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K. Takayama
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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
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.01-055 - Prospective Study of UGT1A1*27 Gene Polymorphism for Irinotecan Therapy: Result of Lung Oncology Group in Kyushu (LOGiK1004B) (ID 675)
09:30 - 17:00 | Author(s): K. Takayama
- Abstract
Background:
UGT1A1*27 is known that exist together with UGT1A1*28 as linkage disequilibrium and impair the effect of UDP-glucuronosyltransferase (UGT) in basic research, however, poor clinical investigation because of the rare frequency. The aim of this study is to evaluate the effect of UGT1A1*27 gene polymorphism for safety and efficacy in irinotecan therapy.
Methods:
Eligibility criteria were: lung cancer patients; scheduled the dose of irinotecan therapy as single ≥ 80 mg/m[2], combination ≥ 50 mg/m[2], radiation with single ≥ 50 mg/m[2], radiation with combination ≥ 40 mg/m[2]; age ≥ 20 years; performance status 0-2. After informed consents, patients were enrolled and collected the blood to examine UGT1A1*28 and UGT1A1*6 polymorphism and received irinotecan therapy. Examination of UGT1A1*27 were added when founding UGT1A1*28 polymorphism. We planned 111 enrollment for an accrual of 10 patients with UGT1A1*27 gene polymorphism.
Results:
Fifty patients were enrolled in this trial between October 2011 and December 2013. Two patients judged protocol violation. Remaining 48 were evaluated. UGT1A1 gene polymorphisms *28/*28, *6/*6, *28/*6, *28/-, *6/-, -/- observed 0, 1, 1, 7, 17 and 22, respectively. UGT1A1*27 were analyzed in 9 patients including ineligible one patients with *28/*28, however, no UGT1A1*27 gene polymorphism was found and the study was stopped. A total of 153 times of irinotecan therapy were administered with a median of 3 times per one patient: 1 time in 7 patients (15%), 2 times in 9 (19%), 3 in 19 (40%), 4 in 3 (6%), 5 in 1 (2%), and 6 in 9 (19%). Irinotecan were used as combination chemotherapy in 32 (67%) patients, with cisplatin in 12 (25%), carboplatin in 10 (21%), gemcitabine in 9 (19%), paclitaxel in 1 (2%). In remaining 16 patients (33%), only irinotecan single therapy were administered. Radiotherapies were administered concurrently in 23 (48%) patients with median 60 (range 40-61.4) Gy. Febrile neutropenia were observed higher tendency in patients with UGT1A1*6 (32%) and UGT1A1*28 (25%) gene polymorphism compare with wild type (14%) but had no significant difference. Grade 3/ 4 leukopenia and neutropenia were observed in 6 out of 8 patients with UGT1A1*28 gene polymorphism and significant higher compare with wild type (75% vs. 32%, p=0.049; 75% vs. 36%, p=0.039, respectively). The other toxicities have no difference between UGT1A1 gene polymorphism and wild type. There was no pneumonitis and treatment-related death. Tumor response was not evaluated because not included endpoints. Median PFS of 48 patients was 6.8 months and the 1- and 2-year survival rates were 20.8%. Median PFS separated by UGT1A1 gene polymorphisms were 10.1 months in UGT1A1*28 heterozygous, 8.5 months in UGT1A1*6 heterozygous, and 6.8 months in both wild type, respectively. Median OS of 48 patients was 15.7 months and the 1- and 2-year survival rates were 57.7% and 40.3%, respectively. Median OS separated by UGT1A1 gene polymorphisms were not reached in in UGT1A1*28 heterozygous, 16.4 months in UGT1A1*6 heterozygous, and 12.3 months in wild type, respectively.
Conclusion:
UGT1A1*27 gene polymorphism was not found in our methods. Further investigation might be warranted in patients with UGT1A1*28 wild type.
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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
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.11-004 - Assessment of Pain Management in Cancer Outpatients Who Receive Chemotherapy (ID 1389)
09:30 - 17:00 | Author(s): K. Takayama
- Abstract
Background:
Pain is one of the most frequent and burdensome symptoms in cancer patients. In addition, inadequate pain management may limit anti-cancer active treatment in these patients and impair their quality of life. Chemotherapy in the outpatient settings has become common in Japan in the last decade. However, the adequacy of pain management in patients who receive outpatient chemotherapy is not yet well-known. The primary objective of this study was to assess pain prevalence and intensity in these patients. The secondary objective was to assess the pain management status using the pain management index (PMI).
Methods:
Cancer patients with solid tumors or hematologic malignancies who received chemotherapy in the outpatient setting were enrolled. The PMI scores were calculated using the patient-rated pain score and the analgesic score. The PMI was evaluated twice in each patient on the first day and 3 to 5 weeks later when patients received chemotherapy at Outpatient Chemotherapy Administration Unit, Kyushu University Hospital, Japan. Patients were required to complete questionnaires including Japanese Brief Pain Inventory and the Distress Thermometer and Impact Thermometer.
Results:
Of 740 patients enrolled, 524 patients (71%) who completed the questionnaires at both baseline and follow-up were applied to the statistical analysis. 54% patients experienced any pain and 14% patients had moderate or severe pain. 286 patients (55%) received adequate pain management at both baseline and follow-up, while 238 patients (45%) received inadequate pain management at baseline and/or follow-up. Multivariable analysis revealed that major depression had the most impact on adequacy of pain management.
Conclusion:
Patients who receive outpatient chemotherapy have a high prevalence of pain. The PMI is available to evaluate the pain management status of cancer patients in outpatient setting. Pain management for cancer patients needs to be assessed regularly even though their initial pain management is adequate.
