Browsing Over 783 Presentations
133P - Which patient subgroup needs more attention in early treatment failure? A matched cohort study of treatment failure patterns in locally advanced gastric cancer (ID 692)
- Dong Wu (Fuzhou, China)
Abstract
Background
The aim of this study was to compare the treatment failure patterns after laparoscopic (LG) and open gastrectomy (OG) in locally advanced gastric cancer (LAGC).
Methods
A total of 1792 LAGC patients who underwent radical resection between January 2010 and December 2016 were divided into an LG group (n=1557) and OG group (n=235). Propensity score matching was performed to balance the two groups. Dynamic hazard rates of failure were calculated using the hazard function.
Results
A total of 1175 LAGC patients were included after matching (LG group, n=940; OG, n=235). The treatment failure rate of the whole group was 43.23% (508/1175), accounting for 41.38% (389/940) and 50.64% (119/235) in the LG and OG groups, respectively. The static treatment failure pattern showed that only distant recurrence rate of the LG group was significantly lower than that of the OG group (22.02% vs. 28.94%, P=0.025). Landmark analysis showed a lower early treatment failure rate of the LG group in stage Ib-IIIb subgroup (P=0.004). Furthermore, dynamic hazard curve peaked at 9.4 months (Peak rate=0.0186) and then gradually declined. For stage Ⅰb to Ⅲb patients, time of peak failure hazard was 5.2 months earlier in the OG group (OG versus LG: 11.0 versus 16.2 months). Finally, LG was an independent protective factor associated with early treatment failure in stage Ib-IIIb patients (hazard ratio, 0.63; 95% CI, 0.43-0.93; P=0.019).
Conclusions
Given the differences in treatment failure patterns between LG and OG, shorter-interval surveillance for the first 2 years should be considered for stage Ib-IIIb patients after OG.
Legal entity responsible for the study
The authors.
Funding
Scientific and Technological Innovation Joint Capital Projects of Fujian Province.
Disclosure
All authors have declared no conflicts of interest.
429P - Demographics, pattern of care, and outcome analysis of malignant melanoma cases from a tertiary care centre in India (ID 743)
- Anshul Agarwal (Mumbai, India)
Abstract
Background
Melanoma care is revolutionized with checkpoint inhibitors (CPI) and targeted therapies; however, access to drugs is challenging in Low-Middle income countries (LMICs).
Methods
Histologically proven melanoma cases registered from 2013–2019 were analysed.
Results
There were 443 patients with median age of 54 years; 60% were males with 41% cutaneous, and 57% mucosal melanomas; most common primary sites were anorectal (41%) and extremities (27%); 11% were BRAF mutated. Among the 258 non-metastatic patients, the median follow up was 30 months (0–83 months). Of these, 114 (44%) had prior surgery and 73 (64%) were already metastatic at presentation to us. Of the remaining 144 (56%), 101 underwent resection, 11 were unresectable, and rest 32 did not take treatment. Median EFS of non-metastatic patients was 17 (95% CI: 11-23) months while median OS was 38 months (95% CI: 30-46); 2-years OS predictions was 66% (95% CI: 59-73). Overall metastatic cohort (n=311) comprised of baseline metastatic (n=185) and non-metastatic patients with (73) or without prior therapy (53) who failed with distant metastasis.Commonest metastatic sites were liver (52%) and non-regional nodes (51%). Median follow up in this cohort was 21 (0–74 months); 138 (44.4%) received chemotherapy(taxane, dacarbazine), Interferons, while 29 (9.3%) patients received CPI. The clinical benefit rate was 31%. In baseline metastatic cohort, the median EFS and OS with BSC alone were 3.8 (95% CI: 2.6-5.0) months and 3.5 (95% CI: 2.45-4.63) vs. 5.55 (95% CI: 3-8) months and 11 (95% CI: 9-13.1) months in any systemic therapy group (HR for OS: 0.34, 95% CI: 0.22-0.52; P<0.001). Grade 3/4 toxicity were observed in 16 % with predominance of thrombocytopenia and anemia (both 4%) in chemotherapy and anemia (10%) for CPI. Any therapy received was significant in both cohort;additionally, site, surgery, were significant in non-metastatic cohort.
