Toxicity Of Chemotherapy In Patients Research Articles

The Impact of Frailty on the Toxic Reaction of Chemotherapy in Patients With Cervical Cancer: A Longitudinal Study.

Longitudinal research on the impact of frailty on chemotherapy toxicity in patients with cervical cancer is limited. To explore the impact of frailty on chemotherapy toxicity in patients with cervical cancer. Two hundred fifty-nine postoperative cervical cancer patients from a hospital located in Northwest China were enrolled between July 2020 and December 2021. Participating patients were followed up for 4 chemotherapy cycles after surgery. Frailty was measured using the Tilburg Frailty Indicator. Chemotherapy toxic reactions were evaluated using the Common Terminology Criteria for Adverse Events 4.0. Repeated-measures analysis of variance and Cox regression analysis were used to analyze the effect of frailty on chemotherapy toxicity. Cox regression analysis showed that frailty could serve as an independent risk factor for total toxicity (hazard ratio [HR], 5.423; 95% confidence interval [CI], 3.260-9.023; P < .001), nausea (HR, 3.967; 95% CI, 2.446-6.433; P < .001), and vomiting (HR, 3.081; 95% CI, 1.921-4.942; P < .001). Repeated-measures analysis of variance showed that the white blood cell values of the frail group were lower than those of the nonfrail group (Fgroup effect = 4.172, P = .043), and the hemoglobin values of the frail group were lower than those of the nonfrail group (Fgroup effect = 6.589, P = .012). Frailty can increase the risk of total chemotherapy toxicity, nausea, and vomiting. Frailty can reduce the white blood cell and hemoglobin values of postoperative adjuvant chemotherapy cervical cancer patients. Findings may assist healthcare providers in taking effective measures to reduce the toxicity of chemotherapy.

Cardiovascular toxicity of chemotherapy and thyroid status of patients with gastric and colon cancer: Current state of the problem. A review

Cardiovascular and oncological diseases are the main causes of disability and mortality in Russia, sharing common risk factors and exacerbating each other. The specific toxicological effects of fluoropyrimidines, platinum drugs, and taxanes commonly used in the treatment of gastric and colorectal malignancies have been noted to potentially contribute to the onset of cardiovascular pathologies in some cases. However, the manifestation and prevalence of cardiovascular toxicity due to cancer treatment regimens are influenced by various factors beyond just the chemotherapy protocols employed. Gender, age, overall health status (including cardiac and thyroid functions), and other risk factors play significant roles in the development and progression of heart and vascular diseases in these patients. Thyroid dysfunction, even in the absence of severe clinical symptoms, can significantly impact the course of cardiovascular pathologies, complicating the management of toxic effects associated with polychemotherapy on both the cardiac muscle and vascular system. This paper analyzes modern ideas about pathogenetic relationship between cardiovascular diseases and gastric and colon cancer. The profile and mechanism of cardiovascular toxicity of chemotherapy in patients with gastric and colon cancer, pathogenetic relationship of thyroid status and cardiovascular diseases are presented. Organizational management issues of chemotherapy toxicity are briefly highlighted.

Frailty and prognosis in lung cancer: systematic review and meta-analysis

Lung cancer is one of the most common malignant tumours. Patients are frequently at risk of frailty as lung cancer progresses. The meta-analysis aims to explore the impact of frailty...

Association of sarcopenia with relative dose intensity of neoadjuvant chemotherapy in older patients with locally advanced esophageal cancer: A retrospective cohort study

IntroductionSarcopenia impacts the toxicity of chemotherapy in patients with cancer, but there is little information on the association of sarcopenia with the relative dose intensity (RDI) of chemotherapy. We investigated the association of sarcopenia with RDI of neoadjuvant chemotherapy (NAC) in older patients with locally advanced esophageal cancer (LAEC). Materials and MethodsThis was a single-center retrospective cohort study of patients aged ≥65 years who underwent curative esophagectomy after NAC for LAEC between 2016 and 2020. Skeletal muscle mass index (SMI) was calculated from computed tomography images at the L3 level. Sarcopenia was defined using the Youden index of SMI. Average RDI was calculated from delivered-dose intensity and standard-dose intensity of all drugs. The cutoff point of low average RDI was defined as <85%. The multivariate logistic regression model was used for the endpoint. ResultsWe analyzed 188 patients with a mean age of 71.3 years. The cutoff points of sarcopenia for low average RDI were defined as 42.81 cm2/m2 in males and 37.48 cm2/m2 in females. Sarcopenia significantly affected low average RDI, adjusted for age, sex, body mass index, drug regimen, clinical stage, and creatinine clearance (adjusted odds ratio: 2.195, 95% confidence interval: 1.107–4.411, p = 0.024). Compared with the non-sarcopenia patients, the sarcopenia patients with low average RDI had a higher rate of dose reduction, delayed, or discontinuation after the first cycle because of neutropenia (45% vs. 38%), and decreased performance status (11% vs. 0%). DiscussionSarcopenia predicted low average RDI (<85%) of NAC in older patients with LAEC. In the future, the information about the mechanism of association of sarcopenia with RDI will progress the development of intervention strategy and novel supportive care.

