Effects of gender on capecitabine toxicity in colorectal cancer

Ilich, Alastair; Danilak, Melanie; Kim, Christina; Mulder, Karen; Spratlin, Jennifer L.; Ghosh, Sunita; Chambers, Carole; Sawyer, Michael B.

doi:10.1177/1078155215587345

Cited by 23 publications

(19 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The results also differ from numerous studies with cancer populations that did not find associations between sex and participation [4–6] or attrition [9–11]. An explanation may be provided by growing evidence for sex-based differences in response to anticancer treatments, showing that women experience higher incidence of toxicity and adverse reactions than men [40, 41]. It is possible that women in our sample experienced more treatment-related symptoms than men, which made them more likely to discontinue participation.…”

Section: Discussioncontrasting

confidence: 87%

Cancer survivors who fully participate in the PROFILES registry have better health-related quality of life than those who drop out

et al. 2019

View full text Add to dashboard Cite

PurposeAttrition and subsequent missing data pose a challenge in longitudinal research in oncology. This study examined factors associated with attrition in the PROFILES registry, and its impact on observed health-related quality of life (HRQOL) estimates.MethodsSociodemographic, clinical, and HRQOL data were collected annually from a cohort of 2625 colorectal cancer survivors between 2010 and 2015. Participant characteristics according to time of dropout were compared using analysis of variance and chi-square tests. Predictors of attrition were examined in logistic regression analysis. Multilevel linear mixed models were constructed to investigate associations between attrition and HRQOL over time.ResultsParticipants who dropped out were more likely to be female (OR = 1.23, CI = 1.02–1.47), older (OR = 1.20, CI = 1.09–1.33), less educated (OR = 1.64, CI = 1.30–2.11), and to have depressive symptoms (OR = 1.84, CI = 1.39–2.44) than full responders, and less likely to have high socioeconomic status (OR = 0.74, CI = 0.61–0.94). Participants who dropped out earlier reported significantly worse HRQOL, functioning, and psychosocial symptoms, which declined at a steeper rate over time, than full responders.ConclusionsCancer survivors’ HRQOL may be overestimated in longitudinal research due to attrition of the most unwell participants.Implications for Cancer SurvivorsCancer survivors with the poorest health are at risk of dropping out of PROFILES and possibly withdrawing from other activities. Optimizing participation in PROFILES—a potential mechanism for providing information and access to support—is an avenue for keeping this group engaged.Electronic supplementary materialThe online version of this article (10.1007/s11764-019-00793-7) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussioncontrasting

confidence: 87%

Cancer survivors who fully participate in the PROFILES registry have better health-related quality of life than those who drop out

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Our study did not confirm some previously reported risks for cardiotoxicity, including age >55 years, female sex, use of platinum, hemoglobin levels, IHD, and common CVRF. 7 , 15 , 21 , 24 , 25 , 45-47 The proportion of patients with IHD in this study was higher in the cardiotoxicity group, but the difference was not significant, possibly because of the small number of patients and this aspect should be investigated in a larger group.…”

Section: Discussionmentioning

confidence: 60%

Cardiotoxicity from Capecitabine Chemotherapy: Prospective Study of Incidence at Rest and During Physical Exercise

