COCOON: Discussion of Clinical End Points and Dose Modifications
Panelists discuss how the COCOON dermatologic management protocol significantly reduced grade 2 or higher dermatologic adverse events in multiple locations, particularly on the face/body (23% vs 62%), scalp (9% vs 29%), and nails (16% vs 21%).
Video content above is prompted by the following:
Dermatologic Adverse Events—COCOON vs Standard of Care
Study Focus:
This study assessed the impact of the COCOON dermatologic management intervention vs standard of care in reducing dermatologic adverse events (DAEs) during oncology treatment.
Primary End Point:
- Grade 2 or higher dermatologic adverse events within the first 12 weeks
Key Findings:
- Grade 2 or higher DAEs:
- COCOON: 38%
- Standard of care: 76%
- Half the rate of significant skin toxicities with COCOON
- Grade 3 DAEs:
- COCOON: 4.3%
- Standard of care: 8.8%
- Severe cases were also notably reduced.
- Statistical significance:
- OR: 0.19—a highly significant finding, rarely seen in oncology
DAEs by Location:
- Face/body: 23% (COCOON) vs 62% (standard of care)
- Scalp: 9% vs 29%—noted as particularly difficult to manage because of the risk of infection and scabbing
- Paronychia: 16% vs 21%—bothersome, especially in dry weather, but generally manageable
Clinical Impact:
- The COCOON intervention not only reduced the severity and frequency of DAEs but also helped patients:
- Stay on treatment longer
- Avoid dose interruptions and reductions
Treatment Tolerability:
- Dose interruptions: 16% (COCOON) vs 34% (standard of care)
- Dose reductions: 7% (COCOON) vs 19% (standard of care)
- Discontinuations: 1 patient (COCOON) vs 3 patients (standard of care)
Conclusion:
The COCOON intervention significantly reduces dermatologic toxicities, improves patient quality of life, and allows for better adherence to cancer therapy within the critical first 12 weeks, and likely beyond.
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