Evaluation of the relationship of the amount of ascites as measured quantitatively using computed tomography with chemotherapy toxicity in patients with ovarian cancer

Evaluation of the relationship of the amount of ascites as measured quantitatively using computed tomography with chemotherapy toxicity in patients with ovarian cancer

Short-term efficacy and toxicity of total neoadjuvant chemotherapy in patients with resectable gastric cancer

Background. Currently, perioperative chemotherapy is the standard treatment option for resectable gastric cancer (GC ) at stages higher than T1. Preoperative chemotherapy was shown do not adversely affect the course of the postoperative period in gastric cancer patients. However, approximately 60 % of radically operated patients complete adjuvant chemotherapy. In this regard, the problem arises of postponing all courses of chemotherapy for operable gastric cancer to the preoperative period.The purpose of the study was to analyze short-term efficacy and toxicity of total neoadjuvant chemotherapy with FLOT regimen in patients with resectable gastric cancer.Material and Methods. Since 2020, the Research Cancer Institute of Tomsk National Research Medical Center has been conducting a pilot study, which included 25 patients with resectable gastric cancer (T2–4N0–2M0) who received 8 cycles of neoadjuvant chemotherapy with FLOT regimen followed by radical surgery (gastrectomy or distal subtotal resection of the stomach).Results. Preoperative chemotherapy was completed in 25 (100 %) patients. Side effects that occurred during chemotherapy did not require cancellation or interruption of treatment and reduction in the initial dose of drugs. The most common adverse events were emetogenic reactions (92 %), peripheral neuropathy (60 %), and neutropenia (48 %). All patients had no greater than grade II toxicity, which was reversed with standard maintenance therapy. Radical surgeries were performed 6 weeks after completion of chemotherapy cycle 8. There were no significant postoperative complications (grade III or higher according to the Clavien–Dindo scale) and deaths. The histological examination revealed pathological response of TG R2–3 grade in 21 (84%) patients. Downstaging in both T and N categories was found in 13 (52%) patients.Conclusion. Eight cycles of total neoadjuvant chemotherapy for resectable gastric cancer demonstrates high efficacy, moderate toxicity, and do not adversely affect the course of the perioperative period.

Meta-Analysis of Therapy of Cinobufacini Capsule Adjunct with First-Line Platinum-Based Chemotherapy for the Treatment of Advanced NSCLC

Background Cinobufacini capsule, an anticancer traditional Chinese patent medicine, has been widely used as adjunctive treatment to platinum-based chemotherapy in patients with advanced NSCLC. Purpose To evaluate the efficacy and safety of cinobufacini capsule combined with first-line platinum-based chemotherapy for advanced NSCLC. Study Design. A systematic review and meta-analysis of eight outcome measures selected for this study were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Methods A comprehensive literature search was conducted in 7 electronic databases to identify all the relevant randomised controlled trials. Cochrane handbook 5.1.0 was applied to evaluate the quality of included trials, and the RevMan 5.3 and Stata 15.1 software were used to combine the trials for data analysis and assess the publication bias. Results From the 19 studies reviewed, a total of 1,564 patients were included. Compared with first-line platinum-based chemotherapy alone, cinobufacini capsule combined with chemotherapy showed significant effects in improving ORR (RR = 1.49, 95% CI (1.33, 1.66)), 1-year survival rate (RR = 1.44, 95% CI (1.28, 1.63)), and 2-year survival rate (RR = 1.78, 95% CI (1.42, 2.22)), raising the percentages of CD3+ cells (SMD = 1.25, 95% CI (1.05, 1.45)), CD4+ cells (SMD = 1.52, 95% CI (1.33, 1.71)), and ratio of CD4+/CD8+ (SMD = 1.36, 95% CI (1.17, 1.54)), and reducing chemotherapy toxicity including leukopenia (RR = 0.61, 95% CI (0.51, 0.72)), thrombocytopenia (RR = 0.52, 95% CI (0.41, 0.67)), and vomiting (RR = 0.79, 95% CI (0.70, 0.88)). Conclusion Cinobufacini capsule may increase the therapeutic effectiveness, improve cellular immune function, and reduce the toxicity of first-line platinum-based chemotherapy in patients with NSCLC. These results require confirmation by further rigorously designed randomised controlled trials (RCTs).

