e-Poster Display Session (ID 87) Poster Display

YO9 - Prolonged survival of HER2-positive proximal esophageal adenocarcinoma (ID 652)

Presentation Number
YO9
Lecture Time
09:00 - 09:00
Speakers
  • Erick F. Saldanha (Sao Paulo, Brazil)
Location
On-Demand e-Poster Display, Virtual Meeting, Virtual Meeting, Singapore
Date
20.11.2020
Time
09:00 - 20:00

Abstract

Case summary

Esophageal adenocarcinoma (EAC) is a poor prognostic disease, the 5-year survival rate for people with esophageal cancer is 20%. According to the current literature, the rate of HER2 positivity in EAC varies, ranging from 15 to 29%. Currently there is no data about the incidence rates of HER2-positive proximal EAC.

76-year old man presented in 2015 to our hospital, ECOG 1, with loss of weight and dysphagia. His Medical history was significant for primary hypertension and benign prostate hyperplasia. He was an active Smoker (30 pack-years) and Alcoholic. Denied family history for neoplasm.

Initial staging with upper gastroinstestinal (UGI) endoscopy shows a circumferential, friable, ulcerated and infiltrative lesion that is 19 cm from the ADS and extends up to 26 cm. CT showed thickening of the middle and proximal esophagus with regional lymph node enlargement. Presence of distant metastases was not detected.

Histopathological findings showed Proximal esophagus moderately differentiated, ulcerated and invasive adenocarcinoma. Immunohistochemical (IHC) analysis showed HER2 3+, CK7 positive, CK20 positive, CDX2 positive and GATA-3 negative.

At the time given the lack of accurate data on anti HER2 therapy for EAC, the sistemic chemotherapy (CT) chosen was carboplatin plus Paclitaxel. After 5 months he presented local progression. We chose Folfox as next line CT and after that local Radiotherapy. Follow up with CT Scans and UGI endoscopy.

After 4 years of stable disease patient presented to our hospital with odinophagy, increased esophageal lesion and loss of weight. we proposed modified FOLFOX (mFOLFOX) with dose reduction 5-FU and oxaliplatin. After 2 cycles of mFOLFOX the patient is currently presenting good clinical response.

Overexpression and amplification of HER2 is generally correlated with worse prognosis in solid malignancies. The impact of HER2 overexpression on EAC are conflicting, since studies do not differ EAC from gastric cancer and esophageal.

Recent studies shows negative results with adding Trastuzumab to standard of care. Despite that HER 2 remains an important target. Precision oncology is currently working on trials to access different ways to access these biomarkers.

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e-Poster Display Session (ID 87) Poster Display

157P - Efficacy and safety of penpulimab (AK105), a new generation anti-programmed cell death-1 (PD-1) antibody, in upper gastrointestinal cancers (ID 687)

Presentation Number
157P
Lecture Time
09:00 - 09:00
Speakers
  • Amy Prawira (Sydney, Ontario, Australia)
Location
On-Demand e-Poster Display, Virtual Meeting, Virtual Meeting, Singapore
Date
20.11.2020
Time
09:00 - 20:00

Abstract

Background

Upper gastrointestinal (UGI) cancers are a group of highly aggressive malignancies with poor prognoses. Immunotherapy is emerging as an effective treatment option for some of these cancers. Penpulimab, a new generation anti-PD-1 monoclonal antibody, was engineered to optimize receptor occupancy by improving duration of drug binding, and to eliminate Fc-mediated effector function that compromises anti-tumor immune cell function. Here, we present the preliminary antitumor and safety data on Penpulimab in patients (pts) with advanced UGI malignancies.

Methods

Pts with advanced cancers, relapsed or refractory to standard therapy but naïve to immune checkpoint inhibitors (ICIs), were enrolled in two phase I trials of Penpulimab (NCT03352531 and NCT04172506). Pts received Penpulimab IV at 1-10 mg/kg Q2W or 200mg Q2W until disease progression or unacceptable toxicity. Antitumor activity was investigator-assessed per RECIST v1.1 criteria.

