University of Rochester Medical Center, Rochester, NY
Sarah L Kerns , Chunkit Fung , AnnaLynn Williams , Mohammad Issam Abu Zaid , Howard D. Sesso , Darren R. Feldman , Robert James Hamilton , David J. Vaughn , Clair Beard , Hai Liu , David Herrmann , Deepak M. Sahasrabudhe , Sophie D. Fossa , Lawrence H. Einhorn , Lois B. Travis
Background: Few studies have systematically evaluated CBM in survivors of adult-onset cancer, accounting for both the number and severity of health conditions (HCs). TCS provide a unique opportunity to do this, given their young age at diagnosis, relatively homogeneous cisplatin-based chemotherapy (CHEM) and high cure rates. We comprehensively evaluated CBM after CHEM among TCS enrolled in an ongoing multi-center investigation (the Platinum Study). Methods: Eligible TCS (aged < 50 y at diagnosis and given first line CHEM) completed questionnaires assessing a comprehensive panel of HCs and prescription drug use. HCs (n = 54) were mapped and graded to the NCI Common Terminology Criteria for Adverse Events v4.03. A CBM score was calculated based on number and severity of each HC, following Geenen et al. (JAMA 2007; 297:2705). To examine the association between CBM score and both health status and cumulative cisplatin dose, we applied ordinal logistic regression adjusting for age at evaluation and bleomycin use. Results: Among the first 751 consecutively enrolled TCS, median age at evaluation was 38 y and median time since CHEM 4.6 y (range, 1-30 y). The most common HCs were paresthesias (27% grade 1, 18% grade 2, 17% grade 3), hearing loss (27% grade 1, 15% grade 1, 1.3% grade 3, 0.1% grade 4), tinnitus (31% grade 1, 7% grade 2, 7% grade 3), and obesity (42% grade 2, 29% grade 3, 4% grade 4. Low, medium, high, and severe CBM scores were observed in 8%, 69%, 20%, and 0.5% TCS, respectively, with a score of zero in 3%. Increasing CBM score was significantly associated with worse self-reported health status (OR = 2.34, 95% CI 1.91, 2.87; p < 0.001). Each 100 mg/m2 increase in cisplatin dose was associated with a non-significant increase in CBM (OR per 100 mg/m2 = 1.14; 95% CI, 0.96-1.34; p = 0.129). Adjustment for bleomycin did not affect results. CBM score increased with older age at evaluation (p < 0.001). Conclusions: CBM is strongly correlated with worse self-reported health, indicating that HCs frequently seen after CHEM are perceived by TCS as impacting negatively on their health. Survivorship care plans for TCS should take into account the CBM which appears relatively early, and is likely to increase with the aging of this population.
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Disclosures
2021 ASCO Annual Meeting
First Author: Shirin Ardeshirrouhanifard
2024 ASCO Gastrointestinal Cancers Symposium
First Author: Hendrik-Tobias Arkenau
2023 ASCO Annual Meeting
First Author: Marcin W Wojewodzic
2024 ASCO Genitourinary Cancers Symposium
First Author: Zuzana Orszaghova