Public Release: 

Women may experience more side effects than men during gastric cancer chemotherapy

The Royal Marsden NHS Foundation Trust

ESMO 2018 abstract 619PD_PR - Influence of sex on chemotherapy efficacy and toxicity in oesophagogastric (OG cancer): a pooled analysis of 4 randomised trials.

Women may experience certain chemotherapy side-effects including nausea, vomiting, diarrhoea, mouth ulceration and hair loss more frequently than men, according to a new analysis of oesophageal and stomach cancer patients.

The study, led by The Royal Marsden NHS Foundation Trust and presented today (Friday 19 October 2018) at the European Society for Medical Oncology (ESMO) Congress 2018, analysed data from four randomised trials carried out in the UK and Australasia. All four studies looked at commonly used first-line chemotherapy combinations in advanced oesophageal and stomach cancer.

Drawing on data from 1,654 patients (1,328 men and 326 women), the researchers found that women experienced significantly higher rates of nausea and vomiting (89 per cent for women versus 78 per cent for men), diarrhoea (54 per cent vs 47 per cent), mouth ulceration (50 per cent vs 41 per cent) and hair loss (81 per cent vs 74 per cent). There was also a trend towards more infections in women as a result of low white blood cell counts, although this did not reach statistical significance.

The occurrence of 'serious adverse events' during treatment - potentially serious treatment complications which often require hospital admission - was also higher in women. When looking at chemotherapy effectiveness, there was no difference in survival between men and women, although overall response rate to chemotherapy - the proportion of patients experiencing a reduction in tumour size - was higher in men.

Dr Michael Davidson, Clinical Research Fellow at The Royal Marsden NHS Foundation Trust, said: "Our findings show that women seem to experience higher rates of certain chemotherapy side effects than men in this cancer type, particularly those related to gastro-intestinal function.

"We have known for a long time in oncology that there are differences between males and females in the incidence and prognosis of many non gender-specific cancers. However, we are only just beginning to understand how genetic and biological differences between men and women influence cancer development and response to treatment. There is also on-going research looking at differences in how men and women respond to newer anti-cancer treatments such as immunotherapy, and it is an area that is likely to become increasingly important in the future."

Professor David Cunningham, Director of the NIHR Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research, London, said: "This work adds to the growing body of evidence that gender can be an important factor in cancer treatment, and that clinicians need to be aware of such differences. For example, knowing female patients are more likely to experience side effects such as nausea and vomiting or diarrhoea may allow for more tailored chemotherapy education and support to be given in order to optimise the management of these common problems."

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This study was funded by The Royal Marsden's GI and Lymphoma Unit, the NIHR Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research (ICR), and The Royal Marsden Cancer Charity.

ESMO 2018 abstract 619PD_PR - "Influence of sex on chemotherapy efficacy and toxicity in oesophagogastric (OG cancer): a pooled analysis of 4 randomised trials" - will be presented by Dr Michael Davidson during Poster Discussion Session on Friday 19 October 2018, 16-17.30 (CEST) in Room 21 - Hall B3. Annals of Oncology, Volume 29 Supplement 8 October 2018

For further media information please contact Jack Stonebridge, Senior PR & Communications Officer at The Royal Marsden on jack.stonebridge@rmh.nhs.uk or 0207 808 2605.

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 groundbreaking 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.

The National Institute for Health Research (NIHR): improving the health and wealth of the nation through research.

Established by the Department of Health and Social Care, the NIHR:

  • funds high quality research to improve health
  • trains and supports health researchers
  • provides world-class research facilities
  • works with the life sciences industry and charities to benefit all
  • involves patients and the public at every step

For further information, visit the NIHR website http://www.nihr.ac.uk

This work uses data provided by patients and collected by the NHS as part of their care and support, and would not have been possible without access to this data. The NIHR recognises and values the role of patient data, securely accessed and stored, both in underpinning and leading to improvements in research and care. Read more http://www.nihr.ac.uk/patientdata.

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