The landscape and role of IO-Chemo combination in NSCLC treatment (ID 1802)

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

Changing paradigm of treatment strategy for intermediate and advanced HCC (ID 1834)

Poster display session Poster Display

430P - Emetic risk of carboplatin plus pemetrexed is higher than that of carboplatin plus paclitaxel in patients with lung cancer: A propensity score-matched analysis

Presentation Number
430P
Lecture Time
06:00 PM - 06:00 PM
Session Name
Speakers
  • Koichi Matsuo
Location
Exhibition area, Singapore, Singapore, Singapore
Date
Sat, 23.11.2019
Time
06:00 PM - 07:00 PM
Authors
  • Koichi Matsuo
  • Mototsugu Shimokawa
  • Toshinobu Hayashi
  • Hirotoshi Iihara
  • Takafumi Nakano
  • Osamu Imakyure
  • Takashi Egawa

Abstract

Background

The emetogenic classification of antineoplastic agents has provided a framework for defining antiemetic treatment recommendations in international guidelines. The most widely used classification schema identified four emetic risk levels. However, information on the emetogenicity of each chemotherapeutic regimen is insufficient. We previously reported that the emetic risk of pemetrexed was higher than that of taxans. Risk factors for chemotherapy-induced nausea and vomiting (CINV) were also assessed in patients with lung cancer receiving carboplatin plus pemetrexed (CBDCA+PTX) or carboplatin plus paclitaxel (CBDCA+PEM), and the CINV incidence was compared between these two regimens.

Methods

Data were pooled from two prospective studies, and propensity score matching was used to compare the CINV incidence between CBDCA+PTX and CBDCA+PEM groups. Risk factors for CINV were identified using logistic regression models. The pattern of CINV occurrence was evaluated by 7-day patient diary for recording CINV after the commencement of chemotherapy.

Results

Among 240 evaluable patients, the CINV incidence was higher in the CBDCA+PEM group than in the CBDCA+PTX group at the delayed phase (nausea: 51.1% vs. 36.2%, P = 0.040; vomiting: 23.4% vs. 14.9%, P = 0.138). The pattern of delayed CINV occurrence peaked on days 5 and 4 for CBDCA+PEM and CBDCA+PTX regimens, respectively. Logistic regression analysis identified younger age, female sex, no alcohol consumption, two antiemetics, and CBDCA+PEM regimen as independent risk factors associated with delayed nausea, and female sex and two antiemetics for delayed vomiting.

Conclusions

The emetic risk of CDBCA+PEM regimen was higher than that of CBDCA+PTX regimen. More aggressive antiemetic prophylaxis such as quadruple therapy, including olanzapine, may be considered in patients receiving CDBCA+PEM regimen.

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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Poster display session Poster Display

182P - Durable response to second-line m-FOLFIRINOX for advanced pancreatic adenocarcinoma in patients with performance status of two or less

Presentation Number
182P
Lecture Time
06:00 PM - 06:00 PM
Session Name
Speakers
  • Adarsh Das
Location
Exhibition area, Singapore, Singapore, Singapore
Date
Sat, 23.11.2019
Time
06:00 PM - 07:00 PM
Authors
  • Adarsh Das
  • Andrew Dean
  • Nicholas Travers
  • Mikael Johansson
  • Ian Yusoff

Abstract

Background

The efficacy of FOLFIRINOX in the treatment of pancreatic adenocarcinoma is well known and documented. However, most published data involves young patients with a performance status ≤1 (ACCORD study). Thus, traditionally FOLFIRINOX has been regarded as a first line only treatment for patients with good performance status. Patients requiring second line therapy are not regarded as being fit enough to receive FOLFIRINOX. We have previously published our experience that m-FOLFIRINOX can be utilised safely in these individuals, with appropriate dose reductions. Our position has been supported by a subsequent systematic review (Tong et al.). This updated report of our dual institution experience adds further evidence supporting the use of m-FOLFIRINOX as a second line treatment for pancreatic adenocarcinoma.

Methods

A retrospective analysis was conducted on patients with locally advanced or metastatic pancreatic adenocarcinoma from two institutions who received first-line gemcitabine plus nab-paclitaxel, followed by second-line m-FOLFIRINOX between December 2011 and July 2019. All patients had an ECOG performance status of 2 or less. Overall survival (OS) was estimated via the Kaplan-Meier method.

Results

We identified 85 patients in our analysis, with 64% patients having metastatic disease at diagnosis. The median age of our patients at diagnosis was 65 (range, 26 – 81). The dose intensity of m-FOLFIRINOX was the following: 65% for oxaliplatin, 68% for irinotecan, 18% for bolus 5-fluorouracil (5-FU) and 68% for infusional 5-FU. The median OS of all patients was 46.0 months (95% CI, 35.0 – 68.0). The median OS of locally advanced and metastatic pancreatic cancer from diagnosis was 68.0 months (95% CI, 45.0 – 68.0) and 23.0 months (95% CI, 19.0 – 49.0), respectively.

Conclusions

Our expanded case series continues to demonstrate the growing role of m-FOLFIRINOX as a second line therapy for advanced metastatic pancreatic cancer, after the failure of first-line gemcitabine plus nab-paclitaxel. We continue to suggest that formal clinical trials are needed to further investigate this efficacy.

