Browsing Over 990 Presentations
36TiP - A prospective study to assess response to neoadjuvant hormonal therapy in postmenopausal women with hormone-receptor positive breast cancer at a regional cancer centre in South India
- Shina Goyal
- Shina Goyal
- AH Rudresha
- D Lokanatha
- Linu A. Jacob
- Suresh Babu Mc
- KN Lokesh
- LK Rajeev
- S Smitha
- Antony G. Thottian
Abstract
Background
Hormonal receptor-positive breast carcinoma constitutes the most common subtype of the disease. Neoadjuvant chemotherapy is the current standard of treatment for any locally advanced breast carcinoma. However, the hormone receptor-positive, Her-2 negative cancers are less likely to respond to neoadjuvant chemotherapy than other biologic subtypes. Studies have explored the efficacy of neoadjuvant hormone treatment in this cohort of patients and efforts are ongoing to identify the subgroup of patients who can be treated with hormonal therapy alone, hence avoiding the unnecessary toxicity of chemotherapy. Our study aims to assess the response to neoadjuvant hormonal therapy (NAHT) in the postmenopausal women who are considered to be low-risk subgroup and for whom chemotherapy can be safely avoided.
Trial design
Objectives Primary objective: To determine the clinical tumor response rate to NAHT. Secondary Objective: To assess the number of patients undergoing surgery and pCR rates. To assess biologic changes in the tumor, including hormonal receptor status and proliferation by Ki67 staining. Methods Type of study: Phase II Prospective single-center study. Patients: Postmenopausal women diagnosed with biopsy-proven, non-metastatic and potentially operable breast cancer. Inclusion Criteria: Clinical stage T3-T4c with node-negative or clinical stage T2-T4c with node-positive disease (N1, N2) ER-positive with Allred score 6-8, Her 2 negative and Ki67 < 14%. Exclusion Criteria: Past history of treatment for any other cancer, history of having received chemotherapy or use of hormone replacement therapy previously. Sample size: 35 patients. Study site and duration: Kidwai Cancer Institute, 1.5 years. Eligible patients will receive Neoadjuvant hormonal therapy with Aromatase inhibitor and will undergo regular monitoring of objective response rate using calipers at the time of diagnosis and monthly once. The response will be noted as per the WHO criteria. Progressive disease recorded at any time will lead to exclusion from the study and the patient will be started on chemotherapy. Toxicity assessment will be done regularly.
Legal entity responsible for the study
Department of Medical Oncology, Kidwai Cancer Institute, Bengaluru.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Head and neck cancer, excluding thyroid
New combinations in metastatic disease
- Caroline Robert
- Caroline Robert
Closing remarks (ID 1810)
YO20 - Can "Superman" have Chronic Myelomonocytic Leukemia?
- Alexander Luchinin
- Alexander Luchinin
- Vanik Ovsepyan
Abstract
Case summary
This is the case of an 62-year-old man who had symptoms such as splenomegaly +10 cm below the costal arch, very high WBC (169*10/9/L), immature granulocytes in CBC ( 7%), low PLT count (85*10/9/L), low HGB level (11.2 g/dL) and monocytosis (22% or 37*10/9/L). He was admitted to hematology clinic in our center. He also presented with hypercellularity with high count of monocytes in bone marrow (18%) and the blasts count was 7%. We did cytogenetic test of bone marrow by standard method. The karyotype was 48, XYY, +13 [20]. In additional we did cytogenetic analysis of lymphocytes stimulated by phytohaemagglutinin. The final cytogenetic conclusion showed that the patient had XYY syndrome or “superman” syndrome. This is rare congenital genetic disorder which often becomes unrecognized. The patient received final hematological diagnosis of Chronic Myelomonocytic Leukemia-1 by WHO 2017 classification. Therapy was invited with Hydroxyurea during 6 months without remission and with progression to acute myeloid leukemia. The second line was chemotherapy of 6-mercaptopurinum and low doses of cytarabine. In spite of treatment, the patient ultimately died from progression AML. It is known, that patients with some different congenital genetic disorders, such as Dawn`s syndrome, Fanconi anemia, severe congenital neutropenia, Shwachman-Diamond syndrome and others, have high risk of leukemia. However, there are very little clinical cases described in science press. It was one of these rare cases. So, can “superman” have a CMML? Yes, if he has acquired trisomy 13.
72P - Novel technique of near-focus mode for accurate operation during endoscopic submucosal tunneling procedure: A two-center comparative study
- Wei Peng
- Wei Peng
- Xiangsheng Fu
Abstract
Background
The working space in the submucosal tunnel of endoscopic submucosal tunnel technique (ESTT) is limited, and the visual field is obscure during close inspection or hemostasis. This retrospective study aimed to evaluate the efficacy and safety of a novel near-focus mode technique for accurate operation during the submucosal tunneling endoscopic procedure.