Effects of prognostic nutrition index on side effects and prognosis of radiotherapy and chemotherapy after radical gastrectomy.

e16002 Background: To investigate the impact of preoperative prognostic nutritional index (PNI) on the severity of radiotherapy and chemotherapy toxicity and survival prognosis in patients with gastric cancer through retrospective analysis and research in order to guide clinical nutritional support treatment for patients with gastric cancer. Methods: Through a retrospective cohort study，we analyzed the data of 191 patients with gastric cancer in the Department of Gastrointestinal Surgery of the Affiliated Hospital of Guizhou Medical University and Guizhou Cancer Hospital from January 2008 to December 2018. According to the cut-off value, the patients were divided into high PNI group (PNI≥47.7) and low PNI group (PNI &lt; 47.7). We Compared the incidences of severe radiotherapy and chemotherapy toxicities and overall survival in high PNI group and low PNI group. and make Analysis of prognostic factors. Results: The low PNI group was more prone to severe radiochemotherapy hematological side effects than the high PNI group, and the postoperative survival time was shorter. Multivariate analysis showed that: TNM stage (P = 0.000) and PNI (P = 0.001) were Independent risk factors in predicting overall survival rate. Conclusions: The preoperative prognostic nutrition index is a useful factor for predicting the incidence of radiotherapy and chemotherapy toxicities in patients after gastric cancer surgery.It is one of the important factors affecting the prognosis of gastric cancer and helps to guide the nutritional support treatment of gastric cancer patients.

Comparative proteomic analysis uncovers potential biomarkers involved in the anticancer effect of Scutellarein in human gastric cancer cells.

Scutellarein (SCU), a flavone that belongs to the flavonoid family and abundantly present in Scutellaria baicalensis a flowering plant in the family Lamiaceae, has been reported to exhibit anticancer effects in several cancer cell lines including gastric cancer (GC). Although our previous study documented the mechanisms of Scutellarein-induced cytotoxic effects, the literature shows that the proteomic changes that are associated with the cellular response to SCU have been poorly understood. To avoid adverse side-effects and significant toxicity of chemotherapy in patients who react poorly, biomarkers anticipating therapeutic responses are imperative. In the present study, we utilized a comparative proteomic analysis to identify proteins associated with Scutellarein (SCU)-induced cell death in GC cells (AGS and SNU484), by integrating two-dimensional gel electrophoresis (2-DE), mass spectrometry (MS), and bioinformatics to analyze the proteins. Proteomic analysis between SCU-treated and DMSO (control) samples successfully identified 41 (AGS) and 31 (SNU484) proteins by MALDI-TOF/MS analysis and protein database search. Comparative proteomics analysis between AGS and SNU484 cells treated with SCU revealed a total of 7 protein identities commonly expressed and western blot analysis validated a subset of identified critical proteins, which were consistent with those of the 2-DE outcome. Molecular docking studies also confirmed the binding affinity of SCU towards these critical proteins. Phosphatidylinositol 4,5-bisphosphate 3-kinase catalytic subunit β isoform (PIK3CB) protein expression was accompanied by a distinct group of cellular functions, including cell growth, and proliferation. Cancerous inhibitor of protein phosphatase 2A (CIP2A), is one of the oncogenic molecules that have been shown to promote tumor growth and resistance to apoptosis and senescence-inducing therapies. In the present study, both PIK3CB and CIP2A proteins were downregulated in SCU-treated cells, which boosts our previous results of SCU to induce apoptosis and inhibits GC cell growth by regulating these critical proteins. The comparative proteomic analysis has yielded candidate biomarkers of response to SCU treatment in GC cell models and further validation of these biomarkers will help the future clinical development of SCU as a novel therapeutic drug.