Conclusions
This real-world data from India reflects the hard reality of access of expensive, standard of care therapies. Interesting finding that any systemic therapy can lead to meaningful clinical benefits at-least in a select group of patients merits exploration if standard options are not feasible, especially in LMICs.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
430P - Teenagers and young adult cancers in rural central India: Access to age-appropriate care (ID 775)
- Runu Sharma (Indore, India)
Abstract
Background
Teenagers and young adults (age 15-29) are increasingly the focus of cancer care in India. Young persons from rural western Madhya Pradesh, a resource crunch area, need provided support, and a care pathway to ensure optimal results in the treatment of cancer.
Methods
Disease characteristics of TYA patients over (30 months) from 2018-thru 2020 were analyzed. Abandonment defined as. Failure to start / complete treatment was quantified, and the cancers were documented by the Birch classification. Early deaths (within 30 days) and trends to completion of therapy were documented. Telephonic tracing of patients, escorting them to hospital, providing accommodation, food caregiver support. Since Feb 2019, the state sponsored Insurance scheme Ayushman Bharat provided TYAs access to cancer care.
Results
Two hundred and forty six cancer patients’ records in the age group 15-29 years were. analysed in a retrospective study. Median age 23 years; M: F 166: 80. Diseases were classified by the Birch Classification: Leukemias 84; Lymphomas. 45; Brain 6; Bone tumors 55; Soft tissue tumors 6; Germ Cell tumors 19; Carcinoma 30; Miscellaneous 1; Twenty two (9%) abandoned treatment. 65 (26%) alive after completed therapy; Early deaths occurred in 56 (23%); as of 30 June 2020, 103 (41%) are alive on treatment.
Conclusions
Early deaths occurred on account of poor nutrition; delayed diagnosis; toxicity of therapy.TYAcan Foundation provided diagnostic, treatment and accommodation support; mitigating early morbidity and mortality; tracking young persons to reduce abandonment. Early trends indicate that the government Ayushman Scheme and the social entrepreneurship of TYAcan together helped establish a viable care pathway for young cancer patients to achieve to survival rates.
Legal entity responsible for the study
Department of Medical Oncology, Sri Aurobindo Institute of Medical sciences.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.
149P - Molecular and clinical characteristics of patients with resectable gastric cancer (ID 796)
- Zhi Zheng (Beijing, China)
Abstract
Background
Gastric cancer (GC) is one of the most common malignancies and a leading cause of cancer deaths worldwide. Currently, the genomic researches mainly focused on metastatic GC, but the clinico-molecular characteristics of resectable GC were poorly investigated.
Methods
A total of 47 resectable GC patients were enrolled. All kinds of genomic mutations were identified by next-generation sequencing (NGS) with Acornmed panel. Programmed death-ligand 1 (PD-L1) expression was analyzed by immunohistochemistry staining.
Results
Overall, a total of 582 mutations were identified from all the patients. TP53, LRP1B, ARID1A, and MDC1 were the most commonly mutated genes in resectable GC. Genomic data revealed significant mutual exclusivity between alterations in TP53 and PIK3CA (p < 0.05) and between those in TP53 and DICER1 (p < 0.05), as well as mutual co-occurence between alterations in FAT1 and ERBB3 (p < 0.05) and between those in FAT1 and NOTCH2 (p < 0.05). Additionally, ARID1A and APC alterations were significantly associated with poor differentiation (p < 0.05), and frequency of ARID1A mutations was markedly higher in intestinal-type GC than diffuse GC (p < 0.05). PD-L1 expression was analyzed in 45 tumors, and 33.3% of them showed positive PD-L1 expression. Further analysis demonstrated that KMT2D and ARID1A alterations were strikingly correlated with positive PD-L1 expression (p < 0.05). The median tumor mutational burden (TMB) in resectable GC was 6.38 mutations/Mb, and AR, CDH1, NOTCH2, and FAT1 mutations were remarkably associated with high TMB (p < 0.05). We further found that patients with positive PD-L1 expression tended to have low TMB (p = 0.057).