Results

As of 1st July 2020, 67 pts with UGI cancers received Penpulimab for a median of 6 (1–64) doses. The antitumor activity of Penpulimab in the 60 pts evaluable for efficacy is shown below. 11/13 (85%) responders had ongoing responses at data cutoff date.

Pancreatic cancer (PCA), n=9 Cholangiocarcinoma (CCA), n=9 Gastric/ gastroesophageal junction (GEJ) cancer, n=19 Hepatocellular carcinoma, (HCC), n=23
ORR, % (95% CI) 11.1 [0.3, 48.2] 22.2 [2.8, 60.0] 26.3 [9.1, 51.2] 21.7 [7.5, 43.7]
DCR, % (95% CI) 33.3 [7.5, 70.1] 44.4 [13.7, 78.8] 42.1 [20.3, 66.5] 52.2 [30.6, 73.2]
Median DoR, months (range) 22.1+ 21.1 [0.03+, 21.1] NR [3.7+, 14.8+] NR [3.7+, 23.0+]
.

Treatment-related adverse events (TRAEs) occurred in 44.8% of pts. There were no discontinuations due to drug-related AEs or drug-related deaths. Grade ≥3 TRAEs occurred in 5 pts (7.5%) – raised liver enzymes (n=2), adrenal insufficiency (n=1) and hyponatraemia (n=1) in the same pt, intestinal obstruction (n=1), and hypertension (n=1).

Conclusions

Penpulimab was well tolerated and demonstrated encouraging antitumor activity with durable response in pts with advanced UGI cancers, including PCA and CCA, which are generally resistant to single agent ICI. Penpulimab in combination with anlotinib, a multi-targeted receptor tyrosine kinase inhibitor, is being evaluated in phase III studies for 1L HCC (NCT04344158) and 2L Gastric/GEJ (NCT04385550).

Clinical trial identification

NCT03352531; NCT04172506.

Legal entity responsible for the study

Akeso Biopharma Inc.

Funding

Akeso Biopharma Inc.

Disclosure

A.R.A. Mislang: Honoraria (self): BMS. A. Cooper: Honoraria (self): MSD; Travel/Accommodation/Expenses: Merck Sharp & Dohme; Travel/Accommodation/Expenses: Roche. X. Jin, K.Y. Kwek: Shareholder/Stockholder/Stock options, Full/Part-time employment: Akeso Biopharma. B. Li, M. Wang, D. Xia: Y. Xia: Shareholder/Stockholder/Stock options, Full/Part-time employment, Officer/Board of Directors: Akeso Biopharma. A. Prawira: Research grant/Funding (institution), Non-remunerated activity/ies: Akeso Biopharma; Research grant/Funding (institution), Non-remunerated activity/ies: Beigene; Research grant/Funding (institution), Non-remunerated activity/ies: Corvus; Research grant/Funding (institution), Non-remunerated activity/ies: CStone; Research grant/Funding (institution), Non-remunerated activity/ies: Macrogenics; Research grant/Funding (institution), Non-remunerated activity/ies: Five Prime; Research grant/Funding (institution), Non-remunerated activity/ies: Virogin; Research grant/Funding (institution), Non-remunerated activity/ies: QBiotics; Research grant/Funding (institution): Arcusbio; Research grant/Funding (institution): Pfizer; Research grant/Funding (institution): Bayer; Research grant/Funding (institution): Roche/Genentech; Research grant/Funding (institution): BMS; Research grant/Funding (institution): Apollomics; Research grant/Funding (institution): ENB Therapeutics; Research grant/Funding (institution): Henlius; Research grant/Funding (institution): Eli Lilly; Research grant/Funding (institution): INXMed; Research grant/Funding (institution): Merck/MSD; Research grant/Funding (institution): Janssen. All other authors have declared no conflicts of interest.

