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A B S T R A C T S
S71
Table (abstract P059) – Pooled Population from Rolapitant Phase 3
Trials
<65 y
65 y
Rolapitant Control
Rolapitant Control
CR, %
(n=892) (n=863) P-value (n=309) (n=338) P-value
Delayed phase 70.7
60.4
<0.001
73.1
62.4
0.004
(
24–120 h)
Acute phase
81.8
77.4
0.021
88.3
82.0
0.023
(
24 h)
Overall phase 67.7
57.5
<0.001
71.5
59.8
0.002
(0–120 h)
Disclosure of interest:
M. Aapro Consultant for: Tesaro,
Inc., Speakers bureau: Tesaro, Inc., D. Powers Shareholder of:
Tesaro, Inc., Employee of: Tesaro, Inc., S. Arora Shareholder of:
Tesaro, Inc., Employee of: Tesaro, Inc.
Keywords:
Chemotherapy, nausea and vomiting,
neurokinin-1, rolapitant
P060
POTENTIALLY INAPPROPRIATE MEDICATION USE IN
ELDERLY BREAST AND COLORECTAL CANCER PATIENTS
M. Karuturi
1,
*, S. S. Giordano
2
, H. Holmes
3
, M. Johnson
4
, X. Lei
2
1
Breast Medical Oncology,
2
Health Services Research, MD Anderson
Cancer Center,
3
Geriatric and Palliative Medicine, University of
Texas Health Science Center at Houston,
4
University of Houston
College of Pharmacy, Houston, USA
Introduction:
Screening for potentially inappropriate medi-
cation (PIM) use is recommended in elderly cancer patients
receiving chemotherapy. However, few studies have examined
the patterns and impact of PIM use in this population.
Objectives:
To determine predictors of PIM use and its
impact on outcomes in breast and colorectal cancer patients
receiving chemotherapy.
Methods:
We used data from the Surveillance,
Epidemiology and End Results database linked to Medicare
claims. Our cohort included patients 66 years and older with a
diagnosis of Stage II/III breast and colorectal cancer receiving
adjuvant chemotherapy for a cancer diagnosis made between
7/1/2007 and 12/31/2009. We used STOPP criteria modified for
use with administrative data to define baseline PIM used as
a dichotomous variable in the 4 months prior to diagnosis.
Outcome measures included ER visits, hospitalization, death
within 6 months of diagnosis, and a composite outcome of
any of these. We used Chi-square or Fisher’s exact test to
determine associations of PIMs with covariates and outcomes,
multivariable logistic regression to determine predictors of
baseline PIM use, and finally a Cox proportional hazards (PH)
model analysis.
Results:
FInal analysis included 1595 breast and 1528
colorectal cancer patients. The frequency of baseline PIM by
STOPP criteriawas 31.5%and 30.9% in the breast and colorectal
cohorts respectively. In the breast cohort, associations with
baseline PIM in the multivariable analysis included higher
comorbidity and more baseline medications. Associations
with baseline PIM in the colorectal cancer cohort included
older age at diagnosis, higher comorbidity, and more baseline
medications. In the multivariable Cox PH model for the
breast cancer cohort for the composite outcome in a 3 mos
time period from first chemotherapy, associations included
stage, comorbidity, baseline medications and baseline ER
visits/hospitalization. In the multivariable Cox PH model
for the colorectal cohort, age, gender, race, comorbidity and
baseline ER/hospitalization were significant predictors of the
composite outcome (Table 1). Baseline PIM via STOPP was not
associated with any of the separate or composite outcomes in
either cohort, aside from an association with hospitalization
in breast cancer patients (HR 1.28, 95% CI=1.02-1.61, p=0.032).
Table 1 (abstract P060) – Cox PH Model for time-to-event (adjusted
for year of diagnosis, poverty, education, number of care providers,
chemotherapy regimen, baseline PIM, and baseline ER/hospitalization)
HR
95% CI
Breast
Baseline PIM via STOPP criteria (yes v. no)
1.07
0.89-1.29
Stage III v. II
1.33
1.13-1.57
Charlson 2+ v. 0
1.46
1.15-1.85
5-10 v. 0-4 baseline medications
1.27
1-1.61
11+ v. 0-4 baseline medications
1.75
1.34-2.28
Colorectal
Baseline PIM via STOPP criteria (yes v. no)
1.11
0.94-1.33
Age 70-75 v 66-70
1.27
1.03-1.55
other v. non-Hispanic white race
0.59
0.44-0.8
Female v. male
1.37
1.18-1.6
Conclusion:
Screening for PIM is recommended as a
preventative measure in older cancer patients receiving
chemotherapy. However, in our analysis, we found no
association between pre-chemotherapy PIM use defined
by STOPP and outcomes. We did find that high medication
number was associated with the composite outcome in
the breast cancer cohort. Limitations of the study are the
modification of STOPP criteria required for application to
claims-based data, and those inherent to a retrospective
study.
Disclosure of interest:
None declared
Keywords:
Geriatric assessment, polypharmacy
P061
POTENTIAL DRUG INTERACTIONS IN OLDER PATIENTS
WITH CANCER: THE ELCAPA COHORT SURVEY (ELCAPA-15)
G. Beinse
1
, D. Reitter
2
, L. Segaux
3
, M. Carvahlo-Verlinde
2
,
C. Tournigand
4
, T. Cudennec
5
, E. Paillaud
1,
*, F. Canouï-Poitrine
3
,
P. Caillet
1
on behalf of ELCAPA Study Group
1
Department of Internal and Geriatric Medicine,
2
Department of
Pharmacy,
3
Department of Public Health and Clinical Research
Unit (URC-Mondor),
4
Department of Medical Oncology, APHP -
Hôpital Henri MONDOR,
5
Department of Geriatrics, AP-HP, Hôpital
Ambroise Paré, Créteil, France
Introduction:
Because of the increasing number of
comorbidities with age leading to polypharmacy, older cancer
patients are at higher risk of adverse events related to drug-