Browsing Over 990 Presentations
Head and neck cancer, excluding thyroid
New combinations in metastatic disease
- Caroline Robert
- Caroline Robert
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
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.
Panel discussion (ID 1777)
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.
365O - Durability of response with larotrectinib in adult and pediatric patients with TRK fusion cancer
- Daniel Shao Weng Tan
- David Hyman
- Daniel Shao Weng Tan
- Cornelis Van Tilburg
- Catherine Albert
- Birgit Geoerger
- Anna Farago
- Ted Laetsch
- Shivaani Kummar
- Francois Doz
- Ulrik Lassen
- Steven Dubois
- Ray McDermott
- Leo Mascarenhas
- Jordan Berlin
- Erin Rudzinski
- Shivani Nanda
- Barrett Childs
- Alexander Drilon
- David S. Hong
Abstract
Background
Genomic rearrangements involving neurotrophic tropomyosin receptor kinase 1, 2, or 3 (NTRK1/2/3) result in constitutively active tropomyosin receptor kinase (TRK) fusion proteins that are oncogenic drivers in multiple pediatric and adult cancers. Larotrectinib is a selective TRK inhibitor approved by the US Food and Drug Administration in 2018 for the treatment of TRK fusion cancer based on a primary analysis in 55 patients from 3 clinical trials [Drilon et al. NEJM 2018]. Here, we report median duration of response (DOR) data in the primary cohort and updated data in an expanded cohort of 159 patients with TRK fusion cancer treated with larotrectinib, with 153 (55 primary + 98 supplemental) evaluable for efficacy.
Methods
Patients with TRK fusion cancer detected by local molecular profiling were treated with larotrectinib across 3 studies (NCT02122913, NCT02637687, NCT02576431). Disease status was assessed by investigators using RECIST 1.1. Data cut-off was February 19, 2019.
Results
In the primary cohort of 55 patients with a median follow-up of 26 months, the median DOR in 44 patients with complete or partial responses was 35.2 months (95% CI 21.2–not evaluable [NE]), with 17 progression events and 27 responses ongoing (range 1.6–44 months). Median progression-free survival in the primary cohort was 25.8 months (95% CI 9.9–NE), with 27 patients having progressed. In the expanded combined dataset, the most common tumor types included soft tissue sarcoma (n = 36), infantile fibrosarcoma (n = 29), thyroid carcinoma (n = 26), salivary gland carcinoma (n = 21), and lung cancer (n = 12). Median age was 43 years, ranging from < 1 month to 84 years; 33% < 18 years. The overall response rate was 79% (95% CI 72–85), with complete responses in 16%. Adverse events were mostly grade 1–2; 13% of patients had a grade 3–4 event related to larotrectinib. Only one patient discontinued due to an adverse event related to larotrectinib.
Conclusions
These data confirm the marked tissue-agnostic efficacy and long durability of response in patients with TRK fusion cancer treated with larotrectinib. Larotrectinib demonstrated a favorable long-term safety profile. Screening patients for NTRK gene fusions should be considered.
Clinical trial identification
NCT02122913, NCT02637687, NCT02576431.
Legal entity responsible for the study
Bayer.
Funding
Bayer.
Disclosure
F. Doz: Advisory / Consultancy, Research grant / Funding (self), Travel / Accommodation / Expenses: BMS; Advisory / Consultancy, Research grant / Funding (self): Celgene; Advisory / Consultancy: Bayer; Advisory / Consultancy: Loxo Oncology; Advisory / Consultancy: Servier. L. Mascarenhas: Speaker Bureau / Expert testimony: Bayer. J. Berlin: Research grant / Funding (institution): PsiOxus; Advisory / Consultancy, Research grant / Funding (institution): Bayer; Advisory / Consultancy, Research grant / Funding (institution): EMD Serono; Research grant / Funding (institution): Symphogen; Research grant / Funding (institution): Roche/Genentech; Research grant / Funding (institution): Immunomedics; Research grant / Funding (institution): Novartis; Research grant / Funding (institution): Taiho; Research grant / Funding (institution): AbbVie (pharamcyclics); Research grant / Funding (institution): Boston Biomedical; Research grant / Funding (institution): FivePrime; Research grant / Funding (institution): Loxo; Research grant / Funding (institution): Incyte; Research grant / Funding (institution): Macrogenics; Honoraria (self): Nestle; Advisory / Consultancy: Rafeal; Advisory / Consultancy: Seattle Genetics; Honoraria (self): Eisai; Advisory / Consultancy: Taiho; Advisory / Consultancy: Armo. All other authors have declared no conflicts of interest.
142P - Relation between Interleukin -4 (590C/T) gene polymorphism and hepatocellular carcinoma risk in HBV and HCV patients
- Suzy F. Gohar
- Suzy F. Gohar
- Belal Montaser
- Naglaa Elabd
- Moamena Elhamoly
- Amany Saleh
- Eman Salem
- Ghada Abo-Zeid
- Mahmoud Rizk
Abstract
Background
Interleukin-4 (IL-4) is an important modulator in the immune response of macrophages, B and T cells to stand in front of infections and malignancy. This study aimed to assess the association between IL-4 gene 590CT polymorphism and risk of hepatocellular carcinoma (HCC) on top of viral hepatitis.
Methods
This study was conducted on 220 patients and 60 apparently healthy individuals. One hundred and twenty patients with HCV infection (group 1) classified as sixty patients with liver cirrhosis and sixty with HCC, one hundred patients with HBV infection (group 2) classified as fifty with liver cirrhosis and fifty with HCC. Virus status of the patients was confirmed by measuring HBsAg, HCV antibodies and real time PCR. Liver cirrhosis was assessed by laboratory investigations, abdomino-pelvic ultrasound and CHILD score. Patients with HCC were diagnosed by triphasic CT, alphafeto-protein level (AFP) and biopsy. The studied groups were genotyped for IL-4 590C/T gene polymorphisms by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.
Results
IL-4 590C/T gene analysis detected significant variation between studied groups, regarding genotype and allele frequencies (p = 0.025 and p = 0.002 respectively). There were higher frequencies of CC genotype and C allele in HCC and cirrhotic hepatitis C patients than controls. C allele had higher prevalence in HCC than cirrhosis in HBV patients. CT+CC genotype carriers had an elevated HCC risk odd ratio (OR): 4.6 [95% CI: 1.5 –14] and OR 3.6 [95% CI: 1.1 –11.6], in HCV and HBV patients in contrast to controls. C allele was associated with increased cirrhotic and HCC risk in HCV infected patients with OR = 4 [95% CI: 1.8 – 8.8] and OR = 2.3 [95% CI: 1.1 – 5.2] versus control group. In HBV patients C allele showed higher HCC risk with OR = 4.2 [95% CI: 1.8 – 9.5] when compared to controls.
Conclusions
IL-4 590C/T gene polymorphism may have a role in occurrence of HCC on top of liver cirrhosis.
Legal entity responsible for the study
authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.