Conclusions
This study is of great significance in understanding the population characteristics of patients with resectable GC, which will be useful to guide personalized therapy and promote the clinical management in this population.
Legal entity responsible for the study
Zhi Zheng.
Funding
Beijing Municipal Science & Technology Commission.
Disclosure
All authors have declared no conflicts of interest.
189P - Prognostic value of inflammation-based score for patients treated with FOLFIRINOX (FFX) or gemcitabine plus nab-paclitaxel (GnP) (ID 823)
- Takahiro Yamamura (Sapporo, Japan)
Abstract
Background
Inflammation-based score such as Glasgow prognostic score (GPS) or Neutrophil -Lymphocyte ratio (NLR) is associated with clinical outcome of cancer patients. However, the prognostic value of GPS and NLR for patients with advanced pancreatic cancer who received systemic chemotherapy remains unclear.
Methods
We conducted single center retrospective study. Inclusion criteria was defined as patients with metastatic or recurrent pancreatic cancer treated with FFX or GnP as first line treatment at Hokkaido university hospital between January 2014 and December 2018. Baseline GPS was identified that GPS 0 was CRP ≤1.0 mg/dL and Alb ≥3.5 g/dL, GPS 1 was CRP >1.0 mg/dL or Alb <3.5 g/dL, and GPS 2 was CRP >1.0 mg/dL and Alb <3.5 g/dL. NLR was defined as the ratio of absolute neutrophil count and absolute lymphocyte count. As no clear NLR cutoff level has been established in this setting, we used the cutoff ≧3. Cox-proportional hazards model were used to identify prognostic factors in univariate and multivariate analyses.
Results
A total of 101 patients were eligible. Median age of patients was 67, male/female was 63/38, ECOG PS 0/1/2 was 36/62/3, FFX/GnP was 19/82, GPS 0/1/2/unknown was 52/21/23/5, NLR ≧3/<3/unknown was 51/44/6, respectively. In GPS 0/1-2 patients, median PFS were 5.2/2.3months (HR 1.772, 95%CI 1.165-2.693, p=0.007), median OS were 12.4/5.7 months (HR 2.384, 95%CI 1.534-3.706, p<0.001), respectively. In NLR 3</≧3 patients, median PFS were 6.4/2.6 months (HR 2.436, 95%C.I. 1.568-3.784, p<0.001), median OS were 14.6/6.0 months (HR 2.496, 95% C.I. 1.616-3.856, p<0.001), respectively. In multivariate analysis, High NLR (NLR ≧3 vs <3 : HR 2.067, 95%C.I. 1.278-3.343, p=0.003) was significantly associated with poor PFS. For OS, female (HR 2.006, 95%C.I. 1.206-3.34, p=0.007), liver metastasis (HR 2.137, 95%C.I. 1.281-3.565, p=0.004), high NLR (NLR ≧3 vs <3: HR 2.745, 95%C.I. 1.639-4.599, p<0.001), high GPS (GPS 0 vs 1-2: HR 2.016, 95%C.I. 1.233-3.296, p<0.001) were significantly associated with poor OS.
