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312: Table: Chemotherapy uptake within MWRH
Decision-making tools (DMT)
Nottingham Prognostic Index (NPI) · Excellent (≤ 2.40) ·
Good (2.41 – 3.40) · Moderate (3.41 – 5.40) · Poor (≥
5.41)
Adjuvant! Online (AO) – additional 10-year survival
benefit of chemotherapy and hormonal therapy ·
0.0 – 2.5% · 2.6 – 5.0% · 5.1 – 7.5% · ≥ 7.5%
Oncotype Dx Recurrence Score (RS) Assay · Low (1–17) ·
Intermediate (18 – 30) · High (>31)
312 CORRELATION BETWEEN DECISION-MAKING TOOLS AND
CHEMOTHERAPY UPTAKE IN NODE-NEGATIVE ENDOCRINE
RECEPTOR EARLY-STAGE BREAST CANCER IN
MID-WESTERN IRELAND
K.I. Quintyne 1 , B. Woulfe 1 , J.C. Coffey 2 , R.K. Gupta 1
1 Mid-Western Cancer Centre (MWCC), Mid-Western Regional Hospital (MWRH),
Limerick, IRELAND, 2 Department of Surgery, Mid-Western Regional Hospital
(MWRH), Limerick, IRELAND
Background: Good clinical judgement remains the best tool in determining a
therapeutic plan; however this process has become easier, and more reproducible
with the ongoing progression of decision-making adjuncts such as: Nottingham
Prognostic Index (NPI), which incorporates pathological features; Adjuvant! Online
(AO), which incorporates clinic-pathological features; and Oncotype Dx ® Recurrence
Score (RS) assay, which incorporates genetic features. We herein report our
experience with the use of these tools, and their potential impact on chemotherapy
uptake for patients in MWRH, Limerick, Ireland.
Methods: Study period: 01/09/2008 – 31/12/2012. Data was derived from (1) MWCC
Oncology database (2) pathology reports (3) patient files (4) RS assay reports. Data
was collated and entered into an Access database and exported into SPSS (v.18) for
analysis. Results Seventy-seven (77) patients with early stage endocrine positive breast
cancer were analysed. Median age: 55.9 years (range: 30.6 – 72.3 years). Median
follow-up: 20.9 months. Findings are shown below in tabular form.
Conclusions: Chemotherapy uptake from the decision-making tools was varied
within the cohort, but it was uniformly noted that patients were more likely to
undertake chemotherapy if they had higher indices derived from these DMT, except
in cases where the patients declined therapy, or if physicians’ preference differed on
clinical grounds. This highlights that none of the available DMT are perfect in
isolation, but when used in concert, they can elucidate the best potential treatment
pathway following consultation between patients and their healthcare providers; this
is given by the fact that they all rely on different subsets of information to predict
potential outcome. Further work is needed to find an algorithm that can
appropriately incorporate these DMT any potential patient’s best interest.
Disclosure: All authors have declared no conflicts of interest.
313 DOCETAXEL IN THE TREATMENT OF BREAST CANCER: A
MULTICENTER RETROSPECTIVE STUDY FROM CHINA
B. Xu
Medical Department, Cancer Hospital, Chinese Academy of Medical Sciences,
Beijing, CHINA
Background: Docetaxel is considered as a fundamental drug in the treatment of
breast cancer. It has been extensively incorporated into the neoadjuvant, adjuvant
and metastatic treatment. The aim of this study was to investigate how breast cancer
patients are treated with docetaxel in China.
Methods: A retrospective review of chemotherapy with docetaxel performed from
2009 to 2011 was carried out in China. Study included all patients diagnosed with
invasive breast cancer and treated with docetaxel-containing regimens in forty-two
cancer centers from 12 provinces in China. Regimens were compared in different
subgroups based on stage, subtype, and lymph node (LN) status. Patterns of
chemotherapy were also compared to published guidelines.
Results: Among 2188 breast cancer patients treated with docetaxel, 1881 (86.0%)
were in adjuvant or/and neoadjuvant setting (including 91 in both settings). The
mean age was 48.7 (range, 14-82). Compared with 288 patients using docetaxel as
single agent therapy, more patients (86.8%) used docetaxel-containing combination
regimens. The mean cycle administered and dose for every cycle was 4.8 and 73.0
mg/m2, respectively. Dose reduction and delay occurred in 409 (19.7%) patients
mainly due to non-medical factors (10.9%) and hematologic toxicity (5.9%). TAC,
TA, TC, TX, and AC-T regimens were given in 34.8%, 19.7%, 17.4%, 5.3%, and 2.2%
of patients respectively. TAC was used more frequently in triple-negative breast
cancer (TNBC) than other patients (43.0% vs. 32.7%, P = 0.004). In the (neo)
adjuvant setting, TAC regimen was used more frequently in LN-positive patients
Chemotherapy Uptake
Offered Undertaken Not offered
2/7 16/41 21/29 0/0 1/7 13/41 21/29 0/0 5/7 25/41 8/29 0/0
8/21 12/33 9/13 10/
10
Annals of Oncology
6/21 10/33 9/13 10/10 13/21 21/33 4/13 0/10
13/38 20/33 6/6 11/38 18/33 6/6 25/38 13/33 0/6
than LN-negative group (44.2% vs. 30.0%, P < 0.001). Of 1682 patients in adjuvant
setting, 729 (43.3%) were treated with triplet (TAC or AC-T). In 290 patients
receiving neoadjuvant chemotherapy, only 94 (32.4%) used TAC and none used
AC-T (P = 0.013).
