Incidence Of Palmar-plantar Erythrodysesthesia Research Articles

Efektivitas Perendaman Tangan Kaki dengan Air dan Pengolesan Campuran VCO dan Olive Oil dalam Mengatasi Efek Samping Kemoterapi (Palmar-Plantar Erythorodysesthesia) pada Pasien Kanker Kolon di Murni Teguh Memorial Hospital

Patients with colon cancer undergoing chemotherapy at the Pure Teguh Memorial Hospital both inpatient and outpatient experience many Palmar-Plantar Erythrodysesthesia. Palmar-Plantar Erythrodysesthesia incident that occurs in colon cancer patients due to side effects of chemotherapy. The high incidence of Plamr-Plantar Erythrodysesthesia in colon cancer patients is related to the lack of immersion of the feet with water and the application of a misture of VCO and olive oil. This type of research is a quasy experimental study of post test only non eguivalent control group design that aims to determine the effectiveness of soaking the foot with water and applying a mixture of VCO and Olive Oil in overcoming the side effects of chemotherapy (Palmar-Plantar Erythrodysesthesia) in colon cancer patients in Pure Teguh Memorial Hospital.The population in this study were all colon cancer patients who were undergoing chemotherapy in the Murni Teguh Memorial hospital chemotherapy center as many as 90 patients and a sample of 90 patients consisting of 45 people in the intervention group and 45 in the control group). Data were analyzed with chi square test. The results of the study are the effectiveness of foot immersion soaking with water and the application of a mixture of VCO and olive oil to overcome the side effects of chemotherapy (Palmar-Plantar Erythrodysesthesia) in colon cancer patients at Murni Teguh Memorial Hospital.As a suggestion in this study, it is expected that immersion of foot hands with water and the application of a mixture of VCO and olive oil to reduce Palmar-Plantar Erythrodysesthesia in colon cancer patients at Murni Teguh Memorial Hospital and for patients should immerse foot hands with water and basting mixture of VCO olive oil data to reduce the incidence of Palmar-Plantar Erythrodysesthesia.

Incidence of palmar-plantar erythrodysesthesia and hypothyroidism in patients with metastatic cancer treated with cabozantinib: A systematic review and meta-analysis of randomized controlled trials.

204 Background: Cabozantinib is an oral inhibitor of multiple tyrosine kinases, including VEGFR, KIT, RET and MET, and is proven to be beneficial in different types of tumors. Nevertheless, there are noteworthy safety concerns. We performed a systematic review and meta-analysis of randomized controlled trials (RCT) to determine the risk of palmar-plantar erythrodysesthesia (PPE) and hypothyroidism among patients with metastatic cancer treated with cabozantinib. Methods: We systematically conducted a comprehensive literature search using MEDLINE, EMBASE databases and meeting abstracts through January 31, 2017. The randomized controlled phase 3 trials that mention PPE and hypothyroidism as adverse effects were incorporated in the analysis. Mantel-Haenszel method was used to calculate the estimated pooled risk ratio (RR), and risk difference (RD) with 95% confidence interval (CI). Random effects model was applied. Results: Three phase 3 RCTs with a total of 1999 patients were eligible for analysis. Studies compared cabozantinib (C) vs everolimus, C vs placebo, C vs prednisone, were included in the analysis. All grade-PPE incidence was 499 (36.6%) in cabozantinib arm vs 26 (3.36%) in control arm with a RR of 13.998 (95% CI: 5.409 – 36.224, P < 0.0001). The absolute RD was 0.374 (95% CI: 0.258 – 0.489, P < 0.0001). High-grade PPE was reported in 93 (7.58%) in cabozantinib group vs 3 (0.39%) in control group with a RR of 12.486 (95% CI: 4.529 – 34.426, P < 0.0001). The RD was 0.080 (95% CI: 0.045 – 0.115, P < 0.0001). The overall incidence of hypothyroidism was noted in 292 (23.82%) in cabozantinib arm vs 24 (3.1%) in control arm. The pooled RR of hypothyroidism was 15.825 (95% CI: 1.229 – 203.820, P = 0.034) and RD was 0.237 (95% CI: 0.113 – 0.361, P < 0.0001). Conclusions: Our meta-analysis demonstrated that cabozantinib contributed to significant toxicity of all-grade and high-grade PPE as well as hypothyroidism. Identifying these toxicities may aide physicians in providing good supportive care and patients’ quality of life.

Randomized Phase III Study of Canfosfamide in Combination With Pegylated Liposomal Doxorubicin Compared With Pegylated Liposomal Doxorubicin Alone in Platinum-Resistant Ovarian Cancer

