Displaying One Session

Room 326 Mini Oral session
Date
Fri, 22.11.2019
Time
04:30 PM - 05:30 PM
Location
Room 326
Chairs
  • Matti S. Aapro
  • Kiley W. Loh
  • Masanori Mori
Mini Oral session - Supportive and palliative care Mini Oral session

419O - Olanzapine combined with 5-HT3 RA plus dexamethasone for prevention and treatment of chemotherapy-induced nausea and vomiting in cancer patients: A systematic review and meta-analysis of randomized controlled trials

Presentation Number
419O
Lecture Time
04:30 PM - 04:35 PM
Speakers
  • Jian-Guo Zhou
Location
Room 326, Singapore, Singapore, Singapore
Date
Fri, 22.11.2019
Time
04:30 PM - 05:30 PM
Authors
  • Jian-Guo Zhou
  • Su-Han Jin
  • Hu Ma

Abstract

Background

We conducted a review to evaluate the efficacy and adverse events (AEs) of olanzapine combined with 5-hydroxytryptamine type 3 (5-HT3) receptor antagonist (RA) plus dexamethasone compared with 5-HT3 RA plus dexamethasone for the prevention and treatment of chemotherapyinduced nausea and vomiting (CINV) in high and moderate emetogenic chemotherapy based on randomized controlled trials (RCTs).

Methods

PubMed, Web of Science, EMBASE, and The Cochrane Library, WanFang Database, China Biomedical Literature database (CBM), China National Knowledge Infrastructure (CNKI), and Chinese Science and Technology Periodical Database (VIP) (inception to April 2019) were searched to recognize relevant articles. Relative risk (RR) with 95% confidence intervals (CIs) for CINV and AEs were all extracted.

Results

11 studies with 1107 cancer patients were involved in this review. The pooled RR of any level acute CINV (RR = 0.60, 95%CI: 0.48–0.75, Z=-4.57, P < 0.01) and any level delayed CINV (RR = 0.50, 95%CI: 0.38-0.66, Z=-4.87, P < 0.01) were significantly decreased in olanzapine group. While only CINV III and CINV IV were significantly decreased in olanzapine groups. Subgroup analysis indicated that there was no significant difference between 5mg and 10mg for olanzapine. Moreover, the occurrence of insomnia (RR = 0.12, 95%CI: 0.06-0.26, Z=-5.44, P < 0.01) was statistically decreased in the olanzapine group.

Conclusions

Olanzapine significantly decreased the occurrence of moderate-severe CINV (CINV III and IV) and insomnia for the prevention and treatment of CINV in high and moderately emetogenic chemotherapy. Compared with 10mg per day, 5mg oral may be more appropriate for cancer patients.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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Mini Oral session - Supportive and palliative care Mini Oral session

420O - Role of cardioprotective therapies for prevention of cardiotoxicity in breast cancer: A systematic review and meta-analysis

Presentation Number
420O
Lecture Time
04:35 PM - 04:40 PM
Speakers
  • Yek Ching Kong
Location
Room 326, Singapore, Singapore, Singapore
Date
Fri, 22.11.2019
Time
04:30 PM - 05:30 PM
Authors
  • Yek Ching Kong
  • Mustafa Sener
  • Shridevi Subramaniam
  • Nirmala Bhoo-Pathy

Abstract

Background

Cardiotoxicity is a well-recognized adverse outcome following adjuvant breast cancer treatment including anthracyclines, trastuzumab, and chest radiation. Its prevention remains an important challenge in clinical practice. We aimed to determine the effectiveness of prophylactic cardioprotective agents in preventing treatment-related cardiotoxicity in women with breast cancer.

Methods

A systematic review of published literature was conducted by searching PubMed, EMBASE and EBSCO host databases. Studies where prophylactic intervention was given to breast cancer patients without a prior history of heart disease were included. The outcomes of interest were preservation of left ventricular ejection fraction (LVEF), or development of cardiac events. Mean differences (MD) in LVEF, and relative risks (RR) of cardiac events, were evaluated using random-effects models.

Results

Thirteen randomized controlled trials (RCTs), which used prophylactic beta-blockers, dexrazoxane, angiotensin receptor blockers, angiotensin converting enzyme (ACE) inhibitors or other pharmacologic agents were included. Overall, the use of prophylactic cardioprotective agents resulted in a statistically significant smaller LVEF decline compared to use of placebo (MD = 2.42%, 95% confidence interval (CI): 0.59%-4.24%). While there were 52 cardiac events in the intervention arm (n = 405) compared to 79 in the control arm (n = 396), use of prophylactic cardioprotective agents did not significantly protect against incident cardiac events (RR = 0.63, 95%CI: 0.33-1.22).

