JSCO2016: International Session 5 Supportive Care for Adverse Events

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The 54th Annual Meeting of Japan Society of Clinical Oncology (JSCO2016)

"Renovation of Cancer Medicine in the Mature Society"



International Session 1: Lung Cancer
International Session 2: Colorectal Cancer
International Session 3: Gastric Cancer
International Session 4: Urological Cancer (Prostate and Renal Cancer)
International Session 5: Supportive Care for Adverse Events
International Session 6: Gynecological Cancer (Uterine Body Cancer and Ovarian Cancer)
International Session 7: Central Nervous System Tumor
International Session 8: New Development of Particle Beam Therapy for Cancer
International Session 9: International Cooperation in Radiation Medicine
International Session 10: Recent Advances In Cancer Immunotherapy
International Session 11: Breast Cancer
International Session 12: Pharmacology of Antitumor Agents: New Drug Application (NDA)
International Session 13: Malignant Lymphoma
International Session 14: Palliative Care
International Session 15: Radiation Therapy
International Session 16: Head and Neck Cancer
International Session 17: Skin Cancer (Malignant Melanoma)
International Session 18: Hepato-Biliary and Pancreas Cancers
International Session 19: Leukemia
International Session 20: Ethics for Clinical Research
International Session 21: Esophageal Cancer
International Session 22: Bone and Soft Tissue Tumor
FACO/JSCO Joint Symposium

Abstract Archives (in Japanese)


 Session 5: Supportive Care for Adverse Events


Development of supportive care guidelines in Japan
Kenjiro Aogi (Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center)
In Japan, many clinical practice guidelines have been established since 2004 by medical associations supported by Ministry of Health, Labour and Welfare (MHLW). Japan Society of Clinical Oncology (JSCO) have published 32 clinical guidelines, including 27 organ-specific and 5 for supportive care ones, e.g. guidelines for pain control, the use of G-CSF, and anti-emesis. These guidelines have contributed to better outcomes on cancer treatments, which must be evidence-based and updated along with the clinical trial results.
Supportive cares have been provided to patients in a multi- and trans-disciplinary approach. This approach is constructed by the cooperation of medical staffs. Supportive care guidelines are important and indispensable in clinic.
JSCO have been re-assessing of anti-emetic guideline after its publication in 2010 as a guideline evaluating model. The guideline-evaluating team constructed by the anti-emetic guideline committee performed the survey asking about the penetration of Japanese anti-emetic guideline to institutions joining JSCO in 2012. In this survey, to which 1529 Japanese medical staffs responded, 586 (51%) staffs had reported to regard for guideline and 489 (42.6%) refer to it (Saeki T et al Jpn J Cancer Chemother 2015;42:305).
The guideline-practice gap, the discordance of guideline recommendation and clinical practice, has been an obstacle in the evidence-based medicine due to some clinical reasons, e.g. institutional circumstances, domestic insurance coverages and preferences of the patient/ physician. MHLW also has concern about nonadherence to guideline and established the study group to elucidate reasons of nonadherence to recommendation in the other guidelines such as breast and colon cancer in addition to anti-emesis. Therefore, it must be important the development of the supportive care guidelines in order to get better outcomes for cancer patient.


Year in review Europe: ESMO clinical practice guidelines in supportive care
Jørn Herrstedt (University of Southern Denmark and Department of Oncology, Odense University Hospital, Odense, Denmark)
The major European players in Supportive and Palliative Care are the European Society of Medical Oncology (ESMO,www.esmo.org), the Multinational Association of Supportive Care in Cancer (MASCC, www.mascc.org) and the European Association of Palliative Care (EAPC, www.eapcnet.eu).
ESMO definition of Supportive Care in Cancer: The multidisciplinary prophylaxis and management of symptoms from the cancer and side effects of therapy from the time of diagnosis until death or until rehabilitation and survivorship issues have been successfully managed.
MASCC definition of Supportive Care in Cancer: The prevention and management of the adverse effects of cancer and its treatment. This includes management of physical and psychological symptoms and side effects across the continuum of the cancer experience from diagnosis through treatment to post-treatment care. Enhancing rehabilitation, secondary cancer prevention, survivorship, and end-of-life care are integral to supportive care.
ESMO provides several resources within the area of Supportive Care, e.g. the ESMO Clinical Practice Guidelines: Supportive Care (http://www.esmo.org/Guidelines/Supportive-Care). These include recommendations for the best standard of cancer care and are based on evidence-based medicine. Currently 15 supportive care guidelines are available.
ESMO also publish Supportive Care Pocket Guidelines, which are distributed during ESMO events and are abridged versions of ESMO Clinical Practice Guidelines and can be accessed via an App.
This presentation will include an overview of the ESMO Supportive Care Clinical Practice Guidelines and provide a more detailed summary of the most recent updated of these ESMO guidelines.
Finally a look to the future including a list of future Supportive Care Clinical Practice Guidelines to be published in 2016/2017 will be given.


Current situation of supportive care for adverse events in Japan
Akihito Tsuji (Department of Clinical Oncology, Kagawa University Faculty of Medicine)
Nowadays, advances of cancer chemotherapy by new therapies such as immune-checkpoint inhibitor (ICI) and molecular target medicine are promising. However, early detection of adverse events, development of treatment skills, moreover, development of new supportive care are necessary for these advances. Treatment, which has been considered to be difficult because of its toxicity, has been spread as standard treatment by development of supportive care for cancer chemotherapy. We could be able to safely and effectively use the molecular target medicine, because we has mastered its specific toxicity by inducing supportive care. Recently, development of early detection of immuno-related adverse events (irAE) and supportive care with steroid enables clinical use of ICI.
For improvement of safety and efficacy of cancer chemotherapy, following four things are very important.
1. Early detection and intervention of toxicity
2. Sharing toxic information with multiple disciplinary team (MDT)
3. Apply the new supportive care drugs
4. Understanding the guideline of supportive care
Specifically, following five factors are important for treatment development.
1. Standardization the blood test items to each regimens or disease for early detection.
2. Utilizing semi-logarithmic graph for predicting hematologic toxicities
3. Preparing and using template of adverse events for sharing toxic information with MDT
4. Applying new supportive drugs (including developing agents under clinical trials)
5. Understanding various guidelines for supportive care
We present here current situation of supportive care for adverse events in Japan.


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