Chemotherapy and Liver Cirrhosis in Frequently-associated Cancers

University Hospital, Lille7 enrolled

Overview

Cirrhosis and cancers of the upper digestive tract, colorectal and ENT share common risk factors. Liver cirrhosis can change the elimination of cancer drugs. Precise data on management and outcome of patients with liver cirrhosis undergoing chemotherapy are lacking. Most patients have been excluded from clinical trials evaluating conventional therapies. The study of tolerance, side effects, and outcome in patients with cirrhosis could help improve chemotherapy management for better tolerance and efficacy. The main objective is to estimate the frequency of liver cirrhosis among patients evaluated in CPR for ENT, upper digestive or colorectal cancer. Secondary objective includes the evaluation ofthe impact of cirrhosis on the management of chemotherapy by comparing cirrhotic patients' outcomes with a control group of matched non-cirrhotic patients.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Cirrhosis Neoplasms

Interventions

Current care studyOTHER

Observational study in two parts: 1. Cross-sectional study of patients with digestive or ENT cancer with indication for conventional chemotherapy treatment according to management guidelines, the objective of which is to determine the frequency of cirrhosis. 2. Exposed/non-exposed cohort study of patients receiving a first course of conventional chemotherapy initiated in outpatient oncology clinic. (safety population). Exposed subjects will be patients with cirrhosis, included consecutively. Non-exposed subjects will be non-cirrhotic patients. They will be selected non-consecutively according to the following criteria, for matching to exposed subjects: age (±5 years), type of cancer (digestive vs. ENT), treatment stage (curative vs. palliative). Two unexposed subjects will be selected for 1 exposed subject.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Follow-up for the following cancers: upper digestive sphere (stomach, esophagus, pancreas, bile ducts), colorectal, ENT * Theoretical indication of conventional chemotherapy based on 5FU, anthracyclins, platinum salts, gemcitabin, taxans, irinotecan or antiangiogenic drugs, anti-EGFR or anti-HER 2 therapies, according to management guidelines * Beneficiary of a social security system * Dated and signed non-opposition consent Exclusion Criteria: * Other concomitant primary cancer * Pregnant women * Patients under guardianship, curatorship or justice protection

Outcomes

Primary Outcomes

Frequency of patients with ENT, upper digestive-tract or colorectal cancer with a diagnosis of cirrhosis

Time frame: before the chemotherapy initiation, within 45 days of multidisciplinary board

Secondary Outcomes

Percentage of patients receiving at least a first effective course of chemotherapy on all patients with a theoretical indication for chemotherapy

Time frame: within 45 days of multidisciplinary board.

Survival time

Survival time defined as the difference between the date of initiation of chemotherapy,

Time frame: the date of death, the date of last news or the point date (12 months).

Progression-free survival time

Progression-free survival time defined as the difference between the date of initiation of chemotherapy, the date of progression or death, the date of last news or the point date (12 months).

Time frame: the date of initiation of chemotherapy, tthe date of progression or death, the date of last news or the point date (12 months).

Frequency of chemotherapy side effects according to CTCAE version 5.0 classification in cirrhotic patients who have received chemotherapy

Time frame: Up to 5 years after chemotherapy