Methods
A retrospective two-center study was designed. A total of 51 patients undergoing ESTT procedures with near-focus mode (n = 29) or traditional mode (n = 22) between February 2016 and May 2019 were included in this study. Data regarding the efficacy, complications, hospital stay period, and other parameters were recorded.
Results
When using the near-focus mode during the ESTT procedure, it is convenient to acquire a clear image and accurate operation. The clinical success rate was 100% (29/29) in near-focus group, higher than that in traditional group (90.9%, 20/22), although the difference was not significant (P = 0.181). The adverse event occurred more frequently in traditional group (45.5%) compared to that in the near-focus group (17.2%, P = 0.036). Especially, the near-focus group exhibited a significantly lower rate of bleeding compared to that of the traditional group (0 vs 18.2%, P = 0.029). Furthermore, the mean hospital stay after procedure was shorter in near-focus group (5.7 days) than that in traditional group (6.7 days, P = 0.013).
Conclusions
The visual field is more clearly exposed within submucosal tunneling by using near-focus mode than traditional procedures. The efficacy and safety of this novel technique was proved in our procedures.
Legal entity responsible for the study
Xiangsheng Fu.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
331P - A retrospective analysis of immune checkpoint therapy in patients with non-small cell lung cancer: Focus on thyroid disorder
- Sawana Ono
- Sawana Ono
- Hiroaki Senju
- Hirokazu Taniguchi
- Hiromi Tomono
- Midori Shimada
- Fumiko Hayashi
- Takayuki Suyama
- Noritaka Honda
- Yasuhiro Umeyama
- Yosuke Dotsu
- Hiroshi Gyotoku
- Shinnosuke Takemoto
- Hiroyuki Yamaguchi
- Minoru Fukuda
- Hiroshi Soda
- Hiroshi Mukae
Abstract
Background
Previous reports suggested that development of an immune-related adverse event (irAE), including thyroid disorder (TD), is associated with better outcomes of immune checkpoint inhibitor (ICI) therapy. Though TD has been reported most frequently as an irAE, it has not been well analyzed compared to life-threatening adverse events such as interstitial lung disease or colitis.
Methods
We conducted a chart-based retrospective analysis of patients (Pts) with advanced or recurrent non-small cell lung cancer (NSCLC), who are treated with monotherapy using nivolumab, pembrolizumab, or atezolizumab between January 2016 and June 2019 in two facilities in Japan. TD emerging after the first treatment with an ICI was considered as an irAE. Tumor response was evaluated with Response Evaluation Criteria in Solid Tumors version 1.1. Progression-free survival (PFS) and overall survival (OS) on ICIs were evaluated with Kaplan-Meier method. The correlations between time to onset of TD and PFS or OS were analyzed with Spearman's rank correlation coefficient.
Results
In total, 164 consecutive Pts were enrolled. The median age was 68 (range: 34-84) years, and 40 (24.4%) were women. TD of any grade occurred in 26 Pts (15.8%); 11/15/0/0/0 cases were classified as Grade 1/2/3/4/5, respectively, according to Common Terminology Criteria for Adverse Events version 5.0. Onset of TD ranged from 6 to 455 (median: 77.5) days after the first treatment with an ICI. Objective response rates in Pts with and without TD were 28.0% and 18.1%; disease control rates were 68.0% and 50.7%, respectively. Median PFS and OS were significantly longer in Pts with TD (PFS: 226 vs 100 days, p = 0.029; OS: not reached vs 434 days, p = 0.050, log-rank test). Among TD Pts, however, a positive correlation between time to onset of TD and PFS was identified (p = 0.0015). Significantly shorter PFS was observed in Pts with earlier TD onset, especially within 30 days, compared to Pts with later TD onset (median PFS: 72.5 vs 329 days, p = 0.00096, log-rank test).
Conclusions
Development of TD caused by ICIs was associated with longer PFS. Nevertheless, the prognosis of Pts with early onset of TD was poor. This study suggested that physicians should consider the onset of TD in Pts using ICIs.
Legal entity responsible for the study
Hiroyuki Yamaguchi.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Innovation of NGS driven basket trial (K-MASTER)
- Kyong Hwa Park
- Kyong Hwa Park
Navigating HCC treatment decisions: What are the clinical implications for patients? (ID 1842)
Clinical case
- Grace Kusumawidjaja
- Grace Kusumawidjaja
105P - Detection and clinical significance of circulating tumour cells in patients with rectal cancer
- Shuohui Dong
- Shuohui Dong
Abstract
Background
Rectal cancer is one of the most common causes of cancer-related deaths worldwide. Circulating tumor cells (CTCs) are rare aneusomic cells that detach from the primary solid tumors and enter the circulation, and can initiate metastasis. Detection of CTCs in liquid biopsies is a promising strategy for diagnosing, monitoring the relapse and metastasis, and evaluating cancer prognosis and therapy. However, CTC detection in patients with rectal cancer is limited in routine clinical practice. The aim of this study was to elucidate the role of CTCs in patients with rectal cancer.