EP1.16-37 Correlation of Serum Albumin and CRP Levels with Chemotherapy Toxicity in Patients of Metastatic Lung Cancer

significant proportion of patients of lung cancer present with metastatic disease. Chemotherapy is often offered as first line treatment if patients does not have driver mutations in a specific targetable oncologic pathway and is fit to receive systemic therapy. Systemic inflammation associated with advanced cancer is often regarded as one of the factors for poor prognosis in lung cancer patients. High level of CRP and low levels of albumin are regarded as markers of systemic inflammation and prior studies have shown poor survival in such patients. It has also been shown that systemic inflammation alters the metabolism of chemotherapeutic agents resulting in either treatment failure or increased toxicity, both of which can lead to poor outcomes. This study aims to identify if increased systemic inflammatory response leads to enhanced toxicity with chemotherapeutic agents used in palliative setting in patients of metastatic lung cancer, and in turn poorer survival. Trial design Objectives Primary objective – Correlating chemotherapy toxicity with patients’ baseline albumin and CRP levels Secondary objective - Correlating CRP and Albumin levels with PFS and OS Materials and Methods Study Design - Patients with a tissue diagnosis of lung cancer will be prospectively enrolled in the study after informed consent. All clinically relevant details will be entered in a clinical proforma. Site and duration of study - Kidwai Cancer Institute; June 2018 to Dec 2019 Sample size – All patients meeting the inclusion criteria between the study time period will be included Inclusion Criteria Patients of Metastatic Biopsy Proven Lung Cancer Age 18 – 80 Planned for chemotherapy with a platin Doublet Albumin > 2.0 Exclusion Criteria Presence of targettable driver mutations Any other Synchronous / Metachronous cancer Any other uncontrolled medical comorbidities Statistical Analysis The Mann-Whitney U test and the χ2 test will be used to determine statistically significant differences 1/10/2019 #337: Correlation of Serum Albumin and CRP Levels with Chemotherapy Toxicity in Patients of Metastatic. https://cpaper.ctimeetingtech.com/elcc2019/submission/preview/print?publication_id=337 2/2 Kaplan-Meier method will be used to assess survival curves; Log-rank test to evaluate the statistical significance of differences and Cox proportional hazards model for multivariate analysis of the effect of clinicopathological factors on survival. This study aims to identify if increased systemic inflammatory response leads to enhanced toxicity with chemotherapeutic agents used in palliative setting in patients of metastatic lung cancer, and in turn poorer survival.

Visceral adiposity as a predictor of chemotherapy toxicity in patients with ovarian cancer receiving platinum and taxane-based chemotherapy

Visceral adiposity as a predictor of chemotherapy toxicity in patients with ovarian cancer receiving platinum and taxane-based chemotherapy

Sarcopenia as a predictor of chemotherapy toxicity in patients with ovarian cancer receiving platinum and taxane-based chemotherapy.

e17035 Background: Sarcopenia (age-related loss of skeletal muscle mass) is associated with worse oncologic outcomes and adverse events in patients with solid tumors. Limited research in epithelial ovarian cancer (EOC) has shown that sarcopenia is associated with worse patient outcomes. The purpose of this study was to investigate the association of sarcopenia with chemotherapy toxicity in patients with EOC. Methods: EOC patients diagnosed between 6/2000 and 2/2017 who received platinum and taxane-based chemotherapy were included. Age, race, stage, grade, BMI, comorbidities, treatment, and outcomes were collected. Chemotherapy toxicities and associated grades, as well as treatment modifications were recorded. Computed tomography (CT) images within 3 months of diagnosis were evaluated for Skeletal Muscle Area (SMA) at the 3rd lumbar vertebrae. Measurements were obtained with use of TomoVision(R) radiological software (SliceOmatic – version 5.0, Quebec, Canada). Sarcopenia was defined as Skeletal Muscle Index (SMI = SMA/height2) ≤ 41. This preliminary analysis generated descriptive statistics and compared the distributions of toxicity assessments by sarcopenia, with t-tests, rank-sum, chi-square and fisher’s exact tests. Results: 144 patients were evaluated. The majority presented with Stage III /IV, HGSOC (75%, 73%). Median age was 63 yrs and median BMI was 27.2 (IQR = 23.7-32.8). 61% of patients were sarcopenic. The median SMI was 40 (IQR = 34.2-46.2). There was no significant difference between sarcopenic (S) and nonsarcopenic (NS) patients with respect to dose adjustment (p = 0.37), regimen change (p = 0.998), need for blood transfusion (p = 0.60), toxicity-related hospitalization (p = 0.84) or delay in treatment (p = 0.37). Grade 3-4 toxicity was found in 56.8% of S and 58.9% of NS patients (p = 0.992). Similarly, the distributions of grade 1-2 toxicities in S and NS patients were comparable. Conclusions: In this cohort of patients, there was no significant association between sarcopenia and chemotherapy related toxicities. However, given high prevalence of sarcopenia in ovarian cancer patients, our relatively small sample size, and challenges with retrospective collection of chemotherapy toxicity, further prospective exploration is warranted.

