YO Case presentations Young Oncologist session

Q&A and discussion led by the Chairs

Lecture Time
05:10 PM - 05:15 PM
Session Name
Location
Summit 2, Singapore, Singapore, Singapore
Date
Sat, 23.11.2019
Time
04:30 PM - 06:00 PM
Poster display session Poster Display

YO37 - Intraventricular metastasis as the first presentation of non-small cell lung cancer

Presentation Number
YO37
Lecture Time
06:00 PM - 06:00 PM
Session Name
Speakers
  • Siraphong Putraveephong
Location
Exhibition area, Singapore, Singapore, Singapore
Date
Sat, 23.11.2019
Time
06:00 PM - 07:00 PM
Authors
  • Siraphong Putraveephong
  • Kosin Wirasorn
  • Jarin Chindaprasirt
  • Aumkhae Sookprasert
  • Payia Chadbunchachai

Abstract

Case summary

57-year-old man presented with chronic progressive headache for 3 months. He initially visited hospital due to chronic headache with projectile vomiting and ataxia. He also had anorexia and lost 7 kg but he had no respiratory tract symptoms including chronic cough, dyspnea, and chest pain. His smoking history was about 10 pack-year. On his physical examination, pupils with 4 mm. in size and reactive to light, papilledema both eyes and tongue deviation to the left side were detected but others were unremarkable. His routine investigations including chest radiography were unremarkable. He was evaluated with MRI of the brain which showed multiple enhancing lesions at the left lateral ventricle, left temporal horn, 4th ventricle, bilateral foramen of Luschka and both sides of foramen magnum with obstructive hydrocephalus. Consequently, he was diagnosed of intraventricular papilloma and underwent craniotomy with tumor removal and ventriculoperitoneal shunt. Subsequently, he received whole brain radiation therapy for 200 cGy. The pathological result from his intraventricular mass demonstrated papillary tumor with hobnail appearance and further immunohistochemistry was processed. The final result showed strongly diffuse positive AE1/AE3, EMA, CK7, TTF-1, and NapsinA while negative CK20 and Thyroglobulin. Consequently, it was compatible with metastatic adenocarcinoma, most likely from primary lung carcinoma. Further molecular testing demonstrated EGFR Exon 19 deletion mutation by PCR but no detection of ALK rearrangement. Later, he was evaluated with CT of the chest and upper abdomen which showed a 2.4x1.3 cm spiculated pulmonary mass at the apicoposterior segment of the left upper lobe and 0.8 cm pathological lymph node at AP window region. Bone metastasis at T3 vertebral bodies was also seen. Finally, he was diagnosed as adenocarcinoma of the left lung with intraventricular metastasis; stage T1cN2M1b. After completion of WBRT, his neurologic symptoms were improved and he still had no respiratory tract symptoms. His ECOG performance status was 1. Discussing treatment options, the patient and his family made a decision to enroll in the clinical trial for new EGFR TKI.

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Poster display session Poster Display

89P - A phase II trial of adjuvant chemoradiotherapy for patients with high-risk rectal submucosal invasive cancer after local resection

Presentation Number
89P
Lecture Time
06:00 PM - 06:00 PM
Session Name
Speakers
  • Masaaki Noguchi
Location
Exhibition area, Singapore, Singapore, Singapore
Date
Sat, 23.11.2019
Time
06:00 PM - 07:00 PM
Authors
  • Masaaki Noguchi
  • Kohei Shitara
  • Akihito Kawazoe
  • Daisuke Yamamoto
  • Yasumasa Takii
  • Yutaka Saito
  • Toshihiko Sato
  • Takahiro Horimatsu
  • Hideki Ishikawa
  • Yoshinori Ito
  • Masaaki Ito
  • Hiroaki Ikematsu

Abstract

Background

Surgery is recommended for patients with high-risk submucosal invasive rectal cancer (SM-RC) after local resection. However, surgery affect patient’s quality of life due to stoma placement and impaired anal function. Thus, alternative treatments to prevent local metastasis are anticipated. This study assessed the safety of adjuvant chemoradiotherapy with capecitabine for patients with high-risk SM-RC after local resection.

