Lack of statistical power in this study precludes definitive conclusions. Clinicians may consider twice-daily enoxaparin because of potentially fewer adverse events but may be limited by patient preference and/or financial constraints.

Pemetrexed is a multitargeted antifolate indicated for locally advanced or metastatic non-squamous non-small-cell lung cancer and malignant pleural mesothelioma. Cutaneous reactions are associated with pemetrexed use. Pemetrexed prescribing information recommends oral dexamethasone 4 mg twice daily for three days starting the day before pemetrexed infusion to prevent cutaneous reactions. Patients receive intravenous dexamethasone before pemetrexed infusion at the University of New Mexico Comprehensive Cancer Center, but the oral dexamethasone recommendation is not always followed. The objective of this study was to determine if there is a difference between patients who received three days of oral dexamethasone starting the day before pemetrexed infusion and patients who did not by determining incidence of cutaneous reactions, delay in therapy, and therapy change due to adverse reactions. Eighty-five patients received at least one dose of pemetrexed between August 1, 2012 and August 31, 2017. Twenty-nine patients did not receive three days of oral dexamethasone 4 mg twice daily and 56 patients did (34.1% vs. 65.9%). There was no statistically significant difference in the incidence of cutaneous reactions between the intervention group and the control group (13.8% vs. 25.0%; p = 0.384), delay in pemetrexed therapy between groups (44.8% vs. 32.1%; p = 0.2), or therapy change due to adverse events (34.5% vs. 23.2%; p = 0.654). Results suggest three days of oral dexamethasone 4 mg twice daily did not significantly affect incidence rates of cutaneous reactions, delay in therapy, or therapy change in patients who received intravenous dexamethasone before pemetrexed infusion at University of New Mexico Comprehensive Cancer Center.

e18166 Background: New Mexico (NM) has one of the highest rates for hepatocellular carcinoma (HCC) in the US. Systemic therapy (ST) for HCC is typically reserved for patients with unresectable or metastatic disease. Sorafenib has been commonly used as the first-line (1L) systemic agent for HCC after its FDA-approval in 2007. Since 2017, several other agents have been FDA-approved for HCC including lenvatinib as 1L therapy and regorafenib, cabozantinib, ramucirumab and checkpoint inhibitors (nivolumab and pembrolizumab) as second-line (2L) treatment options. This retrospective study describes the HCC treatment patterns of patients seen at the University of New Mexico Comprehensive Cancer Center (UNMCCC). Methods: Following approval by the institutional review board, a retrospective chart review of all consecutive HCC patients at the UNMCCC between January 1, 2012 and August 30, 2018 was performed. Patients were identified accessing the UNMCCC tumor registry database. Data on patients’ characteristics, treatments and outcomes were collected. Descriptive statistics were conducted for this initial analysis. Results: A total of 99 of the 380 patients seen at the UNMCCC within the study period were considered for systemic therapy. Most patients were males (82.8%) and of Hispanic/Latino (57.6%) ethnicity. The majority of patients had one or more risk factors for HCC including a history of hepatitis (70.7%), cirrhosis (70.7%), and history of alcohol use (72.7%). Child Pugh class A and B were seen in 30.3% and 44.4% of patients, respectively. Ninety-six patients were prescribed sorafenib initially; however, only 67 patients (70%) successfully initiated treatment. The median time between sorafenib prescription and treatment initiation was 15 days. Only fifty percent of patients started sorafenib with the FDA-recommended dose of 400mg PO BID. Commonly reported adverse events were fatigue, diarrhea, hand and foot syndrome and LFT elevation. After 2017, when 2L options became available, 11 of 27 patients that started on sorafenib continued on to 2L (9 patients received nivolumab and 2 patients received regorafenib). Outcome data are currently being analyzed and will be reported. Conclusions: Although systemic options are available for the treatment of HCC, a significant number of patients are still not accessing and receiving treatment. A detailed analysis of factors affecting treatment patterns in New Mexico is warranted.

No abstract