No abstract

BackgroundThe solution for infusion bags prepared by the pharmacy contains an unknown and variable volume of solution in order to keep a minimum volume.PurposeTo determine the potential under-dosing of oncology patients related to the loss of cytostatic drugs in the remaining volume of the solution for infusion bags.Material and methodsProspective observational study. We randomly assessed 50 cytostatics mixtures prepared by the Pharmacy Service.Studied variables: total dose of cytostatic drug prescribed, total volume of the mixture and the volume remaining after the intravenous administration. The remaining volume was indicated by the infusion pump. The total volume was obtained from the cytostatics compounding program (Farmatools).As we found from the literature, it is acceptable that up to 5% of the total dose prescribed by the oncologist may be lost in the process of IV administration.ResultsOverfilling was detected in all 50 solutions (100%). In 10 cases (20%), the volume of the solution remaining after administration contained a cytostatic dose less than 5% of the total dose. In 40 cases (80%) the remaining dose was higher than 5%. In 16 of these 40 cases (40%), the non-infused dose was higher than 10% of the total dose (32% of the total of mixtures) and in 6 cases (15% of these 40 cases) was higher than 20% of the dose prescribed (10% of all the preparations).ConclusionThe solutions for infusion bags contain more fluid than that specified on the commercial label. If this is not corrected for, the total volume of the mixture will be greater than that shown on the label issued by the Pharmacy Service. The measure adopted is to program an additional volume in the infusion pump, while maintaining the speed shown on the label, so that the entire mixture is administered to the patient.References and/or acknowledgementsL. SantosNo conflict of interest.

No abstract

4615 Background: FOLFIRINOX and nab-paclitaxel plus gemcitabine (nab-P+G) are the standard of care in the first-line treatment of mPC patients (pt) with good performance status. However, no standards of care exist for elderly ( > 70 years) pt as they are usually excluded in clinical trials. This study aimed to evaluate whether the clinical benefit of nab-P+G could be extended to elderly pt with mPC. Methods: This was an open-label, single-arm, multicenter, phase II trial, to assess the efficacy and safety of Nab-P+G in elderly pt (≥ 70 years) with ECOG PS 0–1 and untreated unresectable locally advanced or metastatic PC. Pt received four-week cycles of intravenous (i.v.) nab-paclitaxel 125 mg/m2, followed by i.v. gemcitabine 1,000 mg/m2, on days 1, 8 and 15, until disease progression. Efficacy was evaluated according RECIST v 1.1 criteria and safety according NCI-CTCAE v 4.0 criteria. Results: Eighty pt were enrolled in the study. Median age was 74.6 years (range 70-87.9), 57.5% were men, 71% had ECOG PS 1 and 86% metastatic disease. 16.3% of patients had a history of prior tumor surgical resection, 12.5% received chemotherapy and 3.8% radiotherapy. Primary tumor was located in head (32.5%), tail (25.0%) and body (22.5%). Nab-P and G was reduced in 49% and 41% of pt respectively. 15 pt definitely interrupt study treatment due to toxicity: neurotoxicity (7), asthenia (5), neutropenia (1), leukocytosis (1) and hepatotoxicity (1). Time until definite deterioration (reduction ≥10 points as compared to baseline in EORTC-QLQ C30) was 1.6 months and deterioration-free rate at 3 months was 54.3%. Overall response rate was 13.8%, clinical benefit rate 67.5%, median PFS 7.2 months and median OS 9.2 months. The most common treatment-related adverse events were asthenia (60.0%), diarrhea (40.0%), neutropenia (33.8%), hair loss (28.8%), thrombocytopenia (26.3%), and nausea (23.8%). Only asthenia and neutropenia presented a relatively high incidence of grade 3 and 4 toxicities (21.3%). At least 1 SAE was reported in 55% of pt. Conclusions: BIBABRAX study confirms the clinical benefit of nab-P+G in an elderly population with mPC, in terms of survival, clinical response and tolerance, therefore it could be considered a treatment option for elderly patients. However, it was unable to demonstrate the preplanned benefit on the quality of life. Further research is needed on treatment strategies that could reduce deterioration of the quality of life in these pt. Clinical trial information: NCT02391662 .