Conclusions
NLR may be better prognosticator than GPS for patients with metastatic or recurrent pancreatic cancer treated with FFX or GnP.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
H. Nakatsumi: Honoraria (self): Takeda; Honoraria (self): Sanofi; Honoraria (self): Merck Biopharma; Honoraria (self): Taiho Pharmaceutical; Honoraria (self): Ono Pharmaceutical. Y. Kawamoto: Honoraria (self): Taiho Pharmaceutical; Honoraria (self): Takeda; Honoraria (self): Chudai Pharma; Honoraria (self): Daiichi Sankyo; Honoraria (self): Merck; Honoraria (self): Lilly; Honoraria (self): Japan Agency for Medical Research and Development. S. Yuki: Honoraria (self): Takeda Pharmaceutical Co., Ltd.; Honoraria (self): Ono Pharmaceutical Co., Ltd.; Honoraria (self): Sanofi K.K.; Honoraria (self): Bayer Yakuin., Ltd.; Honoraria (self): Eli Lilly K.K.; Honoraria (self): Bristol-Myers Squibb Co., Ltd.; Honoraria (self): Merck Biopharma Co., Ltd.; Honoraria (self): Chudai Pharmaceutical Co., Ltd.; Honoraria (self): Taiho Pharmaceutical Co., Ltd.; Honoraria (self): Yakult Honsha Co., Ltd.; Honoraria (self): MSD K.K. N. Sakamoto: Honoraria (self): Gilead Sciences; Honoraria (self): Chudai Pharm; Honoraria (self): Bayer AG; Honoraria (self): Otsuka Pharm; Honoraria (self): Daiichi-Sankyo; Honoraria (self): Astellas Pharma; Honoraria (self): Takeda; Honoraria (self): Eisai; Research grant/Funding (self): Gilead Sciences; Research grant/Funding (self): Eisai; Research grant/Funding (self): MSD; Research grant/Funding (self): Otsuka Pharm; Research grant/Funding (self): AbbVie; Research grant/Funding (self): Asuka Pharm. Y. Komatsu: Research grant/Funding (institution): Eisai; Honoraria (self), Speaker Bureau/Expert testimony, Research grant/Funding (institution): Daiichi-Sankyo; Honoraria (self), Speaker Bureau/Expert testimony, Research grant/Funding (institution): Yakult; Honoraria (self), Speaker Bureau/Expert testimony, Research grant/Funding (institution): Chugai; Honoraria (self), Speaker Bureau/Expert testimony, Research grant/Funding (institution): Taiho; Honoraria (self), Speaker Bureau/Expert testimony, Research grant/Funding (institution): Lilly; Honoraria (self), Speaker Bureau/Expert testimony, Research grant/Funding (institution): Sanofi; Research grant/Funding (institution): MSD; Honoraria (self), Speaker Bureau/Expert testimony, Research grant/Funding (institution): Ono; Honoraria (self), Speaker Bureau/Expert testimony, Research grant/Funding (institution): Nipro; Honoraria (self), Speaker Bureau/Expert testimony, Research grant/Funding (institution): Asahikasei; Honoraria (self), Speaker Bureau/Expert testimony, Research grant/Funding (institution): Nihonkayaku; Honoraria (self), Speaker Bureau/Expert testimony, Research grant/Funding (institution): Takeda; Honoraria (self), Research grant/Funding (self): Bayer; Honoraria (self): Kyowa Kirin; Honoraria (self): Merck Biopharma; Honoraria (self): Bristol-Myers Squibb; Honoraria (self): Shire Japan; Honoraria (self): Novartis Pharma; Honoraria (self): Pfizer. All other authors have declared no conflicts of interest.
410P - Frequency and spectrum of primary resistance mechanism in Chinese ALK+ non-small cell lung cancer patients progressing on crizotinib: A multicenter study (ID 880)
- Wen-xian Wang (Hangzhou, China)
Abstract
Background
Anaplastic lymphoma kinase (ALK) have been recognized as the most important predictor of response to crizotinib. However, 20-30% of patients harboring ALK fusion non-small-cell lung cancer patients show a poor response requiring investigation for underlying mechanisms.