Conclusions

In breast cancer patients without a history of heart disease, use of cardioprotective agents appear to confer only a very marginal protection against LVEF decline, falling below the ideal 10% cardioprotection. However, given the sample number of RCTs in this area, more studies are needed to substantiate the effectiveness of prophylactic cardioprotective agents in prevention of cardiotoxicity in women with breast cancer.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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Mini Oral session - Supportive and palliative care Mini Oral session

Discussion led by moderator

Lecture Time
04:40 PM - 04:50 PM
Speakers
  • Matti S. Aapro
Location
Room 326, Singapore, Singapore, Singapore
Date
Fri, 22.11.2019
Time
04:30 PM - 05:30 PM
Authors
  • Matti S. Aapro
Mini Oral session - Supportive and palliative care Mini Oral session

421O - Effects of an educational program on knowledge and quality of life for Korean breast cancer survivors: A prospective cohort study

Presentation Number
421O
Lecture Time
04:50 PM - 04:55 PM
Speakers
  • Jaekyung Cheon
Location
Room 326, Singapore, Singapore, Singapore
Date
Fri, 22.11.2019
Time
04:30 PM - 05:30 PM
Authors
  • Jaekyung Cheon
  • Jinsuk Bae
  • Yunsuk Choi
  • Byung Kyun Ko
  • Jin Sung Kim
  • Chung Reen Kim
  • Ju Hee Kim
  • Su-Jin Koh

Abstract

Background

The number of long-term cancer survivors has increased substantially over past decades. However, there is insufficient understanding of the symptoms and quality of life (QoL) after cancer treatment, and there is no adequate education program for cancer survivors. The purpose of this study is to investigate the improvement of knowledge and QoL through education among breast cancer survivors.

Methods

We prospectively recruited 100 breast cancer survivors – the education cohort (EC) – who received the educational program. Breast cancer survivors who visited the survivor clinic during the same period were retrospectively enrolled as control cohort (CC) (n = 40). EC was pretested for knowledge on breast cancer survivorship and a trained nurse conducted a 30-minute individual education program which was based on ASCO survivorship guideline, with post-test knowledge assessment to measure changes in this aspect. For measure QoL change, we conducted QoL survey at the time enrollment and six months later in both groups.

Results

For EC, participants’ mean age was 52.7 years, 86% were married, and 75% were high school or college graduates. Further, 78% were employed and over 94% said the economy was in the middle or better. The correct answer rate during pre-test ranged from 28% to 97%, showing an improvement from 96% to 100% in post-test, immediately after education. While there was no statistically significant difference among the CC, EC showed significant improvement on anxiety (mean [SD] 4.63 [3.58] → 3.66 [3.51]; p = 0.025) and depression (5.60 [3.39] → 4.11 [3.30]; p < 0.001). The FACT-B test showed statistically significant improvement in physical and functional well-being for EC. There was no significant difference in lifestyle change for either group.

421O

CC
EC
Mean±SD
p-valueMean±SD
p-value
PrePostPrePost
HADS anxiety4.98±3.963.80±3.000.0564.63±3.583.66±3.510.025
HADS depression4.78±3.833.98±2.570.1855.60±3.394.11±3.30<0.001

Conclusions

We found education effective in reducing anxiety and depression as well as physical and functional well-being in breast cancer survivors. However, we failed to demonstrate significant intervention effects in lifestyle change. In order to elicit lifestyle changes, more active intervention is needed along with education.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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Mini Oral session - Supportive and palliative care Mini Oral session

422O - Needs of cancer patients in an Asian setting

Presentation Number
422O
Lecture Time
04:55 PM - 05:00 PM
Speakers
  • Nirmala Bhoo-Pathy
Location
Room 326, Singapore, Singapore, Singapore
Date
Fri, 22.11.2019
Time
04:30 PM - 05:30 PM
Authors
  • Nirmala Bhoo-Pathy
  • Yek Ching Kong
  • Ros Suzanna Bustamam
  • Abdullah Matin Mellor Bin
  • Hafizah Zaharah
  • Nur Aishah Taib
  • Gwo Fuang Ho
  • Cheng Har Yip

Abstract

Background

The ASEAN Costs in Oncology (ACTION) Study had previously reported high levels of psychological distress among cancer survivors in the region. We aimed to gain an in-depth understanding of the (unmet) needs in Asian patients living with cancer in a middle-income setting.

