Florian Scotté

Aim: The PROCHE [Programme for optimisation of the chemotherapy network] initiative is an innovative oncology-monitoring program designed to reduce patient waiting time and chemotherapy wastage, ultimately improving patient care. Laboratory test results and side effects data are collected for patients in the PROCHE monitoring program 2 days prior to scheduled chemotherapy visits, allowing oncologists to confirm or delay each patient's chemotherapy. Methods: This prospective study compared the program Data from patients entered in the PROCHE program with 513 control patients. Primary objective was to evaluate the evolution of delay between arrival and start of chemotherapy from 2008 to 2013. Secondary objectives were evolution of toxicity incidence and patient satisfaction along 4 years of activity. Incidence per year was compared using the Maentel-Haenszel Khi-2. Results: Between Oct 2008 and Dec 2013, 2 040 patients participated in the program, representing 21,920 scheduled chemotherapy. Results demonstrated significant reductions in mean hospital stay with a decrease of 53 min (116 min in 2008 compared to 63 min in 2013) allowing 30% activity enhancement to reach a 95% of patient satisfaction. Drug wastage was decreased by a factor 2 compared to another ambulatory chemotherapy department in the same hospital (5.4% vs 10.9%). Main adverse events (AE) incidence was collected on an ongoing basis (percentages are rounded to nearest integer). Fatigue was the most incident, with a decrease between 2009 and 2013, respectively 81% vs 54% (p < 0.0001). Incidence of other disorders also decreased following this program between 2009 and 2013: pain: 37% vs 21% (p < 0.0001); nausea: 21% vs 9% (p < 0.0001) and infection: 5% vs 3%, (p = 0.0008). Anticipating anti-cancer treatment adaptation as well as intervention of supportive team (pain, nutrition, psychological) in response to the PROCHE program, may explain these positive results. Conclusions: the PROCHE initiative resulted in improved patient quality of care and improvement of hospital as well as pharmacy efficiency. Disclosure: All authors have declared no conflicts of interest.

Aim: MARS is a multicentric, non-interventional, prospective study which first reported the high prevalence of both baseline and de novo hypertension (HTN) and proteinuria (Pu) in several sub group of cancer patients [Gligorov J et al. SABCS 2013; Ray-Coquard I et al. ASCO GI 2014; Ray-Coquard I et al. ASCO GU 2014; Goldwasser F et al. ECC 2013; Launay-Vacher V et al. ASCO 2013]. In this sub-group analysis, we focused on elderly cancer (EC) patients treated with bevacizumab. Methods: MARS included 1'124 patients, all naïve of any previous anti-VEGF treatment. A First Renal Assessment was performed at baseline before the anti-VEGF was started with periodic follow-up for 1 year. Elderly was defined as age ≥65 years at inclusion. Univariate (UA) and multivariate analyses (MA) tested the associations of HTN and Pu, at baseline or de novo, with overall survival (OS) (pre-planned) in EC patients. Results: 845 patients treated with bevacizumab were included. Among them 226 were EC patients (colorectal 81, breast 78, ovarian 26, lung 22 …). At inclusion, HTA was statistically higher in EC patients (table), mean aMDRD was 79.6 ml/min/1.73m² and 15.1% had aMDRD2/year and 16.2% had aMDRDConclusions: There were no differences in term of renovascular safety in EC patients treated with bevacizumab. Furthermore, HTN and Pu were not associated with OS in EC patients treated with bevacizumab. Disclosure: V. Launay-Vacher: Bayer, Schering Pharma, Gilead Sciences, Janssen-Cilag, LEO Pharma, Amgen, Celgene, Boehringer Ingelheim, Daiichi Sankyo, Ipsen, Fresenius Biotec; N. Janus: Roche, Fresenius Medical Care, Pfizer; I.L. Ray-Coquard: Roche, Pharmamar; J. Gligorov: Roche, Teva; P. Beuzeboc: Roche; J. Spano: Cephalon, Merck Serono, MSD, LEO Pharma, GlaxoSmithKline, Amgen, Teva, Sanofi, Roche; J. Thery: Novartis; F. Goldwasser: Roche; O. Mir: Astra-Zeneca, Bayer, GSK, Novartis, Pfizer, Roche, Servier; J. Rey: B-Braun, Baxter, Fresenius, LEO Pharma, Merck Serono, Mundipharma, Sandoz, BMS, Amgen, Archimedes, Merck, Pfizer, Roche, Boehringer Ingelheim, Helsinn Healthcare; S. Oudard: Pfizer, Roche, Bayer, GSK, Novartis. All other authors have declared no conflicts of interest.