Methods
We screened 3207 patients with NSCLC for ALK fusion. Among them, 92 patients received crizotinib treatment,and a total of 81 patients with stage IIIb-IV ALK+NSCLC were undergoing tumor biopsies or blood withdrawing by the time of primary or acquiring resistance to crizotinib, including 43 formalin-fixed paraffin-embedded (FFPE) samples, 25 serum samples and 24 serous effusions. We used targeted NGS to detect genes status of patients.
Results
Among 92 patients treated with crizotinib, 76.09% (70/92) developed acquired resistance, and 11.96% (11/92) had primary resistance. Using the specimens at the baseline, there were 2 (18.18%) patients with BCL2L11 loss (BIM deletion polymorphism), 1 (9.09%) patient with PTEN mutation, 1 (9.09%) patient with PIK3CA mutation, 1 (9.09%) patient with CCND1 mutation, 1 (9.09%) patient with SMARCA4 mutation, 1 (9.09%) patient with CMTR1-ALK, 1 (9.09%) patient with EML4-ALK fusion (non A20), and 3 (27.27%) patients with unknown status.
Conclusions
BCL2L11 loss, PI3K-AKT-mTOR signaling pathway (PTEN, PIK3CA mutations), SMARCA4 mutations or EML4-ALK fusion (non A20) might contribute to molecular mechanisms of primary resistance to crizotinib in ALK+NSCLC.Further investigations are warranted to overcome these primary resistance.
Legal entity responsible for the study
Chun-wei Xu.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
320P - Psychometric interplay of the perception of the real-life impact of COVID-19 pandemic: A cross-sectional survey of patients with newly diagnosed malignancies (ID 912)
- Kelvin Bao (Kowloon, Hong Kong PRC)
Abstract
Background
Patients newly diagnosed with malignancies amidst the COVID19 pandemic outbreak face the psychological double whammy of a gruesome diagnosis and a public health crisis. We conducted a cross-sectional survey to examine the association between common psychological disorders and cancer patients’ perception of COVID19’s real-life impact.
Methods
Newly diagnosed cancer patients were surveyed with a two-part questionnaire constructed by oncologists and clinical psychologists. It first explored patients’ perceptions of pandemic’s impact on cancer care resources, treatment quality, health-seeking behaviour and other concerns. The second part involved the measurement of post-traumatic stress disorder (PTSD) (abbreviated PCL-5), anxiety and depression (emotion thermometer) and intolerance to uncertainty (IUS12), where patients were assigned into high and low-risk groups accordingly. Their associations were observed and analysed using chi-square test.
Results
103 new cancer patients in Hong Kong were surveyed in May 2020. Results revealed there were more worries about the impact of COVID19 on cancer care manpower, and secondly about risk of infection during OPD waiting time, in patients of high risk group for PTSD (p= 0.011; p=0.015 respectively), anxiety (p=0.013; p=0.034), depression (p=0.017; p=0.043) and uncertainty tolerance (p=0.004; p=0.044). High IUS12 score was associated with more worry on pandemic’s impact on progress of cancer research and drug development (p=0.03). Patients of the high anxiety risk group were less likely to accept hospital’s “no visitor” policy during admission (p=0.013). High-risk group for anxiety (p=0.024) and depression (p=0.044) tend to consider the availability of media information on COVID19’s impact on cancer as inadequate. Patients of high PTSD risk group showed greater fear of being infected by family/carers (p=0.005).
Conclusions
This original survey revealed the potential value of psychometrics in understanding cancer patient’s perception of COVID19’s impact and predicting particular concerns in patients with different psychological phenotypes, allowing better-tailored pandemic time cancer care.
Legal entity responsible for the study
The authors.
Funding
Kowloon Central Cluster Research Committee Research Grant 20/21, Hospital Authority, Hong Kong, China.
Disclosure
All authors have declared no conflicts of interest.