Methods

Twenty focus group discussions were conducted among patients with breast, cervical, prostate or colorectal cancer (N = 102) at five tertiary Malaysian hospitals (public, academic, private). Thematic analysis was performed.

Results

Seven themes were identified. (1) Information; participants emphasized the need for physicians to provide detailed information on latest treatment options. Besides medical advice, informational needs on diet, and traditional and complementary medicine remained unmet.”(2) Psychosocial; “coping with cancer diagnosis” and “fear of recurrence” were major issues. The need for “support groups” as a source of informational and psychological support was raised. It was also stressed that increased “public awareness” was needed to circumvent the stigma against cancer survivors. (3) Physical; patients stressed on concerns regarding “side effects of treatment”, including “fertility”, “sexuality” and “sexual function”. (4) Practical support; major unmet needs in “transportation and parking” and “comfortable facilities” in hospitals were reported. (5) Financial; The burden of “out-of-pocket” expenses, “paying first then claim” and the costs of “essential items” e.g. breast prosthesis, colostomy bags were highlighted. (6) Systemic; Issues with “accessibility and eligibility of financial aid” were frustrating to needy patients. The need for an “integrated care system” where different departments work together to avoid repeated tests, and consolidate hospital appointments into the same day was repeatedly raised. (7) Employment; Patients needed “job security” and “cancer leave”. Lack of work-related flexibility, and discrimination at workplace were voiced out.

Conclusions

There seems to be an overarching theme of limited patient-centered healthcare during the survivorship period in Asian settings. These findings underscore the need for holistic cancer survivorship services that address wider aspects of wellbeing including the urgent need for patient navigation programs.

Legal entity responsible for the study

The authors.

Funding

Pharmaceutical Association of Malaysia.

Disclosure

N. Bhoo-Pathy: Research grant / Funding (institution): Pharmaceutical Association of Malaysia. All other authors have declared no conflicts of interest.

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Mini Oral session - Supportive and palliative care Mini Oral session

Discussion led by moderator

Lecture Time
05:00 PM - 05:10 PM
Speakers
  • Kiley W. Loh
Location
Room 326, Singapore, Singapore, Singapore
Date
Fri, 22.11.2019
Time
04:30 PM - 05:30 PM
Authors
  • Kiley W. Loh
Mini Oral session - Supportive and palliative care Mini Oral session

351O - The FAFA (FAn on FAce) trial: A randomized clinical trial on the effect of a fan blowing air on the face to relieve dyspnea in Filipino patients with terminal cancer

Presentation Number
351O
Lecture Time
05:10 PM - 05:15 PM
Speakers
  • Frederic Ivan L. Ting
Location
Room 326, Singapore, Singapore, Singapore
Date
Fri, 22.11.2019
Time
04:30 PM - 05:30 PM
Authors
  • Frederic Ivan L. Ting
  • Carla Emille Barbon
  • Sachiko Estreller
  • Heinrik Martin Jude Strebel

Abstract

Background

Dyspnea is a very common distressing symptom in patients with advanced stages of cancer. Fan therapy has been suggested by some studies as a non-pharmacological intervention to alleviate breathlessness in addition to the prescribed standard of care. Unfortunately data among Asians is very limited, and there are currently no published studies showing that this intervention works among Filipinos –thus this study.

Methods

This study is an open, randomized, placebo-controlled, crossover phase 2 trial. The experimental group had a fan blowing air directly to the patient’s face for five minutes, and the control group had a fan blowing air to the patient’s legs. Treatment cross-over was done after a wash-out period of one hour. The primary outcome which is dyspnea was measured subjectively using the Modified Borg Scale (MBS), and objectively using the patient’s respiratory rate (RR) and oxygen saturation (SaO2).

Results

A total of 48 patients were enrolled in this trial. The mean age of the patients enrolled was 51 years old, and the most common primary tumor sites were lung, breast, and osteosarcoma. More than two-thirds of the participants had pneumonia and had an ECOG performance status of 4. 29% of the patients were intubated. T-test was used for analysis. In the control group, results showed that the mean difference before and after intervention in the MBS was 0.15, mean difference in RR was 0.25, and mean SaO2 difference was 0.10. On the other hand, the intervention group showed a statistically significant decrease in the patient’s dyspnea as evidenced by a mean MBS decrease of 2.79, mean RR decrease of 1.88, and a mean SaO2 improvement of 0.67 (p value <0.0001).