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e-Poster Display Session (ID 87) Poster Display

145P - A nomogram for predicting the benefit of adjuvant chemotherapy after resection in patients with Borrmann type IV gastric cancer (ID 709)

Presentation Number
145P
Lecture Time
09:00 - 09:00
Speakers
  • Qing-Zhu Qiu (Fuzhou, China)
Location
On-Demand e-Poster Display, Virtual Meeting, Virtual Meeting, Singapore
Date
20.11.2020
Time
09:00 - 20:00

Abstract

Background

This study sought to explore prognostic factors for patients with Borrmann type IV gastric cancer and to establish a predictive model for survival benefit of postoperative adjuvant chemotherapy in such patients.

Methods

This study reviewed the clinical data of patients who underwent curative surgery at Fujian Medical University Union Hospital from 2006 to 2014 for Borrmann type IV gastric cancer using a prospective database. Cox regression analyses were performed to identify prognostic factors that formed the basis for a nomogram and risk groups. Establishment of risk groups to identify patients with Borrmann type IV gastric cancer who would benefit from adjuvant chemotherapy.

Results

265 patients who underwent R0 resection were included in this study.Multivariate analysis showed that BMI, tumour differentiation, pT stage, pN stage, and ASA score were independent prognostic factors. Patients in the ACT-group had longer OS than patients in the SA-group, although the p-value for this difference was marginally above the threshold for statistical significance (23.8% vs. 10.9%, p=0.057). Stratified analysis showed that there was no significant difference in OS between the ACT-group and the SA-group for each AJCC stage (stage II: 40.6% vs. 29.8%, p=0.44; stage III: 21.4% vs. 9.7%, p=0.056).A nomogram was established based on these independent risk factors, and nomogram scores were used to divide all patients into a high-risk group (score>16), an intermediate-risk group (8<score≤16) and a low-risk group (score≤8).Further stratified analysis based on AJCC stage showed that the 3-year survival rate was higher in the adjuvant chemotherapy group than in the surgery alone group for low- and intermediate-risk patients in each AJCC stage, while high-risk patients in stage III did not significantly differ.

Conclusions

The nomogram that we established may effectively be used to identify patients with Borrmann type IV gastric cancer who would benefit from postoperative adjuvant chemotherapy. Postoperative adjuvant chemotherapy can improve survival in low- and intermediate-risk patients.

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.

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e-Poster Display Session (ID 87) Poster Display

183P - Textbook outcome as a measure of surgical quality assessment and prognosis in gastric neuroendocrine carcinoma: A large multicenter sample analysis (ID 736)

Presentation Number
183P
Lecture Time
09:00 - 09:00
Speakers
  • You-Xin Gao (Fuzhou, China)
Location
On-Demand e-Poster Display, Virtual Meeting, Virtual Meeting, Singapore
Date
20.11.2020
Time
09:00 - 20:00

Abstract

Background

Quality assurance is crucial for oncological surgical treatment assessment. For rare diseases, single-quality indicators are not enough. To develop a comprehensive and reproducible measurement, called the "Textbook Outcome” (TO), to assess the quality of surgical and prognosis of gastric neuroendocrine carcinoma (G-NEC) patients.

Methods

Data from patients with primary diagnosed gastric neuroendocrine neoplasms (G-NEN) included in the Study Group for Gastric Neuroendocrine Tumors (involving 24 high-volume Chinese hospitals, October 2005-September 2018) were analyzed. After applying the exclusion criteria, 860 G-NEC patients were included in this study. TO included receiving a curative resection, ≥15 lymph nodes (LNs) examined, no severe postoperative complication, hospital stay ≤21 days, and no hospital readmission ≤30 days after discharge. A Sankey plot displayed changes between TO and long-term survival. Hospital variation in TO was analyzed using a case mix-adjusted funnel plot. Prognostic factors for survival and risk factors for non-TO were analyzed using Cox and logistic regression analyses, respectively.

Results

TO was achieved in 56.6% of G-NEC patients. TO patients had better overall (OS), disease-free (DFS), and recurrence-free (RFS) survivals than non-TO patients (P <0.05). Sankey plot showed that the prognostic outcome of most TO patients flowed to alive (62.1%). Moreover, TO patients accounted for 60.3% of patients without recurrence. Multivariate Cox analysis revealed non-TO as an independent risk factor for OS, DFS, and RFS of G-NEC patients (P <0.05). Increasing TO rates were associated with improved OS for G-NEC patients, but not hospital volume. Multivariate logistic regression revealed that non-lower tumors, open surgery, and >200 ml blood loss were independent risk factors for non-TO patients (P <0.05).

