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M.E. Pacher



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    P2.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 207)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Advanced Diseases - NSCLC
    • Presentations: 1
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      P2.01-034 - Predictive Factors of Brain Metastases Development in Non-Small Cells Lung Cancer (ID 2291)

      09:30 - 17:00  |  Author(s): M.E. Pacher

      • Abstract
      • Slides

      Background:
      Brain metastases are evidenced in 10 to 30 % of NSCLC patients sometime during the disease. The purpose of our research is to identify the clinical pathological characteristics in patients with stage IIIB-IV in relation to the development of brain metastases.

      Methods:
      590 patients with lung cancer at our institution were analyzed between 2000 and 2013, of which 190 (32,3%) were stage EIIIB and 400 (67,7%) EIV. 76 (12.8%) had brain metastases. The variables included in the analysis of patients with and without brain metastases were: gender, age, histology, smoking status and ECOG. The multivariate logistic regression model was used to identify factors related to brain metastases.

      Results:
      64 patients out of the total 76 had brain metastases at initial diagnosis and 11 EIIIB developed brain metastasis in relapses. The development of brain metastasis was higher in men compared to women (77.7% vs 22.2%). Over 80% of patients presented ECOG of 0-1. Regarding histology, 60.32% were adenocarcinomas; 30% squamous, and 9.5% undifferentiated. 65% of patients were under 65 years old. 66.6% of patients were former smokers. Patients under 65 years old were at increased risk of developing brain metastases than older patients (HR=0,5-IC95%= 0,6-1,16- p=0,045). Adenocarcinoma histology was associated with an increased number of brain metastases development (OR = 2.42 - 95% CI = 1.84 to 3.00 - p= 0.003).

      Conclusion:
      Patients who were younger than 65 years old and adenocarcinoma histology, had a statistically significant higher risk of developing brain metastases. Regarding gender, we observed an increased risk in men; however, the differences were not statistically significant.

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    P2.11 - Poster Session/ Palliative and Supportive Care (ID 230)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Palliative and Supportive Care
    • Presentations: 1
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      P2.11-005 - The Use of Duloxetine in Chemotherapy-Induced Peripheral Neuropathy (ID 2287)

      09:30 - 17:00  |  Author(s): M.E. Pacher

      • Abstract
      • Slides

      Background:
      Approximately 50% to 70% of patients with cancer who receive neurotoxic chemotherapy with taxanes and platinums will develop painful chemotherapy-induced peripheral neuropathy. Duloxetine is a balanced serotonin and noradrenaline reuptake inhibitor licensed for the treatment of major depressive disorders and the management of neuropathic pain associated with peripheral neuropathy. Our objective is to assess the efficacy, compliance and toxicity of duloxetine for treating painful neuropathy.

      Methods:
      We analyzed data from 79 patients of the Instituto Oncológico de Córdoba (IONC) with breast, lung, colorectal, cervix and endometrium cancer. Eligibility required that patients have grade 2 (G2) or higher sensory neuropathy according to the NCI Common Terminology Criteria for Adverse Events, after paclitaxel, other taxane, or platinum treatment. The initial treatment consisted of taking 1 capsule daily of 30 mg of duloxetine for the first week and 2 capsules of 30 mg of duloxetine daily for 4 additional weeks.

      Results:
      We enrolled 79 patients with a median age of 63.25 years. Of these, 67% were female and 33% male; 40.5% received adjuvant treatment, 55.6% advanced treatment and 3.7% neoadjuvant treatment. Chemotherapies used were Oxaliplatin (35.4%), paclitaxel (36.5%) carboplatin + paclitaxel (25.3%), and cisplatin (2.5%). At the time of starting treatment with duloxetine, 78.5% of patients had neuropathy G3 and 21.5% G4. 91.5% of them have at least one decrease of neuropathy grade after 30 days of treatment (p = 0.001). 12.6% of patients discontinued treatment due to somnolence (10.8%), vomiting or abdominal pain. 6.3% refused to receive treatment for being a psychotropic drug.

      Conclusion:
      In our study, treatment with duloxetine showed a response rate, statistically significant, of 91.5% (p: 0,001). Adherence to treatment was 81.1%, with somnolence and vomiting as the primary adverse events.

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