306P - Detection of anaplastic lymphoma kinase (ALK) mutations using circulating tumour DNA (ctDNA) in advanced non-squamous non-small cell lung cancer (non-Sq-NSCLC) in Asia (ID 947)
- Kirsty W. Lee (Hong Kong, Hong Kong PRC)
Abstract
Background
ALK gene rearrangement occurs in 3-7% of non-Sq-NSCLC. Tumor ALK testing by immunohistochemistry (IHC) is recommended. Next generation sequencing (NGS) and fluorescent-in-situ hybridization are validated for samples with inconclusive IHC staining. NGS testing of plasma ctDNA is non-invasive, allowing diagnosis where tissue is inaccessible, and detection of resistance mutations post-progression. One study has reported clinical utility of ALK testing using NGS on plasma, but data are otherwise limited to small samples. We assessed clinical utility of ctDNA NGS for ALK testing for non-Sq-NSCLC in Asia.
Methods
Between September 2015 to May 2020, 464 plasma specimens from 413 patients were analyzed. ctDNA was genotyped using Guardant360 (Guardant Health, Redwood City CA USA). Data on clinicopathologic features and treatment status were extracted from database (Sanomics Ltd, Hong Kong).
Results
ALK fusion and/or resistance mutations were detected in ctDNA of 24 (6%) non-Sq-NSCLC patients. 12 patients (50%) were male. 19 (79%) were adenocarcinoma, 5 (21%) were unknown. Tumor ALK status was available in 21 patients: 13 were ALK positive, 8 previously tested negative. ALK fusion partners included EML4 (85.7%), STRN (9.5%), and KIF5B (4.8%). ALK resistance mutations were detected only in patients with prior ALK inhibitor treatment (8/12, 67%). 13 types of resistance mutations were identified: G1202R, then L1196M, were the most frequent. (Table) NOTE: TKI - tyrosine kinase inhibitor; a, b, c - 1st, 2nd, 3rd ctDNA NGS test; NA - not available; Y - yes; N - no; O - other therapy; P - positive.
Patient no. 1a 1b 2a 2b 3a 3b 3c 4a 4b 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Prior TKI treatment NA Y NA NA Y Y Y O O NA O Y Y Y N Y N Y Y Y O Y NA Y O Y NA O O ALK TKI Crizotinib Y Y Y Y Y NA Ceritinib Y Y Y Alectinib Y Y Y Y Y Y Y Y Y Y Lorlatinib Y Y Y ALK fusion EML4-ALK P P P P P P P P P P P P P P P P P P P KIF5B-ALK P STRN-ALK P P ALK resistance mutation E1210K P D1203N P F1174C P F1174L P P P G1202R P P P P P G1269A P I1171N P I1171T P P L1152R P L1196M P P P P L1196Q P L1198F P P V1180L P P
Conclusions
NGS testing for ALK fusions and genomic alterations in plasma ctDNA has clinical utility in non-Sq-NSCLC patients in guiding ALK targeted treatment at initial diagnosis and upon cancer progression. Detection rate and distribution of ALK fusion partners are comparable to existing data of tumor ALK testing. Further data on ALK treatment outcomes of patients with detectable ALK fusion on plasma ctDNA is warranted.
Legal entity responsible for the study
Sanomics Limited.
Funding
Has not received any funding.
Disclosure
K.W.C. Lee, S.T. Wu, P.Y. Lo, C.T. Choy, T.C. Kwong, Y.T.N. Lau. L. Lin, S.W. Lau: Full/Part-time employment: Sanomics Limited.
294P - Interventional pain treatment in patients with pain syndrome in advanced tumours of small pelvis (ID 982)
- Yakhyo Ziyaev (Tashkent, Uzbekistan)
Abstract
Background
More than a third of small pelvis cancer cases in Uzbekistan are diagnosed in the late stages, where the main goal of medical interventions is to increase life expectancy with maximum maintenance of the quality of life. Opioid prescription and opiophobia in medical personnel make it harder to control pain in this group of patients, decreasing the quality of their life.