Methods

This single-arm, multicenter, phase II trial enrolled patients with high-risk SM-RC who underwent local resection within 12 weeks prior to enrollment. High-risk SM-RC was defined as the presence of at least one of the following factors: poor differentiation of adenocarcinoma, ≥ 1mm of submucosal invasion, presence of lymphovascular invasion, and grade 2 or 3 of tumor budding. Protocol treatment included 45.0 Gy radiotherapy with conventional fractionation and 825 mg/m2 capecitabine administered twice daily until the completion of radiotherapy. The primary endpoint was treatment completion rate, with an expected rate of 95% and a threshold of 80%. This study was registered with the University Hospital Medical Information Network, number UMIN000016785.

Results

A total of 29 patients from six institutions were enrolled between May 2015 and February 2018. One patient was ineligible. Twenty-three patients completed treatment with a completion rate of 82% (80% confidence interval; range, 69%–91%). The remaining five patients also completed treatment with protocol deviation from the planned treatment schedule. The mean relative dose intensity of capecitabine was 89% (range, 58%–100%). The most common adverse events were radiation dermatitis (54%), anal pain (39%), and anal mucositis (29%). No grade 3 or higher adverse events were reported.

Conclusions

Adjuvant chemoradiotherapy using capecitabine demonstrated manageable safety in patients with high-risk SM-RC after local resection.

Clinical trial identification

UMIN000016785.

Legal entity responsible for the study

The authors.

Funding

The National Cancer Center Research and Development Fund (25‐A‐12) to Dr Saito.

Disclosure

All authors have declared no conflicts of interest.

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Poster display session Poster Display

353P - A prediction model for the intents regarding life-sustaining treatment decisions in patients with terminal cancer

Presentation Number
353P
Lecture Time
06:00 PM - 06:00 PM
Session Name
Speakers
  • Yoonsun Kim
Location
Exhibition area, Singapore, Singapore, Singapore
Date
Sat, 23.11.2019
Time
06:00 PM - 07:00 PM
Authors
  • Yoonsun Kim
  • KYUNG A Kwon

Abstract

Background

Life-Sustaining Treatment Decision systems have been in effect since February 2018 in South Korea. These systems ensure that medically insignificant life-sustaining treatments, which are undesired by the patient, are avoided. This study was designed to develop and verify an explanatory model of terminal cancer patients’ intent related to decisions regarding discontinuing or not performing meaningless, life-sustaining treatments in South Korea.

Methods

Data were collected from April 15 to July 10 2019, via a survey using self-reported questionnaires. A total of 220 patients, with terminal cancer, were recruited. The hypothetical model was constructed using four exogenous variables—family function, knowledge on life-sustaining treatment decisions, likelihood of the treatment outcome, and treatment burden—and three endogenous variables—attitudes towards, the efficacy of, and intent regarding life-sustaining treatment decisions.

Results

The goodness-of-fit of this hypothetical model was x2=169.25, χ2/df=1.90, RMSEA=.07, RMR=0.02, GFI=.91, AGFI=.90, NFI=.97, CFI=.98, RMSEA=.06 The results demonstrated that knowledge on, attitudes towards, the efficacy of life-sustaining treatment decisions, and treatment burden all had significant and direct effects on participants’ intent regarding their treatment decisions. Family function was indirectly associated with participants’ intent regarding life-sustaining treatment decisions. These variables explained 88.8% of the total variance with respect to the intent regarding life-sustaining treatment decisions, with knowledge on these decisions being the most influential factor.

Conclusions

The results of this study suggest that, in order to improve terminal cancer patients’ intent regarding life-sustaining treatment decisions related to discontinuing or not performing meaningless life-sustaining treatments, nursing interventions should focus on enhancing their knowledge around this topic, as well as the efficacy of these choices. In particular, a patient’s family function is a crucial intervention strategy that can enhance their intent regarding life-sustaining treatment decisions.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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Proffered paper session - Breast cancer Proffered Paper session

25O - Effects of immune architecture on response to adjuvant capecitabine in triple negative breast cancer (FinXX trial)

Presentation Number
25O
Lecture Time
09:00 AM - 09:12 AM
Speakers
  • Douglas A. Hinerfeld
Location
Hall 405, Singapore, Singapore, Singapore
Date
Sat, 23.11.2019
Time
09:00 AM - 10:30 AM
Authors
  • Douglas A. Hinerfeld
  • Saranya Chumsri
  • Karama Asleh
  • Heather Ann Brauer
  • Jennifer Kachergus
  • Susannah Lauttia
  • Henrik Lindman
  • Torsten Nielsen
  • Heikki Joensuu
  • Aubrey Thompson

Abstract

Background

Recent studies have demonstrated a benefit of adjuvant capecitabine, particularly in triple negative breast cancer (TNBC) patients with residual disease after neoadjuvant chemotherapy. However, biomarkers to predict which patients are more likely to benefit from capecitabine are needed.