Lestuzzi¹,

Stolfo

Paoli

et al. 2022

The Oncologist

View full text Add to dashboard Cite

Background Physical activity may increase the risk of cardiotoxicity (myocardial ischemia, major arrhythmias) of 5-Fluorouracil, but this risk has never been investigated for its prodrug capecitabine. Patients and Methods One hundred and ninety-two consecutive patients undergoing capecitabine chemotherapy from December 1, 2010 through July 31, 2016 were prospectively evaluated. The baseline evaluation included electrocardiography (ECG) and echocardiography (2DE); a follow-up evaluation, including ECG and exercise stress testing (2DE in case of ECG abnormalities), was done after ≥10 days of treatment. Cardiotoxicity was suspected from ischemic ECG changes, new kinetic abnormalities at 2DE, Lown classification ≥2 ventricular arrhythmia, symptomatic arrhythmias, or positive stress test, and confirmed by a negative stress test after capecitabine washout. Results Cardiotoxicity was diagnosed in 32 patients (16.7%): six at rest and 26 during exercise. All 32 patients had ECG abnormalities: ST-segment changes (24 patients), negative T-waves (2) and/or arrhythmias: ventricular arrhythmias (14 cases), supraventricular tachycardia (2), complete heart block (1). Eight patients had typical symptoms, 6 had atypical symptoms, 1 had syncope, 17 (53%) were asymptomatic. Cardiotoxicity was more common in patients with atypical symptoms during daily life (OR = 15.7) and in those on a therapeutic schedule of 5 days/week (OR = 9.44). Conclusion Capecitabine cardiotoxicity is frequent, and often elicited by physical effort. Oncologists, cardiologists, and general practitioners should be aware of this risk. Active cardiotoxicity surveillance with ECG (and echocardiogram and/or stress testing in suspected cases) during therapy is recommended. Clinical Trials registration number CRO-2010-17.

show abstract

“…Because capecitabine is predominantly eliminated renally, it is contraindicated in patients with severe renal impairment (creatinine clearance below 30 mL/min). The incidence of grade 3 or 4 adverse events was higher in our study than in the overall population [23]. In patients with mild renal impairment no dosage reduction is required; however, it is plausible that renal dysfunction leads to higher capecitabine blood concentrations and greater toxicity, requiring dose adjustment.…”

Section: Discussionmentioning

confidence: 74%

Real-World Adverse Effects of Capecitabine Toxicity in an Elderly Population

Beek¹,

Roukens²,

Jacobs³

et al. 2018

Drugs - Real World Outcomes

View full text Add to dashboard Cite

BackgroundFew studies have assessed the safety and effectiveness of the numerous available chemotherapeutic therapies for geriatric oncology patients. Most safety studies are conducted in large trials, and there is some uncertainty surrounding whether the results would be the same in typical daily use.ObjectiveThis retrospective study aims to assess the adverse effects of real-world capecitabine use in elderly patients.MethodsWe reviewed the records of patients treated with capecitabine in an oncology department of a University Clinic in Nijmegen, The Netherlands. We scored adverse effects such as hand-foot syndrome and diarrhea, and dosage adjustments and the reasons for them. In total, 132 patients were included, 69 of whom were aged 70 years or below (mean age: 57 years), while 63 were aged older than 70 years (mean age: 74 years).ResultsPatients aged over 70 years experienced more serious adverse effects than younger patients. Grade 2 or 3 hand-foot syndrome toxicity was experienced by 20.2% of patients aged younger than 70 years and by 34.9% of patients older than 70 years (p = 0.059). Grade 2, 3, or 4 diarrhea was experienced by 17.4% of the patients aged younger than 70 years but by 31.7% of the patients aged older than 70 years (p = 0.044). Dosage was adjusted for 27/69 patients in the younger group and 52/63 patients in the older group (p = 0.001).ConclusionThe difference in observed adverse effects cannot be the sole explanation for the high incidence of observed dose adjustments. A prospective follow-up study of elderly patients using capecitabine outside clinical trials is needed to evaluate the optimum balance between adverse effects and efficacy.

show abstract

Effects of gender on capecitabine toxicity in colorectal cancer

Abstract: Female colorectal cancer patients experience a higher dose-limiting toxicity incidence than male patients when given adjuvant capecitabine dosed according to body surface area.

Cited by 23 publications

References 12 publications

Cancer survivors who fully participate in the PROFILES registry have better health-related quality of life than those who drop out

Cancer survivors who fully participate in the PROFILES registry have better health-related quality of life than those who drop out

Cardiotoxicity from Capecitabine Chemotherapy: Prospective Study of Incidence at Rest and During Physical Exercise

Real-World Adverse Effects of Capecitabine Toxicity in an Elderly Population

Contact Info

Product

Resources

About