Methods
34 patients with locally advanced tumors of small pelvis (17 rectal cancer, 11 cervical cancer, 6 prostate cancer) with pain syndrome by visual analog scale (VAS) 8-10 were selected as the study group. Patients were treated in National cancer center of Uzbekistan in 2017-2020. Epidural catheter was placed in V4-5. Solution of bupivacaine 2.5% 20 ml with 1% of morphine injected at primary point. Then, 5 ml of bupivacaine 2.5% every 6 hours, 1 ml of 1% morphine every 12 hrs. Mean period of catheter placement was 23,6 days (7-36). in order to decrease the possibility of infection wide spectrum of antibiotics and wound dressing were administered. Control group included 34 patients with locally advanced tumors of small pelvis (20 rectal cancer, 12 cervical cancer, 2 prostate cancer) with pain syndrome by visual analog scale (VAS) 8-10. They underwent standard WHO pain ladder therapy morphine 1%-1 ml every 4-6 hrs ± ketorolac 30 mg – 1 ml.
Results
Withing the 20 minutes of administering, median pain syndrome by VAS was 0.78 (0-4). 6 (17.6%) patients admitted headache, 3 dizziness (8.8%). 2 patients admitted 1st grade nausea (5.9%). Constipation was not admitted in the main group. Drowsiness was admitted in 7 patients (20.6%). All of the symptoms disappeared within the 7 days period of hospitalization. In control group, the mean pain syndrome was 4.6 (0-7) by VAS. Drowsiness effect was observed in 27 patients (79.4), however, 21 (61.8%) cases this effect regressed in 7-day period. In 3-months observation period, 11 (32.6) patients from second group had complains on constipation which was resolved with laxatives and enemas.
Conclusions
Analgesia with usage of long-term epidural catheter placement allowed to achieve better pain control, lower opioid usage and avoid severe complications in patients with severe chronic pain syndrome of small pelvis tumors.
Clinical trial identification
N/A
Legal entity responsible for the study
National Cancer Center of Uzbekistan.
Funding
National Cancer Center of Uzbekistan.
Disclosure
All authors have declared no conflicts of interest.
438P - Real-world data of relapse after adjuvant treatment (Tx) in high-risk melanoma (ID 1001)
- Carolina Ortiz Velez (Barcelona, Spain)
Abstract
Background
Adjuvant (adj) Tx with programmed cell death protein 1 (PD-1) inhibitors or targeted therapy (TT) for 1 year in patients (pts) with high-risk resected melanoma prolongs relapse-free survival (RFS). However, up to 1/3 of pts recur in the year after adj Tx and there are few data regarding patterns of relapse, management and outcomes. Our aim was to describe how adj Tx impacts the outcomes in melanoma pts in our center.
Methods
Single-institution experience of 123 consecutive pts with melanoma resected in our center from 2014 to 2019 were retrospectively analyzed. Clinicopathological factors, adj Tx, timing and patterns of relapse, Tx at relapse and subsequent outcomes were examined.