Legal entity responsible for the study

St John of God Hospital, Subiaco.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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Immunotherapy in GU cancers: Focus on kidney and bladder cancers Challenge Your Expert session

Bladder

Lecture Time
11:55 AM - 12:05 PM
Speakers
  • Ravindran Kanesvaran
Location
Summit 2, Singapore, Singapore, Singapore
Date
Fri, 22.11.2019
Time
11:45 AM - 12:30 PM
Authors
  • Ravindran Kanesvaran
ESMO Colloquium supported by Astellas - State of the art management of mCPRC ESMO Colloquium

Introduction

Lecture Time
11:00 AM - 11:05 AM
Speakers
  • Arun A. Azad
Location
Summit 2, Singapore, Singapore, Singapore
Date
Sun, 24.11.2019
Time
11:00 AM - 12:30 PM
Authors
  • Arun A. Azad
Poster display session Poster Display

454P - Predictors of severity and comparison of CTCAE V3.0 vs V4.3 in assessing chemotherapy induced extravasation injuries

Presentation Number
454P
Lecture Time
06:00 PM - 06:00 PM
Session Name
Speakers
  • Sangana S. Reddy
Location
Exhibition area, Singapore, Singapore, Singapore
Date
Sat, 23.11.2019
Time
06:00 PM - 07:00 PM
Authors
  • Sangana S. Reddy
  • Shalaka Somayaji
  • Mamatha Krishna Murthy
  • Vinayak V. Maka

Abstract

Background

Extravasation is an important Adverse Event in chemotherapy, which is evaluated using CTCAE (Common Terminology Criteria for Adverse Events) grading scale. This study focuses on predicting risk factors and comparing CTCAE v3.0 and 4.3 in assessing chemotherapy-induced extravasation.

Methods

An observational study was conducted in medical oncology wards of a tertiary care hospital among adult patients receiving parenteral chemotherapy. European society of medical oncology – European oncology nursing society (ESMO-EONS) guidelines was used to classify chemotherapeutic agents. Significant risk factors were determined using binary logistic analysis. Spearman’s rank correlation coefficient and Wilcoxon’s sign rank test was applied to evaluate the difference between CTCAE v3.0 and v4.3.

Results

A total of 46 patients were enrolled in the study. According to CTCAE v4.3, amongst the 46 patients who experienced extravasation 30 presented with Grade II and the rest 16 with Grade III severity. Patients aged above 60 years showed significance (OR: 2.236, p = 0.007), and females were prone to severe extravasation injury (OR: 2.713, p = 0.010). Ambulation was found to be a major risk factor (OR: 4.66, p = 0.001). Patients with comorbidities had higher chances of getting severe extravasation (OR: 3.009, p = 0.029) and irritants were found to be predominant in worsening it (OR: 2.24, p = 0.007). The Spearman’s rank correlation coefficient established a good association in EV grades between both versions of CTCAE (rho=0.877, p = 0.000). Wilcoxon’s Rank test revealed a significant difference between the two. (p = 0.0003).

Conclusions

The severity of EV depends on early identification of symptoms, patient related factors and nature of drug. This information is pivotal to work towards a scenario of better-prevented and managed events of EV. The updated versions of CTCAE (v4.3 and v5) are better fit to use for accurate scoring of severity.

Legal entity responsible for the study

All Authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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Mini Oral session - Public policy Mini Oral session

393O - Timeliness of lung cancer treatment utilizing the rapid access lung cancer clinic in a regional Australian Hospital

Presentation Number
393O
Lecture Time
09:10 AM - 09:15 AM
Speakers
  • Nguyen M. Chau
Location
Room 326, Singapore, Singapore, Singapore
Date
Sat, 23.11.2019
Time
09:00 AM - 09:50 AM
Authors
  • Nguyen M. Chau

Abstract

Background

Patients in remote and rural areas of Australia are disadvantaged in receiving and accessing healthcare. Lung cancer incidence and mortality is increased in remote areas compared to metropolitan regions. The rapid access lung cancer (RALC) clinic was established in 2017 in order to optimize timeliness to treatment and improve patient outcomes.

Methods

Retrospective audit of all patients diagnosed with lung cancer in 2018 within the Ballarat Health service and was stratified according to stage of cancer. Mean timeframes were derived from the Australian optimal care pathway (OCP) for people with lung cancer and analysed using descriptive statistics.

Results

Total of 84 patients were diagnosed with lung cancer in 2018, with 72% being seen in the RALC clinic. Overall 77.3% met the OCP timeframe of referral to treatment in less than 42 days as compared to only 48.5% in 2015-2016. Stage I/II, III and stage IV patients had mean referral to treatment intervals of 53, 40 and 22 days respectively. Stage IV RALC patients compared to general clinic patients, proceeded to treatment faster after diagnosis (7 days vs 28 days, p = 0.04) and were presented at MDT more frequently (44.5% vs 13.5%). In Stage I/II and stage III patients who had delays from diagnosis to treatment, main reasons were waiting times for surgery, radiotherapy and further diagnostic test. Limitations of a regional centre include having to refer externally for both EBUS and complex surgery offered only in metropolitan hospitals.

Conclusions

RALC clinics have reduced time to definitive treatment. Early stage patients require more complex work up and multi-modality treatment, so have a longer time to first treatment over advanced stage patients. Despite the obstacles of a regional centre, the time to treatment were shorter that of metropolitan public hospitals. Longer follow-up will determine if improved timeliness will lead to better patient outcomes.

Legal entity responsible for the study

Ballarat Health Service.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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