P-520: Association of polypharmacy and potential inappropriate medication with toxicity to anti-neoplastic treatment

摘要

Background: The prevalence of potential inappropriate medications (PIM) in the geriatric cancer population is 24-54%. The effect of PIMs on outcome in cancer patients is not well studied. We hypothesized that older cancer patients exposed to polypharmacy (PP) and/or PIMs will experience more toxicity and reduced adhesion to cancer treatment. Further CARG (predictive model for chemotherapy toxicity in C 65 years) was assessed. Method: The study was undertaken at the Department of Oncology, Odense University Hospital, Denmark 2017-2018. Prospective observational cohort study including (1) patients with cancer, (2) aged ≥ 70 years, (3) starting taxane-based chemotherapy. Patients were included consecutively during a 12 months period. Baseline PP, PIMs (EU(7)PIM list), potential drug-drug interactions, Charlson comorbidity score (CCIS), ECOG performance status (PS) and CARG score, planned dose and number of treatments and toxicity according to the Common Terminology Criteria for Adverse Events (CTCAE) was noted. Primary endpoint was treatment adherence in relation to the above points. Results: 96 patients, median age 75, 62% male were included. PS was 0-1 in 73.7% indicating good functional status, risk of grade C 3 toxicity according to the CARG score was intermediate (6-9) in 62.5%, and, median CCIS 1 (IQR 0-2). Most patients were exposed to major PP at baseline. Only 21% of patients completed treatment as planned. 62% of patients had CTCAE grade 3-4 toxicity. PIM exposure was low and exposure was associated with interrupted or reduced chemotherapy (OR 3.2 (1.12-8.90) (unadjusted). Conclusion: PIMs had a negative influence on the treatment adherence. Many patients had severe toxicity.