Results
Median age at diagnosis was 57 years, 45% were male and BRAF-mt was found in 38%. Stage III A/B/C/D or IV was 6%, 10%, 19%, 1% and 1%, respectively. Sentinel node biopsy was performed in 80% and lymphadenectomy in 33% of 123 pts. A total of 49 pts received adj Tx: 3 pts (6%) TT, 8 pts (16%) IFN-α, and 38 pts (31%) immunotherapy (iTx) with anti-PD-1 and/or ipilimumab. A total of 40 pts (32%) had relapse (65% locoregional and 35% distant), 8 pts (21%) had prior adj iTx with a median RFS of 21.5 months (m) (CI95%17.4-NA). 24 pts (60%) were resected (6 pts with distant recurrent), 14 pts received adj Tx (12 pts iTx, 1 pt IFN-α and 1 pt TT), for 4-pts was the second adj Tx. A total of 31 of 123 pts (25%) developed metastatic melanoma (MM), of these 17 pts (55%) received adj Tx. PFS at 1st line of Tx of pts with prior adj-Tx vs no was similar (HR=1.01, p=0.98), mainly Tx were iTx (65%), TT (31%) and chemotherapy (4%). Remarkably, there was no worse response rate (complete response [CR] or partial response [PR]) in pts with prior adj Tx (68.8% vs 35.7%, p=0.14). Of 17 pts with prior adj-Tx (16 pts adj-iTx) who had MM, twelve (70.6%) received iTx at 1st line, 50% had response to iTx. Also, all 4 pts BRAF-mt with prior adj iTx who received TT at 1st line had CR or PR. There was no correlation between treatment-free interval after adj TX and PFS at 1st line (p=0.66).
Conclusions
Our real-world data demonstrates that after a locoregional or distant relapse of melanoma, despite prior adj-Tx, Tx with iTx or TT can be active. But additional research is needed.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
R. Dienstmann: Advisory/Consultancy: Roche, Boehringer Ingelheim; Honoraria (self): Roche, Ipsen, Amgen, Servier, Sanofi, Merck Sharp & Dohme; Research grant/Funding (self): Merck, Pierre Fabre. E. Muñoz-Couselo: Advisory/Consultancy: BMS; Advisory/Consultancy: Novartis; Advisory/Consultancy: Roche. All other authors have declared no conflicts of interest.
287P - Establishment of nasopharyngeal carcinoma organoid culture system and preliminary exploration of drug sensitivity test in vitro (ID 1031)
- Wang X. Wen (Guangzhou, China)
Abstract
Background
Nasopharyngeal carcinoma (NPC) has a high incidence among malignant tumors in China, accounting for the highest incidence of head and neck tumors. The treatment of recurrent NPC is difficult, and both the traditional in vitro cell line and PDX models have obvious shortcomings. Therefore, it is imperative to establish better disease models, to study further the mechanism of recurrent NPC, and to explore a more effective treatment method. Tumor organoids are tumor micro-organs in which stem cells are cultured in 3D in vitro. They have been verified by histopathology, molecular biology and genomics, and can retain most of the biological characteristics and tumor heterogeneity of primary tumors, which could be the best models for basic and clinical research. This study aimed to culture and identify NPC organoids using NPC biopsy and resected tissues.
Methods
Fifteen fresh nasopharygeal cancer tissue samples (diagnosed by pathology)were collected from NanFang hospital for 3D culture from June 2018 to December 2019. NPC organoids were collected, fixed with 10% formalin, embedded in paraffin, sectioned, and stained with hematoxylin and eosin. The expression of CD133/CD44/CD47/BMI-1/EBER were detected by immunohistochemistry and in situ hybridization.
Results
1.Successful establishment of nasopharyngeal carcinoma organoid culture system. A total of 50 NPC samples were collected, and 29 organoids were successfully cultured, with a success rate of 58%. There were 16 primary NPC organoids and 13 recurrent NPC organoids. The success rate of culture of primary and recurrent NPC organoids was 47.06% and 81.25%, respectively. The success rate of culture was mainly related to tissue quality and size, specimen pollution, etc. (P= 0.002). 2. The 3D cultures were identified as NPC organoids. The pathological characteristics of HE staining of 3D NPC cultures were consistent with those of parental tumor tissues, which had typical nuclear atypia. The markers, CD133/CD44/CD47/BMI-1 and EBER, were all positivelv expressed in both 3D cultures and parent tumor tissues.
Conclusions
We have successfully established a NPC organoid model which provides a good reference for future study of the molecular mechanism of NPC.
Legal entity responsible for the study
Li Gang.
Funding
Nanfang Hospital.
Disclosure
All authors have declared no conflicts of interest.