High temporal variability of clinical side effects with and without adjuvant chemotherapy in 4,684 early breast cancer patients in the CANTO trial.

Authors

Paul Cottu

Paul H. Cottu

Institut Curie, Paris, France

Paul H. Cottu , Marie-Laure Tanguy , Enora Laas , Olivier Tredan , Sylvie Giacchetti , Sophie Guillermet , Jean-Marc Ferrero , Olivier Rigal , Carole Tarpin , Mario Campone , Christelle Levy , Patrick Soulie , Laurence Vanlemmens , Marion Fournié , Christelle Jouannaud , Sibille Everhard , Jerome Lemonnier , Patrick Arveux , Ines Maria Vaz Duarte Luis , Fabrice Andre

Organizations

Institut Curie, Paris, France, Institute Curie, Paris, France, Département d'Oncologie Médicale, Centre Léon Bérard, Lyon, France, Hopital Saint Louis, Breast Disease Center, Paris, France, Centre Eugène Marquis, Rennes, France, Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France, Centre Henri-Becquerel, Department of Medical Oncology, Rouen, France, Institut Paoli Calmettes, Marseille, France, Institut de Cancérologie de l'Ouest, René Gauducheau, St Herblain, France, Centre François Baclesse, Department of Medical Oncology, Caen, France, Institut de Cancérologie de l'Ouest, Angers, France, Centre Oscar Lambret, Lille, France, Institut Bergonié, Bordeaux, France, Institut Jean Godinot, Reims, France, Unicancer, Paris, France, Biostatistics and Quality of Life Unit, Centre Georges François Leclerc and EA 4184, Dijon, France, Institut Gustave Roussy, Villejuif, France

Research Funding

Other Government Agency

Background: CANTO (CANcer TOxicities - NCT01993498) is a French multicenter prospective longitudinal study dedicated to the quantification and characterization of side effects after treatment for patients with stage I-III breast cancer, and to the development of predictors of toxicities. Methods: The CANTO study has included > 12,000 patients, assessed at diagnosis, and 3-6 months (T0), 15 months (T12), and year 3 and 5 after treatment completion. In the current report, we focus on key toxicities at T0 and T12 according to chemotherapy (CT) administration. For each side effect, 4 populations were defined according to its occurrence at T0 and/or T12 (no/no, no/yes, yes/no, yes/yes). Results: We analyzed 4684 patients with T0 and T12 consolidated data. Median age at diagnosis was 57y (22-89). Patients (pts) had HR+/HER2-, HER2+ or triple negative tumors in 78.9%, 12.4% and 8.7% of cases, respectively. Overall, 2516 pts (53.7%) received CT. Most CT pts (81%) received a sequential anthracyclines– taxanes schedule. As an example, a high proportion of patients presented neurological symptoms including cognitive symptoms, sensory or motor neuropathy, paresthesia, headache, etc (all grades) at either T0 or T12. Overall, CT was strongly associated with neurotoxicity at all times (OR = 2.27, p < 0.0001). However, proportions of patients with neurological side effects changed between T0 and T12. The table shows the proportions of the 4 categories of pts in the CT and no CT groups. Furthermore, at T12, neurological symptoms remained more frequent in the CT group, whether pts had symptoms at T0 (CT vs no CT, 81% vs 77%, p = 0.007) or not (CT vs no CT, 41% vs 36%, p = 0.03). Similar temporal trends were observed (with specific percentages for each considered side effect) for detailed neurological toxicities, pain and joint/bone toxicity (stratified on endocrine therapy), gastro-intestinal, pulmonary and cardiac toxicities. Conclusions: Overall, symptoms burden is extremely high at T0 and T12 after treatment, and much higher in pts receiving CT. A high temporal variability was observed in all subsets, including a clinically meaningful delayed onset of e.g. neurological side effects. Clinical trial information: NCT01993498

neurological side effects
at T0
then at T12CT (%)no CT (%)
NoNo17.732.8
NoYes12.318.3
YesNo13.411.5
YesYes56.737.4

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Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Symptoms and Survivorship

Track

Symptom Science and Palliative Care

Sub Track

Late and Long-Term Adverse Effects

Clinical Trial Registration Number

NCT01993498

Citation

J Clin Oncol 37, 2019 (suppl; abstr 11566)

DOI

10.1200/JCO.2019.37.15_suppl.11566

Abstract #

11566

Poster Bd #

258

Abstract Disclosures

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