IC had a manageable toxicity profile and achieved resectability in 19% of our patients with T4b OSCC. Patients underwent resection had a significantly better median OS than those who received nonsurgical local treatment.
Background: Patients with chronic or resolved hepatitis B virus (HBV) infection have a risk of reactivation after chemotherapy. Japanese guidelines recommend that all patients on chemotherapy should be screened for HBV infection. Although Asian peoples are considered to be a high risk population of HBV infection, little is known about the screening rate in Japan. Methods: We analyzed health insurance claims data linked with hospital-based cancer registry. Patients diagnosed with cancer in 2014, 20 years and older, who received at least one dose of systemic anticancer therapy in 2014-15 entered the analyses. We assessed the HBV screening rates by HBsAg or anti-HBc test ordered around initial treatment, HBV-DNA test and entecavir prescription. A multiple logistic regression model was used to identify factors related to the receipt of screening. Results: Of 177636 patients (mean [SD] age, 65.6 [12.2] years), 82.6%, 12.9%, 4.5% patients had solid tumor other than hepatocellular carcinoma (HCC), hematologic malignancy and HCC, respectively. Among them, 88.5%, 8.8%, 2.6% patients received cytotoxic chemotherapy, targeted therapy and anti-CD20 antibody, respectively. Overall, 70.6% of patients were screened but 34.5% were tested HBsAg only. The positive predictors of the HBV screening were hematologic malignancy (OR 2.45; 95%CI, 2.35-2.55) and negative predictors were age 85 (OR 0.75 compared to age <65, 95%CI, 0.71-0.80), age 75-84 (OR 0.77; 95%CI, 0.75-0.79), targeted therapy (OR 0.79; 95%CI, 0.76-0.82). Among the screened patients, 13.2% were tested HBV-DNA and 1.49% were prescribed prophylactic entecavir. Conclusions: This is the largest study to evaluate the HBV screening rate before systemic anticancer therapy in Japan. Although the screening rate is higher than previous reports from other countries (13-19%), half of the screened patients were tested HBsAg only. The elderly patients and patients who received targeted therapy were less screened. Legal entity responsible for the study: Takahiro Higashi. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest. 421O Assessment and comparison of CISNE model versus MASCC model in clinically stable febrile neutropenia patients
Background:Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract. Historically, a poor prognosis for metastatic disease has been reported with systemic chemotherapy. Significant advances have been made in the last decade, since the introduction of different tyrosine kinase inhibitors (TKIs). Unfortunately, even though the TKIs have been used for a long time, there are very few published data of the experience of TKI therapy in metastatic GIST from India.Materials and Methods:Patients diagnosed with metastatic GIST from January 2005 to October 2016 at our center, who received first-line therapy with imatinib 400 mg/day, were reviewed retrospectively. Patients’ profile, response to treatment, toxicity of TKI therapy, time to progression, and survival were evaluated.Results:Of the 44 metastatic GIST patients, 23 (52.2%) were males. Median age at diagnosis was 48 years. The most common presenting symptom was an abdominal pain (52%), followed by weight loss (23%). Most frequently affected metastatic site was liver (57%), followed by peritoneum (16%), and lungs (4.5%). Metastases to both liver and peritoneum were found in 10 patients (22.5%). All patients were initially treated with imatinib at a dose of 400 mg/day. Disease stabilization was documented in 21 cases (48%), and 13 patients (29%) achieved a partial response. TKI therapy was well-tolerated in most cases. Median progression-free survival (PFS) was 26 months, and estimated median survival was 48 months. Patients with lung metastases have a significantly inferior median PFS and overall survival, in comparison to patients with other metastatic sites (P < 0.05).Conclusions:Imatinib therapy was well tolerated and induced a sustained clinical benefit in more than half of the patients with metastatic GIST. Lung metastases seemed to be a poor prognostic factor in this patient population.
The median age of diagnosis for chronic myeloid leukemia (CML) in India is 35 years on the contrary to western literature which is 47 years. The outcome of the elderly patient in CML TKI era is not reported from the Indian population. However, Western literature suggests that use of TKI alleviate the adverse impact of age in outcomes of CML. This study was carried out to analyze the clinical profile and outcome of elderly, in comparison with younger patients with CML. We retrospectively analyzed CML patients treated at our department from January 2008 to December 2017. The data cutoff date was December 2018. The cohorts of 712 patients were divided into two groups. Patients belonging to the age group of C 60 years were classified as the study group and those who were 18-60 years were used as controls. Patient's clinical history, examination and milestones in terms of achieving hematological, molecular responses and toxicity profile were also recorded. The total of 712 patients, 52 patients in the study group and 660 patients in the control group were treated during the study period. The study group was having more co-morbidities than the control group (15.3% vs. 4.5%). Patients having high-risk EUTOS score were similar in both groups (38.4% vs. 37.6%). The patients presented in blast phase were higher in the study group as compared to control group (9.6% vs. 6.36%) but the differences were not statistically significant. Rates of achieving a hematological response at 3 months (85.1% vs. 86.89%) and the major molecular response at 18 months (54.3% vs. 60.16%) were almost similar in both groups. However, hematological toxicity, muscle cramps and gastritis were reported more in elderly patients. The outcome of CML patients in TKI era do not differ in elderly patients. However, toxicity profile was not significantly inferior in elderly patients.
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