Methods

The NanoString Breast Cancer 360TM (BC360) and PanCancer ImmunoncologyTM (IO360) panels were used to quantify mRNA expression in TNBC samples in the FinXX trial. FinXX is a phase III trial which randomized high risk patients to receive either 3 cycles of docetaxel followed by 3 cycles of cyclophosphamide, epirubicin, and fluorouracil (Arm A: T+CEF) vs. 3 cycles of docetaxel plus capecitabine followed by 3 cycles of cyclophosphamide, epirubicin, and capecitabine (Arm B: TX+CEX). Gene signature scores were analyzed using prespecified algorithms developed by NanoString. Digital Spatial Profiling was carried out using GeoMX™ platform. A total of 111 TNBC patients were included (57 in Arm A and 54 in Arm B) with 10.2 years median follow up.

Results

There were 7 cancer- and immune-related gene signatures identified by BC360 and IO360 panels that were significantly associated with improved recurrent free survival favoring an addition of capecitabine. These include cytotoxic cell signature, endothelial signature, mast cell signature, PDL2 gene, immunoproteasome, exhausted CD8 T-cells, and PD1. Spatially-defined analysis of protein expression of a subset of the tumor specimens using the GeoMx platform revealed biological compartment specific (Tumor and/or Stroma) differential expression of immune-related proteins in patients with improved recurrent free survival.

Conclusions

Analysis of RNA abundance signatures strongly suggests that there are important immune features that are associated with benefit from capecitabine in TNBC. However, analysis of RNA extracted from whole tumor sections lacks spatial discrimination. Using the GeoMx platform for the spatially-defined analysis of protein abundance has provided more insights and has defined specific immune features associated with improved outcome.

Clinical trial identification

NCT00114816.

Legal entity responsible for the study

The authors.

Funding

Finnish Breast Cancer Group.

Disclosure

D.A. Hinerfeld: Full / Part-time employment: Nanostring. H.A. Brauer: Full / Part-time employment: Nanostring. T. Nielsen: Licensing / Royalties: Nanostring. All other authors have declared no conflicts of interest.

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What did you learn from the rad-onc session? Special Session

Discussion

Lecture Time
03:55 PM - 04:15 PM
Speakers
  • Yu Yang Soon
Location
Room 311, Singapore, Singapore, Singapore
Date
Sun, 24.11.2019
Time
03:45 PM - 04:45 PM
Authors
  • Yu Yang Soon
Poster display session Poster Display

GI, non- crc

Lecture Time
06:00 PM - 06:00 PM
Session Name
Location
Exhibition area, Singapore, Singapore, Singapore
Date
Sat, 23.11.2019
Time
06:00 PM - 07:00 PM
Poster display session Poster Display

387P - 5-years conditional disease free survival and overall survival for breast cancer patients in South Korea

Presentation Number
387P
Lecture Time
06:00 PM - 06:00 PM
Session Name
Speakers
  • Jee hyun Ahn
Location
Exhibition area, Singapore, Singapore, Singapore
Date
Sat, 23.11.2019
Time
06:00 PM - 07:00 PM
Authors
  • Jee hyun Ahn
  • Jong han Yu
  • Seok jin Nam
  • Jeong eon Lee
  • Seok Won Kim
  • Se kyung Lee
  • Byung Joo Chae
  • Jai Min Ryu

Abstract

Background

Most of breast cancer patients survive for a long-term period. The existing assessment of survivors’ prognosis has had some limitations in breast cancer because it is based on an evaluation at the time of diagnosis. Conditional survival reflects change over time after diagnosis and treatment of cancer. Conditional disease-free survival (CDFS) and conditional overall survival (COS) can provide more accurate prognosis to breast cancer patients. In this study, we aimed to determine 5-years CDFS and COS according to disease-free period after diagnosis and treatment of breast cancer in Korea.

Methods

We retrospectively reviewed clinical data of 5664 patients aged 16 to 86 who underwent curative surgery for breast cancer between January 2000 and December 2008 at Samsung Medical Center, a single tertiary hospital in Korea. The CDFS and COS rates were based on cumulative DFS and OS estimates up to 15 years using the Kaplan-Meier method.

