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- W2230576779 abstract "3624 Background: The incidence of capecitabine-associated dose-limiting toxicities (DLT) is higher in clinical practice than reported in trials (ASCO 2008, abstr 4101). This often results in a reduced relative dose intensity (RDI). We examined the pattern and impact of DLT and RDI on relapse-free (RFS) and overall survival (OS) in patients (pts) receiving adjuvant capecitabine for CRC. Methods: A chart review was conducted on pts treated at the BC Cancer Agency with ≥1 cycle of single-agent capecitabine for stage II/III CRC. The reference capecitabine regimen was based on 8 cycles dosed at 1,250 mg/m2 BID. RFS and OS were analyzed by the Kaplan-Meier method and multivariate Cox proportional-hazards models. Results: 179 pts (median age 69y, 56% male, 90% colon, 73% stage III) were included. 85% of pts experienced at least one episode of DLT, with the most common causes being HFS (54%) and diarrhea (19%). Median RDI was 70% with 69% of pts having an RDI of <80%. Receiving less than the median RDI was associated with performance status ≥2 (17% vs. 3%, p=0.0016) and having ≥1 DLT (78% vs. 59%, p=0.010). On univariate analysis, pts receiving greater than the median RDI had significantly better RFS (3y 69% vs. 32%, p=0.03) and OS (3y 62% vs. 22%, p=0.01). On multivariate analysis, RDI remained an independent predictor for RFS (HR 0.35, 0.14-0.88) and OS (HR 0.37, 0.17-0.82) when controlled for age, nodal status and gender (see Table). Conclusions: In clinical practice, DLTs from adjuvant capecitabine monotherapy are not uncommon and can lead to reduced RDI. In our retrospective study, achieving an RDI of >70% was independently associated with RFS and OS. However, this was achieved in only 50% of the cohort. Strategies to optimize toxicity management while maintaining dose intensity should be considered for patients on AT with oral capecitabine. Multivariate model for OS Variable HR 95% CI P value RDI (>70%) 0.35 0.14-0.88 0.026 Node status (+ve vs. –ve) 4.47 1.01-19.71 0.048 Sex (M vs. F) 2.85 1.13-7.16 0.026 Age (per year) 0.96 0.92-0.99 0.022 Multivariate model for RFS Variable HR 95% CI P value RDI (>70%) 0.37 0.17-0.82 0.014 Nodal status (+ve vs –ve) 3.3502 1.10-10.20 0.033 Age (per year) 0.95 0.91-0.99 0.032 No significant financial relationships to disclose." @default.
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- W2230576779 date "2010-05-20" @default.
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- W2230576779 title "Association of survival outcomes with dose intensity of adjuvant therapy (AT) with capecitabine for colorectal cancer (CRC)." @default.
- W2230576779 doi "https://doi.org/10.1200/jco.2010.28.15_suppl.3624" @default.
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