smokers live an average 6 months longer.