Conclusions

TO is strongly associated with multicenter surgical quality and prognosis for G-NEC patients. Factors predicting non-TO are identified, which may help guide strategies to optimize G-NEC outcomes.

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.

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e-Poster Display Session (ID 87) Poster Display

331P - The clock stopped with COVID-19 but continued ticking for cancer patients (ID 766)

Presentation Number
331P
Lecture Time
09:00 - 09:00
Speakers
  • Sasi Shanmugam Senga (London, United Kingdom)
Location
On-Demand e-Poster Display, Virtual Meeting, Virtual Meeting, Singapore
Date
20.11.2020
Time
09:00 - 20:00

Abstract

Background

SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) has killed over five hundred thousand people and has infected over 13 million people across the world in over 200 countries. Cancer patients fall under the high-risk category and are susceptible to the SARS-CoV-2 infection given the need for frequent hospital visits.

Methods

In this study, I analysed data from 46 cancer patients who were affected with different types of cancers (Table) and continued to receive cytotoxic treatment between January 2020 till July 2020.

Summary of the types of cancer and the treatment regimen of the 46 patients

Type of cancer Number of patients Treatment regimen
Astrocytoma 1 Temodal + Bevacizumab
Breast 3 EC + T
Breast 8 EC + TC
Breast 4 EC + THP
Colorectal cancer 4 FOLFOX
Colorectal cancer 3 FOLFIRI
Colorectal cancer 1 FOLFOX + Bevacizumab
Ewing sarcoma 1 VCD/IE
Gastric cancer 4 FLOT
Gastric cancer 2 XELOX
Lung cancer 4 Docetaxel + Carboplatin
Lung cancer 1 Topotecan
Lung cancer 4 Etoposide + Carboplatin
Lung cancer 1 Docetaxel + Cisplatin
Osteosarcoma 1 OS99
Osteosarcoma 1 HD-MTX
Pancreatic cancer 2 FOLFIRINOX
Small bowel 1 FOLFOX

Results

All the 46 patients included in the study completed their cytotoxic regimen without developing SARS-CoV-2 infection between January till July 2020.

Conclusions

The results from the study led to the hypothesis that three factors which were common among the cancer patients included in the study namely, 1) the use of granulocyte colony-stimulating factor (G-CSF), 2) the use of dexamethasone and, 3) dysbiosis of microbiome among cancer patients might be potential reasons for evading the deadly SARS-CoV-2 infection, despite their compromised immune status and a high likelihood of repeated exposure during hospital visits in comparison to the healthy general population, who are less likely to visit hospitals during the pandemic. The study aims to provide an alternate perspective and instigate discussion over the continuation of providing cancer care amidst the pandemic.

Legal entity responsible for the study

The author.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.

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e-Poster Display Session (ID 87) Poster Display

261P - Clinical outcomes of early-progressed follicular lymphoma in Korea: A multicenter, retrospective analysis (ID 790)

Presentation Number
261P
Lecture Time
09:00 - 09:00
Speakers
  • Jun Ho Yi (Seoul, Korea, Republic of)
Location
On-Demand e-Poster Display, Virtual Meeting, Virtual Meeting, Singapore
Date
20.11.2020
Time
09:00 - 20:00

Abstract

Background

While the expected survival of patients with FL almost reaches that of the normal population, the outcomes of patients who experience early progression within 24 months, that is, POD24 is dismal. Unlike the West, FL is less frequent in Asia as it accounts about 10% of non-Hodgkin’s lymphoma. To define outcomes and treatment patterns FL patients who experienced POD24 in Korea, we performed a multicenter, retrospective analysis.

Methods

The inclusion criteria were as follows, 1) Histologically confirmed diagnosis of FL grade 1, 2, and 3A; 2) Documented POD24. The primary endpoint was OS from the first diagnosis of FL.

