Journal article
Investigating reasons for discontinuation of first-line adjuvant chemotherapy among ovarian cancer patients in the midwestern United States
Journal of clinical oncology, Vol.39(15_suppl), pp.e17523-e17523
05/20/2021
DOI: 10.1200/JCO.2021.39.15_suppl.e17523
Abstract
e17523 Background: Receipt of surgery and adjuvant chemotherapy greatly impact survival outcomes for ovarian cancer, the deadliest gynecologic malignancy with a high recurrence/progression rate. Most patients receive first-line, platinum-based chemotherapy. Platinum-based chemotherapy causes severe side effects, including nephrotoxicity and myelosuppression. Evidence for other chemotherapeutic agents is lacking and options are limited for women who cannot tolerate first-line chemotherapy. We aimed to determine the prevalence of premature first-line chemotherapy discontinuation and to detail reasons for discontinuation. Methods: We used the population-based cohort, Patterns of Ovarian Cancer Care and Survival in the Midwestern Region of the United States—a CDC Investigation, comprised of women diagnosed with histologically confirmed, stage IB-IV ovarian cancer in 2010-2012 in the Midwestern United States (i.e., Iowa, Kansas and Missouri) between the ages of 18 and 89 years. We limited the cohort to patients who received cancer-directed surgery and initiated adjuvant chemotherapy. Chemotherapy lines, completion, and reasons for discontinuation were abstracted from patient medical records by cancer registrars using standardized protocols. Results: Nineteen percent (N= 107/559) of ovarian cancer patients who initiated adjuvant chemotherapy did not complete first-line treatment. Reasons for chemotherapy discontinuation included toxicity or other kinds of intolerance (39%), poor quality of life or comorbid conditions (19%) or exhibited no response (17%) (Table). No significant differences were observed between gynecologic oncologists and non-gynecologic oncologist chemotherapy providers (p=0.109). Conclusions: One in 5 women who initiated did not complete first-line chemotherapy. Reasons were varied and suggested that lack of tolerance is not the only factor in discontinuation. Lack of response and the presence of comorbid conditions are considerations that can be taken into account during decision-making processes for treatment. More clinical research into additional chemotherapy options that may be useful in these patients is necessary.[Table: see text]
Details
- Title: Subtitle
- Investigating reasons for discontinuation of first-line adjuvant chemotherapy among ovarian cancer patients in the midwestern United States
- Creators
- Kristin S Weeks - The University of Iowa, Iowa City, IASherri L Stewart - Centers for Disease Control and Prevention, Atlanta, GAMichele West - University of Iowa College of Public Health, Iowa City, IARyan Carnahan - University of Iowa, Iowa City, IAJacob Oleson - University of Iowa, Iowa City, IACharles F Lynch - University of Iowa, Iowa City, IA
- Resource Type
- Journal article
- Publication Details
- Journal of clinical oncology, Vol.39(15_suppl), pp.e17523-e17523
- DOI
- 10.1200/JCO.2021.39.15_suppl.e17523
- ISSN
- 0732-183X
- eISSN
- 1527-7755
- Grant note
- name: CDC and NCI
- Language
- English
- Date published
- 05/20/2021
- Academic Unit
- Epidemiology; Biostatistics; Nursing; Injury Prevention Research Center
- Record Identifier
- 9984216740702771
Metrics
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