Methods
A total of 142 patients with rectal cancer were enrolled. CTCs were measured in the peripheral blood (preoperatively, immediately postoperative, day 1 and 7 postoperatively) and inferior mesenteric vein (intraoperatively), usingthe CTCBIOPSY® System (YZYBIO Company, Wuhan, China). General information, initial diagnosis and the integrated pathological information of all participants were recorded. Data Analysis was performed using the Chi-square test, with 95% confidence intervals (95% CIs) as the threshold for statistical significance.
Results
CTCs were detected (≥1 CTC per 5ml blood) in the blood preoperatively more frequently in patients with a higher grade of TNM stage (c2=7.317, P = 0.048) and there was a trend of association (c2=6.457, P = 0.012). CTC detection in the blood was significantly associated with T stage (c2=12.912, P = 0.005) and N stage (c2=17.587, P < 0.001) preoperatively. It proved that age and gender were uncorrelated variables with CTC detection. Compared with CTC detection preoperatively, postoperative CTCs are firstly increased and then decreased.
Conclusions
CTC detection is closely related to TNM stage in patients with rectal cancer, and so it may be a way to predict clinicopathological stage by detecting CTCs. The postoperative CTCs are potential biomarkers for rectal cancer prognosis but needed to be verified in more studies.
Clinical trial identification
NCT02955173; Pre-results.
Legal entity responsible for the study
Qilu Hospital of Shandong University.
Funding
Ministry of Science and Technology of China.
Disclosure
The author has declared no conflicts of interest.
371P - Clinical utility of Encyclopedic tumour analysis to treat patients advanced refractory head and neck cancers
- Rajnish Nagarkar
- Rajnish Nagarkar
- Darshana Patil
- Vijay Palwe
- Vineet Datta
- Ashwini Ghaisas
- Navin Srivastava
- Ajay Srinivasan
- Dadasaheb Akolkar
- Rajan Datar
Abstract
Background
Head and Neck Squamous Cell Carcinomas (HNSCC) account for 4.5% of global cancer incidences and mortality respectively. In India however, HNSCC accounts for 17% of cancer related incidences and 15% of cancer related mortality. Standard of Care (SoC) systemic treatment approaches for HNSCC are based on randomized clinical trials which do not sufficiently consider patient specific features of the tumor. We evaluated the efficacy of personalized treatment in a cohort (n = 31) of advanced refractory HNSCC, where patient-specific treatment regimens were based on Encyclopedic Tumor Analysis (ETA).
Methods
Freshly biopsied tumor tissue and peripheral blood of patients were used for integrational multi-analyte investigations as part of ETA, which included gene alterations and gene expression, as well as in vitro chemosensitivity and response profiling (CRR) of viable tumor cells. Patients received individualized therapy recommendations based on ETA. All patients underwent whole body PET-CT and brain MRI scans prior to start of treatment, and follow-up scans every 6-8 weeks. Treatment response was evaluated as per RECIST 1.1 criteria.
Results
Among the 31 patients who received personalized treatment guided by ETA, partial response (PR) was observed in 14 patients and Stable Disease (SD) in 16 patients yielding an Objective Response Rate (ORR) of 45.2% and Clinical Benefit Rate of (CBR) 96.8%, respectively. Patients were followed up for a median of 146 days (Range 42 – 368). At most recent follow-up 1 patient showed disease progression, whereas Progression Free Survival was observed in 30 patients. Median Progression-Free Survival was 146 days. No grade IV adverse events were observed. There were no treatment related deaths. Most common Grade III adverse events included Fatigue, Anorexia, Thrombocytopenia, Neutropenia and Oral Mucositis. Most patients reported qualitative improvements in symptomatic and functional status.
Conclusions
ETA guided treatments can offer viable treatment options in advanced refractory HNSCC yielding meaningful ORR and disease control in majority of patients.
Legal entity responsible for the study
The Authors.
Funding
Datar Cancer Genetics Limited.
Disclosure
R. Nagarkar: Advisory / Consultancy: Datar Cancer Genetics Limited. D. Patil: Full / Part-time employment: Datar Cancer Genetics Limited. V. Palwe: Non-remunerated activity/ies: Datar Cancer Genetics Limited. V. Datta: Full / Part-time employment: Datar Cancer Genetics Limited. A. Ghaisas: Full / Part-time employment: Datar Cancer Genetics Limited. N. Srivastava: Full / Part-time employment: Datar Cancer Genetics Limited. A. Srinivasan: Full / Part-time employment: Datar Cancer Genetics Limited. D. Akolkar: Full / Part-time employment: Datar Cancer Genetics Limited. R. Datar: Leadership role, Shareholder / Stockholder / Stock options, Licensing / Royalties: Datar Cancer Genetics Limited.