Results

At baseline, each 5-years DFS and OS were 88.0% and 93.8%. For patients who kept disease free status from 1 to 9 years after surgery, the 5-years CDFS rates were calculated as 88.7%, 90.7%, 91.6%, 91.1%, 91.5%, 91.0%, 89.5%, 86.1% and 86.1%, respectively. The 5-year COS rates of the patients who had survived from 1 to 9 years after surgical treatment were calculated as 92.6%, 92.1%, 91.2%, 91.0%, 89.4%, 85.6%, 80.7%, 75.3%, and 73.0%, respectively.

Conclusions

Our study showed that 5-years CDFS and COS for most patients who have breast cancer in Korea seemed to be good prognosis for a long time. However, cancer recurrence tended to occur after a long period postoperatively. Further study is required to identify risk factors associated with recurrence after several years in Korean breast cancer patients.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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Mini Oral session - Gastrointestinal tumours Mini Oral session

Discussion led by moderators

Lecture Time
03:05 PM - 03:10 PM
Speakers
  • Takayuki Yoshino
Location
Room 324, Singapore, Singapore, Singapore
Date
Sat, 23.11.2019
Time
02:30 PM - 03:30 PM
Authors
  • Takayuki Yoshino
Poster display session Poster Display

159P - The relation between obesity and cancer of gastrointestinal tract in Korea: The data from Statistic Korea between 2001 and 2016

Presentation Number
159P
Lecture Time
06:00 PM - 06:00 PM
Session Name
Speakers
  • Hee Man Kim
Location
Exhibition area, Singapore, Singapore, Singapore
Date
Sat, 23.11.2019
Time
06:00 PM - 07:00 PM
Authors
  • Hee Man Kim
  • Ja Sung Choi

Abstract

Background

Obesity is a risk factor for several cancer. In Korea, prevalence of obesity has increased and incidence of several cancers of gastrointestinal (GI) tract, such as colon cancer and rectal cancer have increased. The aim of this study was to evaluate the association between obesity prevalence and cancer incidence of gastrointestinal tract in Korea adults.

Methods

The data were collected from the webpage of Statistic Korea, where the incidence of GI tract cancer between 2001 and 2016 was obtained from National Cancer Center, and the prevalence of obesity between 2001 and 2016 was obtained from National Health and Nutrition Examination Survey. The obesity was defined as BMI ≥25 kg/m2 among adults ≥30 years old. The association between obesity and cancer of GI tract was calculated by using linear regression analysis.

Results

In men, prevalence of obesity was significantly associated with esophageal cancer (β: 0.176, P = 0.001), colon cancer (β: 2.034, P = 0.013), rectal cancer (β: 1.305, P = 0.035), gallbladder cancer and other biliary tract cancer (β: 0.712, P < 0.0001), and pancreatic cancer (β: 0.717, P < 0.0001). But, gastric cancer (β: 1.396, P = 0.076) and liver cancer (β: 0.122, P = 0.496) were not associated with obesity prevalence (Table) In women, incidence of GI tract cancer was not associated with obesity prevalence.

159P Linear regression between obesity and GI cancer in men adults

CancerBeta coefficient95% CIP value
Esophageal cancer0.1670.092 - 0.2410.001
Gastric cancer1.396-1.76 - 2.9680.076
Colon cancer2.0340.535 - 3.5330.013
Rectal cancer1.3050.114 - 2.4950.035
Liver cancer0.122-0.262 - 0.5060.496
Gallbladder and other biliary tract cancer0.7120.498 - 0.927<0.0001
Pancreatic cancer0.7170.434 - 0.999<0.0001

Conclusions

In Korean adults, incidence of some GI tract cancer seems to be associated with obesity prevalence.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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Perspective of liquid biomarkers for cancer care Educational session

Liquid biomarkers for immunotherapy

Lecture Time
10:15 AM - 10:35 AM
Speakers
  • François Clément Bidard
Location
Summit 2, Singapore, Singapore, Singapore
Date
Sun, 24.11.2019
Time
09:15 AM - 10:45 AM
Authors
  • François Clément Bidard
ESMO Colloquium supported by Guardant Health: Liquid biopsy in the management of solid tumours ESMO Colloquium

Use of liquid biopsies in colorectal cancers

Lecture Time
11:30 AM - 11:55 AM
Speakers
  • Takayuki Yoshino
Location
Room 311, Singapore, Singapore, Singapore
Date
Sun, 24.11.2019
Time
11:00 AM - 12:30 PM
Authors
  • Takayuki Yoshino