Toxicity of chemotherapy in patients with colorectal cancer: The role of age in the Latin American setting.

e15095 Background: The incidence of colorectal cancer (CRC) in Peru has increased in the last decades. In our country, the toxicities of systemic treatment have not been analyzed in a large population in the different disease settings. Numerous clinical studies have shown an association between toxicities and age, type of chemotherapy, number of courses, and others. Our objective was to explore the toxicities presented in our population and find if any variables could help us predict these toxicities. Methods: We retrospectively reviewed the electronic medical records of 371 patients with CRC from one specialized Peruvian cancer center between 2006 and 2016. Descriptive results for numeric variables were presented as means with standard deviation (SD) or medians with interquartile range (IQR), depending on their distributions; otherwise, we expressed the qualitative variables as numbers with percentages. The primary outcome measure was if the patient developed toxicity ≥3 assessed with multiple variables: age, sex, tumor location, NLR, PLR, pathological stage group (PSG), type of chemotherapy (CT), liver metastases, metastasectomy performed, albumin level, CEA, nodal involvement, time to CT, number of CT courses. Multivariable analysis in logistic regression model was adjusted for the factors statistically significant in the univariable analysis. Results: A total of 371 patients were included, of which 95 (25.6%) developed a ≥3 grade toxicity. The more frequent toxicity was neuropathy (30.5%). Univariate logistic regression analysis showed that age, albumin level, PSG, time to CT, number of CT courses, type of chemotherapy (CT), tumor location and liver metastases were associated with a ≥3 grade toxicity. Furthermore, multivariate regression analysis demonstrated that stage IV [OR, 0.012; 95% CI, 0.002-0.078; p &lt; 0.001], age ≥70 [OR, 3.475; 95% CI,1.818-6.643; p &lt; 0.001], number of courses [OR, 0.839; 95% CI, 0.763-0.922; p &lt; 0.001] and albumin levels [OR, 0.391; 95% CI,0.257-0.596; p &lt; 0.001]were independently risk factors for ≥3 grade toxicity. Conclusions: Stage IV, age ≥70, a greater number of CT courses and lower albumin levels were independently associated with a ≥3 grade toxicity.

The association between sarcopenic overweight and chemotherapy toxicity in Bile Duct and Gallbladder cancer patients treated with Gemcitabine and Cisplatin

Background: Altered body composition is an independent determinant for the risk of chemotherapy toxicity. Our aim was to investigate the association between skeletal muscle mass and density and chemotherapy toxicity in patients with metastasized or locally advanced bile tract cancer (BTC) treated with gemcitabine/cisplatin. Methods: Skeletal muscle mass and density were measured on computed tomography (CT) examinations in patients with unresectable BTC treated with gemcitabine/cisplatin. Data regarding chemotherapy treatment, toxicity, and tumor response were collected. Toxicity was graded using the CTCAE. Dose-limiting toxicity (DLT) was defined as any dose reduction, treatment delay ≥1 week, or treatment termination due to toxicity. Patients were classified as having low or normal SMI according to previously defined cut-off values. Sarcopenic overweight was defined as low SMI and BMI ≥25 kg2/m2. Overall survival (OS) was calculated from the start of gemcitabine/cisplatin treatment. Results: In total, 96 patients were included with a median OS of 10.3 months (95%CI 6.9–16.4). Twenty-one patients (45.8%) were considered to have sarcopenic overweight. Eight (23.8%) sarcopenic overweight patients developed grade 3/4 infections, compared to 6 (5.5%) in patients with no sarcopenic overweight (p=0.012). Toxicity-related treatment delay was more frequently observed in sarcopenic overweight patients compared with patients with no sarcopenic overweight (65.0% vs 36.1%, p=0.021). Conclusion: In patients with PTC treated with gemcitabine plus cisplatin sarcopenic overweight was associated with more grade 3/4 infections and toxicity-related treatment, potentially hindering palliative cancer treatment. Future studies should investigate methods to calculate chemotherapy dosage to reduce toxicity.

