H Woopen1, R Richter2, F Ismaeel2, R Chekerov2, I Roots3, T Siepmann4, J Sehouli5. 1. European Competence Center for Ovarian Cancer (EKZE), Department of Gynecology, Charité - University Medicine of Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany; Dresden International University, Division of Health Care Sciences, Center for Clinical Research and Management Education, Freiberger Str. 37, 01067 Dresden, Germany. Electronic address: hannah.woopen@charite.de. 2. European Competence Center for Ovarian Cancer (EKZE), Department of Gynecology, Charité - University Medicine of Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany. 3. Institute of Clinical Pharmacology and Toxicology, Charité - University Medicine Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany. 4. Dresden International University, Division of Health Care Sciences, Center for Clinical Research and Management Education, Freiberger Str. 37, 01067 Dresden, Germany. 5. European Competence Center for Ovarian Cancer (EKZE), Department of Gynecology, Charité - University Medicine of Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany. Electronic address: jalid.sehouli@charite.de.
Abstract
BACKGROUND: Ovarian cancer is mostly diagnosed in the elderly woman who is likely to have comorbid disease and to take several comedications on a regular basis. Aim of this study was to evaluate the influence of polypharmacy on grade III/IV toxicity, prior discontinuation of chemotherapy and survival. PATIENTS AND METHODS: In this individual participant data meta-analysis the original data of three phase II/III studies of the North-Eastern German Society of Gynecological Oncology (NOGGO) were analyzed using multivariate logistic and Cox regression. RESULTS: Overall, 1213 patients with recurrent ovarian cancer were included in these analyses. An increasing amount of medication was associated with overall grade III/IV toxicity (p<0.001; OR 1.120), and hematological (p<0.001; OR 1.056) and non-hematological (p<0.001; OR 1.134) toxicities. Prior discontinuation of chemotherapy was not influenced by an increasing amount of medication (p=0.196). There was no association of polypharmacy with overall survival (p=0.068). CONCLUSION: As polypharmacy does not influence survival ovarian cancer patients taking several comedications may be included in clinical trials and should not be deprived of adequate cancer treatment. However, a thorough monitoring is mandatory due to the increased risk of toxicities.
BACKGROUND:Ovarian cancer is mostly diagnosed in the elderly woman who is likely to have comorbid disease and to take several comedications on a regular basis. Aim of this study was to evaluate the influence of polypharmacy on grade III/IV toxicity, prior discontinuation of chemotherapy and survival. PATIENTS AND METHODS: In this individual participant data meta-analysis the original data of three phase II/III studies of the North-Eastern German Society of Gynecological Oncology (NOGGO) were analyzed using multivariate logistic and Cox regression. RESULTS: Overall, 1213 patients with recurrent ovarian cancer were included in these analyses. An increasing amount of medication was associated with overall grade III/IV toxicity (p<0.001; OR 1.120), and hematological (p<0.001; OR 1.056) and non-hematological (p<0.001; OR 1.134) toxicities. Prior discontinuation of chemotherapy was not influenced by an increasing amount of medication (p=0.196). There was no association of polypharmacy with overall survival (p=0.068). CONCLUSION: As polypharmacy does not influence survival ovarian cancerpatients taking several comedications may be included in clinical trials and should not be deprived of adequate cancer treatment. However, a thorough monitoring is mandatory due to the increased risk of toxicities.
Authors: Sean Oldak; Stephanie Ioannou; Priyanka Kamath; Marilyn Huang; Sophia George; Brian Slomovitz; Matthew Schlumbrecht Journal: Oncologist Date: 2019-04-05
Authors: Ryan D Nipp; Margaret Ruddy; Charn-Xin Fuh; Mark L Zangardi; Christine Chio; E Bridget Kim; Barbara Kong Mui Li; Ying Long; Gayle C Blouin; Daniel Lage; David P Ryan; Joseph A Greer; Areej El-Jawahri; Jennifer S Temel Journal: Oncologist Date: 2018-10-19