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A B S T R A C T S
S57
given. Our data suggest that age alone is not a significant
predictor of survival for patients with ovarian cancer and
should not be a reason to deviate from standard treatment
recommendations in an elderly patient.
Disclosure of interest:
S. Robertson: None declared, B.
Khulpateea : None declared, Y. Xiong: None declared, K.
O’Hara: None declared, M. Extermann Grant/Research Support
from: GTx, H. S. Chon: None declared
Keywords:
Comorbidity, elderly, ovarian cancer
P037
SAFETY AND EFFICACY OF LOWER DOSE WEEKLY
TOPOTECAN IN ELDERLY PATIENTS WITH PLATINUM
RESISTANT OVARIAN AND PERITONEAL CANCER
V. Michalaki
1,
*, T. Panoskaltsis
2
, G. Frangulidis
3
, N. Dafnios
3
,
C. Papadimitriou
1
1
Oncology,
2
Gynecology,
3
Surgery, Areteion Hospital University of
Athens, Athens, Greece
Introduction:
Topotecan at a dose of 1.5 mg/m(2) on days
1 to 5 of a 21-day cycle is indicated in the treatment of
advanced-stage ovarian cancers refractory to prior platinum-
based regimen. However, many pretreated patients may be
predisposed to hematologic adverse events.
Objectives:
The aim of this phase II study was to assess the
safety and efficacy of a weekly administration of a lower dose
of topotecan in patients with recurrent ovarian or peritoneal
cancer, having relapsed after platinum/taxane-based first-
line chemotherapy.
Methods:
Elderly patients with advanced ovarian and
peritoneal cancer with progression of disease </=8 months
after first-line chemotherapy were enrolled to receive
topotecan (2.5 mg/m(2)) on days 1, 8 and 15 (q 28 d). The
primary endpoints were dose density, response rate, and
overall tolerance.
Results:
Thirty-two patients were enrolled in the study and
all were evaluable.Twenty-four patients (75%) had measurable
disease at baseline and 8 (25%) had elevated CA125 only. In
order to avoid dose delays and need for GCSF administration,
the dose of topotecan was lowered to 2.5 mg/m(2). Of the 32
enrolled patients (median age, 76 years; range, 71 to 85 years),
30 patients had ovarian cancer, and 2 patients had peritoneal
cancer. A median of 9 topotecan cycles was administered. Of
32 response-evaluable patients, 6 (19%) had a partial response,
14 (43%) had stable disease, and 12 (38%) had progressive
disease. Median duration of response was 4.8 months. Lower
dose weekly topotecan was well tolerated: 6 (18%) patients had
grades 2-3 neutropenia, and 8 (25%) had grades 2-3 fatigue. No
grade 4 thrombocytopenia or anemia was reported. No patient
was admitted with neutropenic fever. Approximately 80% of
the patients received the complete schedule of treatment,
dose interruptions/delays being mainly due to moderate
thrombocytopenia or neutropenia.
Conclusion:
Lower dose of weekly topotecan was well
tolerated in patients with platinum-resistant ovarian or
peritoneal cancer at first relapse, with a favourable hema-
tologic profile. Moreover, antitumor activity was similar to
that reported for the standard dose of weekly regimen.
Disclosure of interest:
None declared
Keywords:
Elderly, ovarian cancer, platinum resistance
P038
DO WE KNOWWHAT OLDER WOMEN WITH BREAST
CANCER WANT? DECISION MAKING PREFERENCES FOR
TYPE OF TREATMENT, FOLLOW UP AND PERCEPTIONS OF
COSMETIC OUTCOMES
Y. K. Jain
1
, D. Tognali
2
, R. Audisio
1,
*
1
General Surgery, St Helens and Knowlsey Teaching Hospitals NHS
Trust, Prescot, United Kingdom,
2
General Surgery, University of
Brescia, Brescia, Italy
Introduction:
Elderly patients with breast cancer make
a different group who requires individualised treatment.
There is a perception that older patients with breast cancer
(OWBC) would chose a mastectomy over breast conserving
surgery (BCS) and cosmetic outcome may not be an important
endpoint among these patients. It is also disputed if OWBC can
comply with adjuvant radiotherapy. The practice of follow-up
is not evidence-based, especially when dealing with OWBC.
Objectives:
We performed a prospective observational study
on surgically treated OWBC with the aim of understanding
their preference for type of treatment. We also took patients’
and surgeons’ views on breast cosmesis and the patients’
perception of adjuvant radiotherapy and their opinion regards
follow up.
Methods:
We conducted a qualitative, observational cohort
study of women aged over 70 years who were diagnosed with
operable primary breast cancer. The face-to-face interview
consisted of a semi-structured questionnaire in the following
domains: patients’ preference for the treatment type, patients’
perception of the follow-up and perception of cosmetic
outcomes. The data were recorded on Excel and analysed.
Results:
55 consecutive OWBC were interviewed (October
2014-July 2015) and 98% of patients with no cognitive
impairment (51/52) were quite happy with the treatment
(breast conservation surgery/mastectomy) they chose/
received. Also, the majority of patients (51/52) were happy
to attend for their annual follow-up at hospital. All patients
treated with BCS were happy with their cosmesis. The
patients’ body image was perceived to be relevant as our
patients commented on their cosmetic outcomes following
BCS. The patients’ judgment appeared to be more positive
than the surgeon’s scores: patients provided appreciation
(good-14 patients; excellent-23 patients) which contrasts with
a slightly more negative score as provided by the surgical team
(poor-2 patients; fair-3 patients; good-12 patients; excellent-20
patients). The only patient who received a mastectomy and
immediate reconstruction was very pleased with the result
(excellent) but her surgeon scored her results as fair.
Conclusion:
This prospective observational study proves
how OWBC are interested in receiving BCS when possible,
including adjuvant radiotherapy; they are apppreciative of the