Aidi injection plus platinum-based chemotherapy for stage IIIB/IV non-small cell lung cancer: A meta-analysis of 42 RCTs following the PRISMA guidelines

Ethnopharmacological relevanceAidi injection is one of the most commonly used Chinese patent medicines for advanced non-small cell lung cancer (NSCLC). It is made from an extraction of Mylabris Phalerata, Radix Astragalus, Radix Ginseng, and Acanthopanax Senticosus. Aim of the studyThe objective of this study is to evaluate the efficacy and safety of Aidi injection in combination with platinum-based chemotherapy for stage IIIB/IV NSCLC. Materials and methodsA systematic review and meta-analysis were performed following the PRISMA (the Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Trials were combined using Review Manager 5.3 and Comprehensive Meta-Analysis(CMA) 2.0. Dichotomous data were expressed as risk ratio (RR) and continuous outcomes as weighted mean difference (WMD), with their 95% confidence intervals (CI) respectively. All randomized controlled trials (RCTs) comparing Aidi injection plus platinum-based chemotherapy versus platinum-based chemotherapy, with efficacy and safety outcomes were selected. Disease Control Rate (DCR) was the primary outcome, Objective Response Rate (ORR), survival rate, quality of life (QOL), and toxic effects were the secondary outcomes. Results42 RCTs recruiting 4081 patients with stage IIIB/IV NSCLC were included, with overall low-moderate methodological quality. Compared with platinum-based chemotherapy alone, Aidi injection plus platinum-based chemotherapy can increase relative benefit of DCR (RR = 1.13, 95% CI 1.09–1.16, P < 0.00001), ORR (RR = 1.26, 95% CI 1.18–1.36, P < 0.00001), improve 1-, 2-, 3-year survival rates (RR = 1.14, 95% CI 1.02–1.28, P = 0.03; RR = 1.31, 95% CI 1.05–1.64, P = 0.02; and RR = 1.88, 95% CI 1.32–2.67, P = 0.0005, respectively), QOL (RR = 1.80, 95% CI 1.61–2.01, P < 0.00001), and reduce severe (grade 3 and 4) toxicities by 36% (RR = 0.64, 95% CI 0.58–0.70, P < 0.00001). ConclusionsFrom the available evidence, compared with platinum-based chemotherapy alone, Aidi injection plus platinum-based chemotherapy improves the clinical efficacy and alleviates the toxicity of chemotherapy in patients with stage IIIB/IV NSCLC. However, considering the intrinsic limitations of the included RCTs, well-designed, rigorously performed, high-quality trials are still required to further assess and confirm the results.

Phase II clinical study of paclitaxel and cisplatin combined with concurrent radiotherapy in the treatment of locally advanced esophageal squamous cell carcinoma

Objective To study the phase Ⅱ clinical efficacy of paclitaxel and cisplatin combined with concurrent radiotherapy in the treatment of locally advanced esophageal squamous cell carcinoma. Methods Sixty-three cases of locally advanced esophageal squamous cell carcinoma patients were selected from January 2014 to January 2016 in our hospital. All patients were randomly divided into the study group (32 cases) and control group (31 cases) according to random number table method. All patients were treated with three-dimensional conformal radiotherapy, the control group was treated with 5-fluorouracil and cisplatin, and study group was treated with paclitaxel combined with cisplatin, 21 days for a course of treatment, continuous 2 cycles of chemotherapy. The therapeutic effects and adverse reactions of the two groups of patients were evaluated. The levels of tumor markers such as carcino embryonic antigen (CEA), CA125 and CA50 were detected in the two groups before and after chemotherapy. The patients were followed up, and the survival rates were recorded. Results The effective rate of the patients in the study group was 93.75%, higher than that of the control group (74.19%, χ2=4.510, P=0.034). Compared with the control group, the radiation esophagitis (Z=2.076, P=0.038), neurotoxicity (Z=3.806, P<0.001), gastrointestinal reactions (Z=2.374, P=0.018), leukopenia (Z=1.979, P=0.048) were significantly lighter in the study group. After chemothe-rapy, the levels of CEA, CA125, CA50 of study group and control group were significantly lower than those before chemotherapy (all P<0.05), and the levels of study group after chemotherapy were significantly lower than those of the control group (all P<0.05). The 1-year survival rate of the patients in the study group was 90.63%, which was significantly higher than that in the control group (70.97%), and the difference was statistically significant (χ2=4.287, P=0.038). Conclusion Paclitaxel and cisplatin combined with concurrent radiotherapy can improve the phase Ⅱ therapeutic effect of locally advanced esophageal squamous cell carcinoma, the toxicity of chemotherapy in patients is low, effectively improve the short-term survival rate, with better clinical value. Key words: Esophageal neoplasms; Treatment outcome; Cisplatin; Paclitaxel

