A. Munoz Martin

Local stress fields and intraplate deformation of Iberia: variations in spatial and temporal interplay of regional stress sources

Tertiary to present deformation in the interior of the Iberian Peninsula reflects spatial and temporal variations of the activity of the plate boundaries. Local deformation patterns observed in many of the numerous intraplate Tertiary basins and their borders, such as the Madrid Basin and the Sierra de Altomira, are at first sight incompatible with the regional stress field under which they were formed. We demonstrate, however, that they can be explained as the effect of several stress fields that acted on the Iberian Peninsula from earliest Tertiary onward. Data on local deformation can constrain both magnitudes and directions of forces acting on the plate boundaries of Iberia, enabling us to estimate the relative importance of the different plate driving and deforming mechanisms providing further constraints on the tectonic evolution of Iberia.

Clinical guide SEOM on venous thromboembolism in cancer patients

Venous thromboembolism (VTE) is a common event in cancer patients and one of the major causes of cancer-associated mortality and a leading cause of morbidity. In recent years, the incidence rates of VTE have notably increased; however, VTE is still commonly underestimated by oncologists. VTE is considered an adverse prognostic factor in cancer patients in all settings. In 2011 the Spanish Society of Medical Oncology (SEOM) first published a clinical guideline of prophylaxis and treatment of VTE in cancer patients. In an effort to incorporate evidence obtained since the original publication, SEOM presents an update of the guideline for thrombosis and cancer in order to improve the prevention and management of VTE.

Safety and efficacy of primary thromboprophylaxis in cancer patients.

Cancer is often complicated by venous thromboembolism (VTE), a common and potentially fatal complication associated with poor prognosis in these patients. An increased incidence of VTE is being observed due to the advanced age of cancer patients, the thrombogenic effect of novel drugs and advances in the diagnosis of related complications. In this review, we look at five different risk groups of cancer patients with an increased probability of developing VTE, including hospitalized patients undergoing chemotherapy, patients undergoing a surgical procedure, ambulatory patients undergoing chemotherapy, patients with a central venous access and patients receiving antiangiogenic drugs or anticoagulant therapy due to previous chronic diseases. The aim of this review is to summarize the most important clinical evidence reported to date on the suitability of primary thromboprophylaxis to cancer patients. Recommendations have drawn up for each group based on current evidence and guidelines to facilitate decision-making in clinical practice.

Pancreatic ductal adenocarcinoma: metastatic disease

Abstract The treatment of choice of metastatic PADC is systemic chemotherapy. In the last decade, there have been significant advances in this area. New combination poli-chemotherapy schemes have shown a significant increase in overall survival and progression-free survival without impairing quality of life. In addition, the value of second-line chemotherapy treatment has consolidated and a new concept called “therapeutic sequencing” has also emerged. The aim of this article is to review the different therapeutic options in metastatic PDAC based on patient’s characteristics.

1504PINCIDENCE OF CHEMOTHERAPY-INDUCED NAUSEA AND VOMITING WITH MODERATELY EMETOGENIC CHEMOTHERAPY: ADVICE STUDY

ABSTRACT Background: Limited information regarding incidence of chemotherapy induced nausea and vomiting (CINV) is available in patients receiving moderately emetogenic chemotherapy (MEC). Methods: Chemotherapy-naive patients receiving MEC, between April-2012 and May-2013 were included in an observational and prospective trial evaluating incidence of CINV during 120 hours post-chemotherapy as primary endpoint. Patients completed a diary to capture intensity of nausea and number of vomiting episodes. Complete response (no vomiting or rescue medication use) and complete protection (no vomiting and no severe nausea or use of rescue medication) were assessed as secondary endpoints. Results: Of 261 patients included, 240 were evaluated. The median age was 64.36 years (36.15-87.3), 44.17% were female and 11.25% were aged less than 50 years. The majority, 95.3% of patients received a combination of a 5-HT3 antagonist+corticosteroid as antiemetic treatment. Episodes of vomiting within 5 days of chemotherapy administration occurred in 20.78% of patients, nausea of any intensity in 42% (≥5 mm to 100mm VAS (visual analog scale)), and significant nausea in 23.8% of patients (≥25 mm to 100 mm VAS). An increase in the percentage of patients with severe nausea and vomiting was observed from the acute to the delayed phase, from 9.44% to 21.65% and from 9.24% to 15.45% respectively. Complete response in the acute phase was 85%, 77% in the late phase and 68.9% in the overall study period. Complete protection was 79.5% in the acute phase, 69.7% in the late phase and 62.4% throughout the study period. Physicians estimated prophylaxis would be effective (no vomiting or nausea and no use of rescue medication) for 75% of patients receiving MEC, compared with 54.1% obtained from patients diary. Conclusions: Despite receiving prophylactic treatment, 31% of patients did not achieve a complete response and 38% patients did not achieve complete protection. In general nausea was worse controlled than vomiting. The results also showed the late phase was worse controlled than the acute phase in all variables. Healthcare providers overestimated the effectiveness of antiemetic prophylaxis. Disclosure: P. Del Barrio: Employee of Merck Sharp & Dohme; M.V. Tornamira: Employee of Merck Sharp & Dohme. All other authors have declared no conflicts of interest.