Conclusions

The results of this study reveal that blowing air from an electric fan directly on the face of terminally ill Filipino cancer patients in addition to the prescribed standard of care significantly alleviated their level of dyspnea as evidenced by improvements in their modified Borg scale score, respiratory rate, and oxygen saturation. Thus, fan on face therapy should be considered as an adjunct to standard of care for these patients.

Clinical trial identification

University of the Philippines - Manila Research Ethics Board (UPMREB) No. 2019-050-01.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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Mini Oral session - Supportive and palliative care Mini Oral session

352O - Parenting experiences of cancer patients with minor children and their conversations about the possibility of death: A cross-sectional web-based survey for the online cancer community

Presentation Number
352O
Lecture Time
05:15 PM - 05:20 PM
Speakers
  • Yuko Usui
Location
Room 326, Singapore, Singapore, Singapore
Date
Fri, 22.11.2019
Time
04:30 PM - 05:30 PM
Authors
  • Yuko Usui
  • Kazuhiro Kosugi
  • Yohei Nishiguchi
  • Tomofumi Miura
  • Daisuke Fujisawa
  • Yuko Uehara
  • Takashi Kawaguchi
  • Kayo Izumi
  • Jun Takehana
  • Yoshihisa Matsumoto

Abstract

Background

Cancer patients with minor children experience distress in telling their children that they have cancer. The aim of this study is to share the parenting experiences of cancer patients with minor children and their conversations about the possibility of death.

Methods

This study is a sub-analysis of a cross-sectional web-based survey. Cancer patients with minor children were recruited from an online community and asked to complete a questionnaire about their experiences. Their responses were then evaluated on a 4-point Likert scale. This study reveals the proportion of patients disclosing their cancer to their children (“told group”), versus those not disclosing (“not-told group”), along with their experiences. Additionally, a t-test or chi-square test was used to analyze the association between telling their children about their cancer, and their experiences or conversations about the possibility of death.

Results

A total of 370 subjects were eligible [19% male, mean age (SD), 43.0 years (5.8)]. The most common primary cancer site was the breast (34%), followed by the colorectal region (12%), and gynecological organs (11%). Among the subjects, 274 (74%) told their children about having cancer. The “told group” were very keen on knowing how their children felt, compared to the “not-told group” (mean score, 3.1 vs 2.6, p < 0.001). Compared to the “told” group, the “not-told” group scored higher on “I did not want my minor children to see my suffering” (3.3 vs 3.0, p = 0.002) and “I had no idea how to explain the disease condition” (2.8 vs 2.1, p < 0.002). In response to the question on talking about the possibility of death, 7 % and 42% in the “not-told” and “told” groups, respectively, had told their children; 57% and 23% in the “not-told” and “told” groups, respectively, had never talked about the possibility of death; and 25% and 11.0% in the “not-told” and “told” groups, respectively, had never thought of the possibility of death (p < 0.001).

Conclusions

The present study showed that 70% of cancer patients with minor children disclosed their cancer to their children. Additionally, sharing this information triggered the conversation about the possibility of their death.

Legal entity responsible for the study

National Cancer Center.

Funding

Takeda Science Foundation.

Disclosure

K. Kosugi: Honoraria (self): Mundipharma. D. Fujisawa: Honoraria (self): Pfeizer; Honoraria (self): Mochida; Honoraria (self): Tanabe-Mitsubishi; Honoraria (self): Shionogi; Honoraria (self): Meiji Pharma; Honoraria (self): MSD. T. Kawaguchi: Honoraria (self): Chugai. K. Izumi: Full / Part-time employment, Employment: Medilead Inc. J. Takehana: Full / Part-time employment: Medilead Inc. Y. Matsumoto: Honoraria (self): Kyowa Kirin; Honoraria (self): Shionogi; Honoraria (self): Terumo; Honoraria (self): Meiji Seika Pharma; Honoraria (self): Hisamitsu Pharmaceutical; Honoraria (self): Eisai; Honoraria (self): Pfizer; Honoraria (self): AstraZeneca; Honoraria (self): Mundipharma; Honoraria (self): Daiichi-Sankyo. All other authors have declared no conflicts of interest.

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Mini Oral session - Supportive and palliative care Mini Oral session

Discussion led by moderator

Lecture Time
05:20 PM - 05:30 PM
Speakers
  • Masanori Mori
Location
Room 326, Singapore, Singapore, Singapore
Date
Fri, 22.11.2019
Time
04:30 PM - 05:30 PM
Authors
  • Masanori Mori