Abstract P6-07-13: Association of pre-chemotherapy peripheral blood pro-inflammatory (IL-6, CRP) and coagulation (D-dimer) markers with chemotherapy toxicity in women with breast cancer

Abstract Background: Pro-inflammatory and coagulation factors serve as biomarkers of aging and functional reserve. Chemotherapy (chemo) decreases the risk of relapse and mortality from breast cancer (BC); however, it comes with the risk of toxicity. The utility of these markers as biological risk factors for chemotherapy toxicity in patients with BC is unknown. This study was performed to determine if pre-chemo IL-6, CRP and D-dimer were associated with chemotherapy toxicity in women with breast cancer receiving adjuvant or neoadjuvant chemo. Methods: This study enrolled women across the aging spectrum with Stage I-III BC. Prior to (neo)adjuvant chemo initiation, peripheral blood was collected for IL-6, CRP, and D-dimer. (Neo)adjuvant chemo regimens were prescribed at the MD's discretion. Grade 3 or above toxicities defined by National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), version 4.0, were captured. Univariate and multivariate analyses were performed to describe the association of these biomarkers with chemo toxicity controlling for relevant tumor and host factors (stage, receptor status, age and co-morbidities). Results: 159 patients (mean age of 58.4, range 30-81) with stage I-III BC (Stage I [n=34; 21.3%], Stage II [n=88; 55.3%], and Stage III [n=37; 23.3%]) were enrolled. 89% and 11% received adjuvant and neoadjuvant chemotherapy respectively. Chemo regimens include: doxorubicin+cyclophosphamide/paclitaxel (37%), docetaxel/cyclophosphamide (35%), doxorubicin+cyclophosphamide/paclitaxel/trastuzumab (7%), docetaxel/carboplatin/trastuzumab (7%), sequential doxorubicin/paclitaxel/cyclophosphamide (5) and other regimens (9%). At least one grade 3 to 5 toxicity occurred in 70 (44%) patients (93% grade 3, 6% grade 4, and 1% grade 5). Grade 3 to 5 hematological (heme) and non-heme toxicity occurred in 23% and 39%, respectively. The most common grade 3 to 4 heme toxicities were anemia (38%), leucopenia (29%), and neutropenia (24%). One patient developed grade 5 toxicity (pneumonitis). The most common grade 3-4 non-heme toxicities were electrolyte abnormalities (12%), neuropathy (10%), mucositis (8%), infection (8%) and fatigue (8%). Univariate analysis revealed an association of increased pre-chemo D-dimer and grade ≥3 toxicity (p=0.02) (Table 1). Among the clinical factors, increased age and number of co-morbidities was associated with grade ≥3 toxicities (p&amp;lt;0.01 respectively). After controlling for age and number of comorbidities the association between elevated D-dimer and chemo toxicities remain significant (OR 2.1 [95%CI1.1-3.9]). Conclusions: Grade 3-5 toxicities are common in women with breast cancer undergoing (neo)adjuvant chemo. A biomarker of aging, D-dimer, is associated with increased risk of chemo toxicity. Table 1 Association of peripheral blood biomarkers of aging and Grade 3-5 chemo toxicities Grade ≥3 Toxicity (N=89)Grade &amp;lt; 3 Toxicity (N=70)P-ValueIL-6 (pg/ml) Median (Range)1.7(0 -42.1)1.9 (0-19.6)0.57D-dimer (µg/ml) Median (Range)0.8(0.1-3.3)0.5 (0.1-2.6)0.02CRP (µg/ml) Median (Range)2.6(0.1-48.4)3.0 (0.2-44.3)0.57 Citation Format: Yuan Y, Vora N, Sun C, Li D, Mortimer J, Luu T-h, Somlo G, Waisman J, Chao J, Katheria V, Synold T, Tran V, Mi S, Levi A, Yost S, Arsenyan A, Choi J, Zavala L, Hurria A. Association of pre-chemotherapy peripheral blood pro-inflammatory (IL-6, CRP) and coagulation (D-dimer) markers with chemotherapy toxicity in women with breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-07-13.

