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. 2024 Mar;20(3):361-369.
doi: 10.1200/OP.23.00580. Epub 2023 Dec 21.

Use of Peripheral Intravenous Access in Patients Undergoing Chemotherapy for Testicular Cancer

Brett Wiesen  1 , Michael Atwell  1 , Colton Leavitt  2 , Nathan Clark  1 , Elizabeth Kessler  3 , Elaine Lam  3 , Thomas Flaig  3 , Janet Kukreja  1 , Simon Kim  1 , Paul Maroni  1 , Nicholas G Cost  1
Affiliations

Use of Peripheral Intravenous Access in Patients Undergoing Chemotherapy for Testicular Cancer

Brett Wiesen et al. JCO Oncol Pract. 2024 Mar.

Abstract

Purpose: Systemic chemotherapy, depending on the regimen, can be administered through peripheral intravenous (pIV) access or through central venous access devices (CVADs). There is no current best practice regarding optimal access for chemotherapy for patients with testicular cancer (TC). We retrospectively evaluated patients undergoing systemic chemotherapy for TC and compared baseline characteristics and complications of patients using pIV versus CVADs.

Methods: We included patients with TC who underwent first-line systemic chemotherapy at the University of Colorado Hospitals from 2005 to 2020. Data were collected on demographics, cancer characteristics, type, duration of chemotherapy, pIV or CVAD use, and associated complication rates. We then performed univariate and multivariate regression analyses to compare complication rates and risk factors for each group.

Results: One hundred fifty-four patients met inclusion criteria. Ninety-two (60%) patients used CVADs, and 62 patients (40%) used pIV for their initial treatment. Only six (9.7%) of 62 patients transitioned from pIV to CVADs during therapy. Similarly, 10 of 92 (10.9%) patients with initial CVAD needed to transition to a different type of CVAD or to pIV (P = .81). There were a greater number of venous access-related complications (48 of 92 patients, 52.2%) and overall thrombotic events (33 of 92 patients, 35.9%) for the CVAD group (P > .001) when compared with the pIV group. We observed an association between the following factors and venous access-related complications during chemotherapy: higher stage TC, increased total chemotherapy cycles, and delayed therapy.

Conclusion: Peripheral IV use for first-line nonvesicant chemotherapy in patients with TC appears to be well tolerated with high rates of therapy completion and lower rates of complications when compared with CVADs. These data support our preferred treatment approach and provide evidence that pIV access is a safe and effective way to deliver chemotherapy for patients with TC.

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Conflict of interest statement

The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated unless otherwise noted. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/op/authors/author-center.

Open Payments is a public database containing information reported by companies about payments made to US-licensed physicians (Open Payments).

Elizabeth Kessler

Speakers' Bureau: Targeted Oncology

Research Funding: Bristol Myers Squibb (Inst), Genentech/Roche (Inst), Pfizer (Inst), Merck Serono (Inst), Lilly (Inst)

Elaine Lam

Consulting or Advisory Role: Calithera Biosciences

Research Funding: Bristol Myers Squibb (Inst), Roche/Genentech (Inst), Pfizer (Inst), Exelixis (Inst), Merck (Inst), Argos Therapeutics (Inst), Peloton Therapeutics (Inst), Calithera Biosciences (Inst), Astellas Pharma (Inst), Advaxis (Inst), Constellation Pharmaceuticals (Inst), Harpoon Therapeutics (Inst), Decibel Therapeutics (Inst), OnQuality Pharmaceuticals (Inst), Amgen (Inst), FORMA Therapeutics (Inst), Phosplatin Therapeutics (Inst), Arrowhead Pharmaceuticals (Inst), Biosplice (Inst)

Thomas Flaig

Leadership: Aurora Oncology, University of Colorado/UC Health

Stock and Other Ownership Interests: Aurora Oncology

Consulting or Advisory Role: Seagen, Janssen Oncology

Research Funding: Novartis, Bavarian Nordic, Dendreon, GTx, Janssen Oncology, Medivation, Sanofi, Pfizer, Bristol Myers Squibb, Roche/Genentech, Exelixis, Aragon Pharmaceuticals, Sotio, Tokai Pharmaceuticals, astrazeneca/MedImmune, Lilly, Astellas Pharma, Agensys, Seagen, La Roche-Posay, Merck, Seagen, Myovant Sciences, Criterium

Patents, Royalties, Other Intellectual Property: The University of Colorado has filed two patents in which I am an inventor. These are related to early-stage bladder cancer treatment and detection. Neither is commercialized or in active clinical development right now (eg, neither are in clinical trials)

Janet Kukreja

Consulting or Advisory Role: Arquer Diagnostics, Photocure, AstraZeneca

Paul Maroni

Honoraria: BK Medical

Consulting or Advisory Role: Janssen Oncology, BK Medical

Research Funding: Dendreon, Astellas Pharma

Open Payments Link: https://openpaymentsdata.cms.gov/physician/768655

Nicholas G. Cost

Employment: Janssen Oncology

No other potential conflicts of interest were reported.

Figures

FIG 1.
FIG 1.
Flow diagram detailing the study's patient populations and the associated exclusion criteria. CVAD, central venous access device; GCT, germ cell tumor; pIV, peripheral intravenous.
See this image and copyright information in PMC

Comment in

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