88 / 154
S58
A B S T R A C T S
cosmetic results achieved and they can cope very well with
repeated follow-up assessments,This new evidence should be
taken into account when considering OWBC for surgery.
Table (abstract P038)
Questionnaire
Response
No. of pts %
Happy with the
Very likely
27
51.9
recommend treatment Likely
24
46.1
including RT?
Neutral
1
1.9
Less likely
0
-
Unlikely
0
-
NA (dementia)
3
NA
Was follow-up
Very likely
30
57.7
acceptable?
Likely
21
40.4
Neutral
1
1.9
Unlikely
0
-
Not at all
0
-
NA (Dementia)
3
NA
Patient’s cosmetic
Poor
0
-
perception
Fair
0
-
Good
15*
39.5
Excellent
23
60.5
NA (mastectomy)
16
NA
Surgeon’s cosmetic
Poor
2
5.4
perception
Fair
4*
10.5
Good
12
31.5
Excellent
20
52.6
NA (mastectomy)
16
NA
*1 patient had mastectomy and breast reconstruction
Reference:
[1] Eduardo Bruera et al. Treatment decisions for breast
carcinoma-patient preferences and physicians’ percep-
tions. Cancer 2002; 94:2076-80.
Disclosure of interest:
None declared
Keywords:
Elderly women with breast cancer, breast
conservation surgery, perception
P039
ASSOCIATION OF PRE-CHEMOTHERAPY PERIPHERAL
BLOOD BIOMARKERS OF AGING (IL-6, CRP AND D-DIMER)
WITH CHEMOTHERAPY TOXICITY AND RELATIVE DOSE
INTENSITY (RDI) IN WOMEN WITH BREAST CANCER
Y. Yuan
1,
*, N. Vora
2
, C. Sun
1
, D. Li
1
, J. Mortimer
1
, G. Somlo
1
,
J. Waisman
1
, J. Chao
1
, V. Katheria
1
, T. Synold
1
, V. Tran
1
, S. Mi
1
,
A. Levi
1
, S. Yost
1
, A. Arsenyan
1
, L. Zavala
1
, J. Choi
1
, A. Hurria
1
1
City of Hope National Cancer Center, Duarte,
2
Long Beach
Memorial Hospital, Long Beach, USA
Introduction:
Chemotherapy (chemo) decreases the risk
of relapse and mortality from breast cancer (BC); however, it
comes with the risk of toxicity. Chemo efficacy depends on
RDI, and patients (pts) who receive <85% RDI have poorer
overall survival. Pro-inflammatory and coagulation factors
serve as biomarkers of aging and functional reserve. The
utility of these markers as biological risk factors for chemo
toxicity in patients with BC is unknown.
Objectives:
This study was performed to determine if pre-
chemo IL-6, CRP and D-dimer were associated with chemo
toxicity and reduced RDI in women with BC receiving (neo)
adjuvant chemo.
Methods:
This study enrolled women across the aging
spectrum with Stage I-III BC. Prior to (neo)adjuvant chemo,
peripheral blood was collected for IL-6, CRP, and D-dimer.
(Neo)adjuvant chemo regimens were prescribed at the
MD’s discretion. Grade
3 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 and
<85% RDI, 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. Eighty nine percent
and 11% received adjuvant and neoadjuvant chemotherapy
respectively. Chemo regimens include: doxorubicin + cyclo-
phosphamide/paclitaxel (AC/T) (37%), docetaxel/cyclophos-
phamide (TC, 35%), AC/T/trastuzumab(AC-TH) (7%), docetaxel/
carboplatin/trastuzumab (TCH, 7%), sequential A/T/C (5%) and
other regimens (9%). At least one grade 3-5 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- 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<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]).
RDI was less than 85% for 26% of pts. There were associations
between RDI <85% and higher D-dimer (p<0.01) and IL-6
(p=0.02) levels pre-chemo. There was no association of CRP
with chemo toxicity or RDI.
Table 1 (abstract P039) – Association of peripheral blood biomarkers of
aging and Grade 3-5 chemo toxicities
Grade
3 Toxicity
Grade < 3 Toxicity
(N=89)
(N=70)
Median (Range)
Median (Range)
P-Value
IL-6 (pg/ml)
1.7 (0-42.1)
1.9 (0-19.6)
0.57
D-dimer (µg/ml)
0.8 (0.1-3.3)
0.5 (0.1-2.6)
0.02
CRP (µg/ml)
2.6 (0.1-48.4)
3.0 (0.2-44.3)
0.57
Conclusion:
Grade 3-5 toxicities are common in women
with BC undergoing (neo) adjuvant chemo. A biomarker of
aging, D-dimer, is associated with increased risk of chemo
toxicity and RDI <85%.
Disclosure of interest:
Y. Yuan: None declared, N. Vora:
None declared, C. Sun: None declared, D. Li: None declared,
J. Mortimer: None declared, G. Somlo: None declared, J.
Waisman: None declared, J. Chao: None declared, V. Katheria:
None declared, T. Synold: None declared, V. Tran: None
declared, S. Mi: None declared, A. Levi: None declared, S. Yost:
None declared, A. Arsenyan: None declared, L. Zavala: None