Conclusions: Docetaxel was widely used in the treatment of breast cancer in China,
especially in the (neo)adjuvant setting. TAC regimen was the most frequent option,
especially in patients with TNBC or LN-positive BC. Although AC-T was also
recommended in adjuvant setting by most guidelines, it was less commonly used
compared to TAC regimen in China.
Disclosure: All authors have declared no conflicts of interest.
314 MOVING FROM 2D TO 3D-CRT PLANNING OF CHEST WALL
FOR POSTMASTECTOMY BREAST CANCER PATIENTS:
MANSOURA UNIVERSITY EXPERIENCE
I. Awad, D. Zayed, N. Abotouk, T. Dawood
Clinical Oncology, Mansoura University Hospital School of Medicine, Mansoura,
EGYPT
Background: This study evaluates the dose distribution of the wedged tangential
beam three-dimensionally planned conformal radiotherapy (3D-CRT) compared to
the previously used (5 years ago) two-dimensionally(2D) planned radiotherapy of the
chest wall for postmastectomy breast cancer patients in Clinical Oncology and
Nuclear Medicine Department - Mansoura University.
Patients and methods: Thirty six breast cancer patients were randomized for
planning by both the standard 3D-CRT and 2D-RT techniques for radiotherapy of
the chest wall. Dose-volume histograms were carried out by the 3D treatment
planning system. They were assessed for the PTV and organs at risk. The total dose
was 50 Gy in 25 fractions.
Results: The three–dimensionally planned conformal radiotherapy showed a
significantly better homogeneity index of the PTV (chest wall). The ipsilateral mean lung
dose was significantly reduced with the tangential beam 3D-CRT plans with an average
of 24.6% (1217 cGy versus 1614 cGy). For the left sided breast cancer patients, the mean
heart dose was also reduced by an average of 48.6% (718 cGy versus 1398 cGy).
Conclusions: The tangential beam 3D-CRT planning demonstrated a significantly
better homogeneity index for the PTV of the postmastectomy breast cancer patients
with a statistically significant reduction in the mean doses of the ipsilateral lung and
the heart for the left –sided breast cancer patients.
Disclosure: All authors have declared no conflicts of interest.
315TiP SAFEHER: A STUDY OF ASSISTED- AND
SELF-ADMINISTERED SUBCUTANEOUS TRASTUZUMAB
(H-SC) AS ADJUVANT THERAPY IN PATIENTS WITH EARLY
HER2-POSITIVE BREAST CANCER (EBC)
J. Gligorov 1 , H.A. Azim 2 , B. Ataseven 3 , M. Delaurentiis 4 , K.H. Jung 5 , F. Herbst 6 ,
A. Llombart 7 , A. Manikhas 8 , S. Osborne 9 , X. Pivot 10
1 Medical Oncology Department, Tenon Hospital, Paris, FRANCE, 2 Clinical
Oncology Department, Cairo University, Cairo, EGYPT, 3 Department of
Obstetrics and Gynaecology, Rot-Kreuz-Klinikum, Munich, GERMANY, 4 Breast
Oncology Department, National Cancer Institute “Fondazione Pascale”, Napoli,
ITALY, 5 Department of Oncology, Asan Medical Center, University of Ulsan
College of Medicine, Seoul, KOREA, 6 Oncology, F. Hoffmann-La Roche Ltd.,
Basel, SWITZERLAND, 7 Medical Oncology Service, Hospital Arnau de Vilanova,
Valencia, SPAIN, 8 Oncology, Oncology Hospital of St. Petersburg,
St. Petersburg, RUSSIAN FEDERATION, 9 Statistics, F. Hoffmann-La Roche Ltd.,
Basel, SWITZERLAND, 10 Chimiothérapie – Oncologie, CHU Jean Minjoz,
Besançon, FRANCE
Purpose: One year of H-based therapy, consisting of 18 q3w cycles, is standard of
care for the adjuvant treatment of HER2-positive EBC. H is administered
ix114 | Abstracts Volume 23 | Supplement 9 | September 2012