Results

Between 2007 to 2019, a total of 73 cases were eligible for analysis. Median age at diagnosis was 53 (range, 28 – 83). All patients were Asians. In terms of FLIPI-1 risk group, 14 (19.2%), 24 (32.9%), and 35 (47.9%) patients were categorized as low-, intermediate-, and high-risk group, respectively. Sixty-two patients (84.9%) had received rituximab as the induction treatment, and 11 patients (15.1%) had not. CVP was the most commonly used regimen (N=40), followed by CHOP (N = 26). Forty-four patients (60.3%) had received maintenance treatment with rituximab and 29 patients (39.7%) had not.

POD24 was documented after a median duration of 11.6 months. Rituximab wad administered in 19 patients, and platinum-based regimens (N = 23) were the most commonly used backbone treatment followed by bendamustine (N = 15) and fludarabine-based regimens (N = 12). PFS from the first progression was 23.7 months. The median OS was 128.9 mo, with the 5-year being 75.2%. OS did not significantly differ by the re-induction regimen, use of rituximab, or SCT.

When we compared these patients to our previous cohort in which 191 FL patients without POD24 were included, the 5-year survival rate was significantly inferior in the current cohort (75.2% vs. 95.7%, p < 0.001).

Conclusions

The 5-year OS rate of our patients with POD24 seems better than Western data, although there are many confounding factors including baseline FLIPI and the induction treatment. As expected, the 5-year OS rate of patient with POD24 was inferior to that of patients without POD24. To best salvage these patients, further studies are warranted to develop effective treatment.

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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e-Poster Display Session (ID 87) Poster Display

96P - Early-onset colorectal cancer prognosis, conflict resolution, review of literature and meta-analysis (ID 817)

Presentation Number
96P
Lecture Time
09:00 - 09:00
Speakers
  • Ereny S. Poles (Assiut, Egypt)
Location
On-Demand e-Poster Display, Virtual Meeting, Virtual Meeting, Singapore
Date
20.11.2020
Time
09:00 - 20:00

Abstract

Background

Early-onset colorectal cancer (EOCRC) is defined as colorectal cancer diagnosed in individuals younger than 50 years old. There is a concept that EOCRC is associated with a worse survival, while the data on literature is conflicting. Evaluation of the available data is highly needed to reach an evidence-based conclusion.

Methods

A systematic literature search was performed using Scopus (2015-2020), CENTRAL PubMed (2015-2020) for studies assessed prognosis of EOCRC in comparison with LOCRC using the relative 5-year survival (OS) as a surrogate for prognosis. Extracted information included: study identification, number of EOCRC and LOCRC patients, AJCC stage, and overall 5-year survival. Keywords and Mesh words used: prognosis, outcome, survival, young, early-onset, age of onset, colorectal cancer, rectal cancer, colon cancer. Statistical analysis was done using MedCalc Statistical Software for the meta-analysis.

Results

Meta-analysis for a total of 428554 LOCRC and 670030 EOCRC patients of the included 9 studies showed no statistically significant difference in male ( P= 0.19 ) or female ( P= 0.20 ) as regards the incidence EOCRC when compared to LOCRC. Younger adults were1.2 more likely to present with left-sided and rectal cancer ( OR;1.20, 95% CI, 0.18 to 7.86, P= 0.84 ) than older patients, while the right colon cancer was less presented by 79% in EOCRC patients (OR; 0.79, 95%CI, 0.05 to 11.13, P= 0.86). Stage I disease was statistically significant less diagnosed in EOROC than LOCRC patients ( P< 0.001, 95%CI, 0.31 to 0.70 ), while there were no statistically significant differences for stages II, III, and IV, ( P= 0.27, 95%CI, 0.03 to 2.58), ( P= 0.84, 95%CI, 0.03 to 4.57) and ( P= 0.70, 95%CI, 0.10 to 4.62 ) respectively. There was no difference in the 5 year OS between EOCRC and LOCRC patients ( P= 0.62, 95%CI, -0.004 to 0.002). Subgroup analysis based on the stage showed a better survival in EOCRC patients in all stage groups; ( P= 0.03, 95%CI,1.34 to 21.19) for stage I, (P, 0.001, 95%CI, 2.38 to 3.64) for stage II, (P< 0.001, 95%CI, 2.20 to 4.80) for stage III, and (P= 0.009, 95%CI, 1.62 to 28.79) for stage IV.