Sarcopenia is Associated with Chemotherapy Toxicity in Patients Undergoing Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis from Colorectal Cancer.

Despite the positive survival results of cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC), criticisms have been put forward regarding the safety of this treatment as a result of a high morbidity rate. Muscle depletion (sarcopenia) is associated with the occurrence of postoperative complications. The purpose of this study was to determine the association between sarcopenia and postoperative morbidity after CRS-HIPEC for peritoneal carcinomatosis from colorectal cancer by distinguishing the complications linked to CRS itself and those associated with chemotherapy (HIPEC) toxicities. Data concerning 97 consecutive patients who had undergone CRS-HIPEC were recorded. We analyzed the events occurring within 30days after surgery that were prospectively recorded in a database. Sarcopenia was assessed using the L3 muscle index on computed tomography performed during the 2months preceding surgery. The sarcopenic patients experienced significantly more chemotherapy toxicities (57 vs. 26%; p=0.004) and especially neutropenia (36 vs. 17%; p=0.04) than their nonsarcopenic counterparts. There was no difference in complications linked to the CRS procedure between sarcopenic and nonsarcopenic patients. In the multivariate analysis, sarcopenia was the only parameter independently associated with the risk of chemotherapy toxicity (odds ratio 3.97; 95% confidence interval 1.52-10.39; p=0.005). Despite the local administration of chemotherapy, systemic toxicity was observed in sarcopenic patients after CRS-HIPEC. This relationship favors new treatment strategies with white blood cell growth factors or chemotherapy dosing based on muscle value.

Real-time monitoring efficiency and toxicity of chemotherapy in patients with advanced lung cancer.

BackgroundThe Response Evaluation Criteria in Solid Tumors (RECIST) guideline and Common Terminology Criteria for Adverse Events (CTCAE) criteria are used to assess chemotherapy efficiency and toxicity in patients with advanced lung cancer. However, no real-time, synchronous indicators that can evaluate chemotherapy outcomes are available. We wanted to evaluate tumor response and toxicity in advanced lung cancer chemotherapy by using a novel synchronous strategy.ResultsWe enrolled 316 patients with advanced lung cancer who were treated with cisplatin-based therapy and followed up them for 3 years. Plasma was obtained before and after every chemotherapy cycle. We quantitative assayed total plasma DNA and methylation of the APC/RASSF1A genes. Four parameters were assessed: methylation level before chemotherapy (meth0 h), methylation level 24 h after chemotherapy (meth24 h), total plasma DNA concentration before chemotherapy (DNA0 h), and total plasma DNA concentration 24 h after chemotherapy (DNA24 h). When meth24 h > meth0 h of at least one gene was used to predict tumor response, the correct prediction rate was 82.4 %. Additionally, patients for whom DNA24 h/DNA0 h ≤ 2 had mild toxicities. Therefore, meth24 h > meth0 h and DNA24 h/DNA0 h ≤ 2 were defined as criteria for better tumor response and fewer adverse events with a high correct prediction rate (84.7 %).ConclusionsQuantitative analysis of total plasma DNA and plasma APC/RASSF1A methylation provide a real-time synchronous rapid monitoring indicator for therapeutic outcomes of advanced lung cancer, which could be a reference or supplementary guidelines in evaluating chemotherapy effects.Electronic supplementary materialThe online version of this article (doi:10.1186/s13148-015-0150-9) contains supplementary material, which is available to authorized users.

2316 Efficacy and toxicity of second-line chemotherapy in patients with advanced oesophageal squamous cell carcinoma progressing after a first line of 5-fluorouracil and platinum-based therapy: An AGEO retrospective multicentric study

2316 Efficacy and toxicity of second-line chemotherapy in patients with advanced oesophageal squamous cell carcinoma progressing after a first line of 5-fluorouracil and platinum-based therapy: An AGEO retrospective multicentric study