Female patients more likely to survive but experience worse side effects from cancer treatment

An analysis of over 3000 patients with cancer of the oesophagus and stomach suggests female patients are more likely to survive longer than male patients, but experience more nausea, vomiting and diarrhoea during therapy.

Oncologists from The Royal Marsden NHS Foundation Trust who led the research, in collaboration with the UK Medical Research Council Clinical Trials Unit (MRC CTU) at University College London, say the interesting findings could potentially help to tailor the management of patients and also highlight those more at risk from specific side effects.

Data from the study will be presented in a poster session at this weekend’s American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, where it will also be awarded a Conquer Cancer Foundation of ASCO Merit Award. The award recognises organisations/individuals who are making great contributions to advancing cancer research.

Researchers conducted an analysis on data taken from four previously published large randomised trials conducted primarily in the UK.

Patients in the trials had been allocated to receive chemotherapy before undergoing surgery to remove the tumours.

In the analysis of 3265 patients – 2668 male patients and 597 female – researchers found female patients were significantly more likely to experience nausea (10% versus 5%), vomiting (10% versus 4%) and diarrhoea (9% versus 4%). Female patients were also significantly more likely to live longer than males following treatment for their cancer, with researchers finding an average of five months additional survival for women. The researchers also looked to see whether there were any differences dependent on age. They found that whilst older patients (70 years or more) experienced significantly more neutropenia – low white blood cells – whilst receiving chemotherapy, there were otherwise no significant differences in cancer-related survival when compared with the younger patients (aged below 70).

Lead author Dr Avani Athauda, Clinical Research Fellow at The Royal Marsden NHS Foundation Trust and recipient of the Merit Award, said: “We tend to use a standard treatment approach for managing oesophageal and stomach cancers. What this research suggests is that there are significant differences between male and female patients not only in how they react to chemotherapy but also how long they survive following treatment for their cancer. For female patients, it may be worthwhile providing additional awareness and counselling for gastrointestinal side effects when prescribing chemotherapy.”

“We already know that there are vast differences in the biology of these cancers between individual patients and we plan to further investigate at a genetic level why there might be such differences in how patients benefit from chemotherapy with varying survival. This may help to explain the differences we have observed between male and female patients undergoing the same treatments.”

Senior author Professor David Cunningham OBE, Consultant Medical Oncologist at The Royal Marsden NHS Foundation Trust said: “This is a significant finding based on a large scale data set, and furthers our understanding about two types of cancer that affect almost 16,000 people each year in the UK alone.”

“The complexity of cancer is a constant challenge to developing effective treatments, with hundreds of different types affecting patients in different ways. At The Royal Marsden we are focused on developing smarter, kinder and more personalised treatments.”

Researchers are following on from this study by looking at tumour samples from patients enrolled into the trials to identify, at a molecular level, markers that may help to predict which patients do well and which don’t.

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This study was funded by the Gastrointestinal and Lymphoma Research Unit at The Royal Marsden and the MRC CTU at UCL.

Notes to editors

‘Impact of age and sex on chemotherapy (CTx) efficacy, toxicity and survival in early oesophagogastric (OG) cancer: A pooled analysis of 3265 patients from four large randomised trials (OE02, OE05, MAGIC & ST03)’ will be presented by Dr Avani Athauda on Monday 3rd June 2019

For further information or interviews contact Hannah Bransden, Senior PR & Communications Officer, [email protected] / 0207 811 8244.

OE02, OE05, MAGIC & ST03 were national studies designed and co-ordinated by the MRC CTU at UCL with Professor David Cunningham as Chief Investigator of MAGIC, OE05 and ST03.

About The Royal Marsden NHS Foundation Trust

The Royal Marsden opened its doors in 1851 as the world’s first hospital dedicated to cancer diagnosis, treatment, research and education.

Today, together with its academic partner, The Institute of Cancer Research (ICR), it is the largest and most comprehensive cancer centre in Europe seeing and treating over 50,000 NHS and private patients every year. It is a centre of excellence with an international reputation for ground breaking research and pioneering the very latest in cancer treatments and technologies.

The Royal Marsden, with the ICR, is the only National Institute for Health Research Biomedical Research Centre for Cancer. This supports pioneering research work carried out over a number of different cancer themes.

The Royal Marsden also provides community services in the London borough of Sutton.

Since 2003, The Royal Marsden Cancer Charity has funded the latest developments in cancer research, diagnosis, treatment and patient care. Over recent years, supporters of The Royal Marsden Cancer Charity have funded facilities including the Oak Centre for Children and Young People, the da Vinci robots, the CyberKnife radiotherapy machine and the Reuben Foundation Imaging Centre.

HRH The Duke of Cambridge became President of The Royal Marsden in 2007, following a long royal connection with the hospital.

About the MRC Clinical Trials Unit at UCL

The MRC Clinical Trials Unit at UCL is at the forefront of resolving internationally important questions in infectious diseases and cancer, and delivering swifter and more effective translation of scientific research into patient benefits. It does this by carrying out challenging and innovative studies, and developing and implementing methodological advances. It is part of the Institute of Clinical Trials and Methodology at UCL, and is funded by the Medical Research Council.