To evaluate the safety and efficacy of canfosfamide in combination with pegylated liposomal doxorubicin (PLD) in platinum-resistant ovarian cancer (OC). Patients with platinum-refractory or -resistant (primary or secondary) OC were randomized to receive canfosfamide at 1000 mg/m² and PLD at 50 mg/m² intravenously or PLD alone at 50 mg/m2 intravenously on day 1 every 28 days until tumor progression or unacceptable toxicity. The primary end point was progression-free survival (PFS). Other end points were objective response rate and safety. The study was originally planned for 244 patients. The trial was temporarily placed on hold after 125 patients were randomized while the results of another trial were being reviewed and the sponsor decided not to resume enrollment. The interim analysis became the final analysis. The median PFS was 5.6 months for canfosfamide + PLD (n = 65) versus 3.7 months for PLD (n = 60) (hazards ratio, 0.92; P = 0.7243). A preplanned subgroup analysis showed that 75 patients with platinum-refractory or primary platinum-resistant OC had a median PFS of 5.6 months for canfosfamide + PLD versus 2.9 months for PLD (hazards ratio, 0.55; P = 0.0425). Hematologic adverse events were 66% on the canfosfamide + PLD arm versus 44% on the PLD arm, manageable with dose reductions. Nonhematologic adverse events were similar for both arms. The incidence of palmar-plantar erythrodysesthesia and stomatitiswas lower on canfosfamide + PLD(23%, 31%, respectively) versus (39%, 49%, respectively) on PLD. Overall median PFS showed a positive trend but was not statistically significant. The median PFS in the platinum-refractory and primary platinum-resistant OC patients was significantly longer for canfosfamide + PLD versus PLD. Canfosfamide may ameliorate the palmar-plantar erythrodysesthesia and stomatitis known to be associated with PLD. Further study of this active well-tolerated regimen in platinum-refractory and primary platinum-resistant OC is planned. This study was registered at www.clinicaltrials.gov: NCT00350948.

Incidence of Palmar-Plantar Erythrodysesthesia in Pretreated and Unpretreated Patients Receiving Pegylated Liposomal Doxorubicin

Association between pegylated liposomal doxorubicin-based regimens and palmar-plantar erythrodysesthesia have just been emphasized, whereas the relationship between previous treatment and palmar-plantar erythrodysesthesia is still a matter of discussion. We evaluate the relationship between previous chemotherapy treatments and the development of palmar-plantar erythrodysesthesia in patients receiving pegylated liposomal doxorubicin-based regimens. Between January 2005 and November 2006, 92 patients received regimens including pegylated liposomal doxorubicin. Patients were divided into three groups based on pegylated liposomal doxorubicin dosing interval length, different dose chosen, and previous chemotherapy. Among pretreated patients receiving regimens including 30 mg/m2 of pegylated liposomal doxorubicin repeated every three weeks, the incidence of palmar-plantar erythrodysesthesia was not significantly higher than in unpretreated patients receiving the same weekly schedule (P = 0.4). There was no difference in the incidence of palmar-plantar erythrodysesthesia between pretreated patients with regimens including 30 mg/m2 of pegylated liposomal doxorubicin every three weeks and pretreated patients receiving 20 mg/m2 of pegylated liposomal doxorubicin every two weeks (P = 0.8). The prevalence of palmar-plantar erythrodysesthesia observed in the unpretreated group exposed to 30 mg/m2 every three weeks was comparable to that of the pretreated group receiving 20 mg/m2 biweekly (P = 0.3). However, excluding all the patients who developed grade 1 palmar-plantar erythrodysesthesia, the incidence of grade 2 and 3 palmar-plantar erythrodysesthesia observed in pretreated patients receiving regimens including 20 mg/m2 of pegylated liposomal doxorubicin biweekly was significantly higher than in unpretreated patients receiving 30 mg/m2 of pegylated liposomal doxorubicin every three weeks (P = 0.001). Our findings indicate that the pretreatment is not involved in the increased incidence of any grade palmar-plantar erythrodysesthesia. On the contrary, the study could suggest that the type of previous treatment may be an important factor in the development of more severe forms of palmar-plantar erythrodysesthesia.

Pegylated liposomal doxorubicin in ovarian cancer patients with renal compromise

e16569 Background: Ovarian cancer patients with renal compromise poses problem in choosing chemotherapy for them. Pegylated liposomal doxorubicin (PLD) can be used in such cases. However there is not much data regarding the efficacy and toxicity of PLD. We used PLD in a few renal compromised ovarian and peritoneal cancer patients. Methods: The clinical records of patients with recurrent ovarian and peritoneal cancer patients with high creatinine or low creatinine clearance level who were given PLD at the Netaji Subhas Chandra Bose Cancer Research institute) (NCRI) from July 2005 to July 2008 was reviewed retrospectively to study efficacy and toxicity. Results: Twenty-one patients were identified, which included 16 with epithelial ovarian cancer, 5 with peritoneal cancer. Renal compromise was diagnosed and graded according to creatinine clearance test (CCT) as severe when less than 28 mL/min/1.5 m2, moderate when CCT is 28–55 mL/min/1.5 m2, and mild when CCT is 55–84 mL/min/1.5 m2. Normal value was taken as 85 mL/min/1.5 m2. Patients had distribution as mild: 4 patients, moderate:7 patients, and severe:10 patients. The initial doses of PLD were classified into regular initial dose (40 mg/m2/4 weeks) and lower initial dose (20–30 mg/m2/4 weeks). The median cycle was 5 (range 1–12). We used lower dose for moderate and severe renal disease. The incidence of palmar-plantar erythrodysesthesia 5/21 (23.8%), stomatitis 6/21(28.5%), and hematologic toxicity 3/21(14.2 %). Dose reduction due to toxicities occurred in 19.04 % (4/21) patients. Amongst 21 cases no patient had deterioration of renal function while and after the treatment with PLD. However we had primary treatment with PLD in four cases (2 moderate and 2 severe) while others had platinum based initial treatment. We did not have any complete responder though we had 6 (28.5%) partial responders, 8 (38.1%) stable diseases and 7(33.3%) progressive diseases. Conclusions: Patients with renal compromise who received PLD therapy at an initial dose lower than 40 mg/m2/4 weeks tolerated their treatment well. They required subsequent dose reduction due to mucocutaneous and cardiological toxicities in 19% cases. Treatment response in this population with ovarian and peritoneal cancer was similar to that of patients with normal renal function. No significant financial relationships to disclose.