Conclusions

EOCRC patients had a similar 5-year OS when compared to LOCRC while had a better 5-year OS when corrected for the disease stage.

Legal entity responsible for the study

The authors.

Funding

Quality Control Unit, Faculty of Medicine, Assiut University.

Disclosure

All authors have declared no conflicts of interest.

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e-Poster Display Session (ID 87) Poster Display

38P - Evaluation of the prognostic value of innate immunity-related biomarkers in early breast cancer (BC) (ID 872)

Presentation Number
38P
Lecture Time
09:00 - 09:00
Speakers
  • Veronica Martini (Novara, Italy)
Location
On-Demand e-Poster Display, Virtual Meeting, Virtual Meeting, Singapore
Date
20.11.2020
Time
09:00 - 20:00

Abstract

Background

CD47 and SIRPα (signal-regulatory protein) are tumor biomarkers of innate immunity, expressed on cancer cells and tumor associated macrophages (TAMs); their interaction provides a “don’t eat me” signal that impairs phagocytosis. The relationship between CD47/SIRPα expression and BC aggressiveness has been investigated, however, its prognostic role is not clarified. With these premises, we have assessed the distribution and the possible prognostic value of CD47/SIRPα expression in early BC.

Methods

To verify our hypothesis, we first used in silico data from GOBO and GEPIA, two publicly available datasets: GOBO is a public repository containing microarray data (Affymetrix U133A) from 1881 early BC patients, with a median follow up of 120 months. GEPIA is a web server for analysing RNA expression data of tumours and normal samples from the TCGA and the GTEx projects, by a standard processing pipeline. Immunohistochemical (IHC) analyses were retrospectively performed on formalin-fixed paraffin embedded tissue (FFPE) samples in a cohort of 105 BC patients referred to our institution. The association between CD47 and SIRPα expression levels and outcome was evaluated using the χ2 test. Disease free survival (DFS) and overall survival (OS) were estimated by Kaplan-Meier life table method.

Results

In silico data showed that CD47 and SIRPα are preferentially expressed in triple negative (TN) BC, as compared to other BC subtypes (p< 0.0001). CD47 upregulation is associated to a worse OS only in Luminal A BC (GOBO p<0.001, n= 189 patients). By IHC analysis in our retrospective series, CD47 was overexpressed in 80% of TNBC and in 56% of Luminal BC samples. Of note, SIRPα was expressed in 20% of TAMs and in 50% of TN BC samples.

Conclusions

Biomarkers of innate immunity are represented but differently expressed in the different BC subtypes; IHC analyses are ongoing to consolidate this result and to assess their prognostic role in our patient cohort. Final analyses will be presented.

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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e-Poster Display Session (ID 87) Poster Display

151P - Treatment patterns, healthcare resource use, economic and survival outcomes associated with unresectable advanced metastatic gastric cancers in Taiwan (ID 902)

Presentation Number
151P
Lecture Time
09:00 - 09:00
Speakers
  • Chee Jen Chang (Taoyuan City, Taiwan)
Location
On-Demand e-Poster Display, Virtual Meeting, Virtual Meeting, Singapore
Date
20.11.2020
Time
09:00 - 20:00

Abstract

Background

Gastric cancer (GC) is the fourth leading cause of cancer-related deaths in Taiwan. Even with significant strides that have been made in GC early detection and management in Taiwan in recent years, patients with GC (including gastro-esophageal junction cancer, GEJC) that present with unresectable advanced metastatic disease (UAM) remain at risk for poor survival outcomes.

Methods

This was a retrospective ‘real world’ observational study using the linked Taiwan National Health Insurance Research Database, which contains health claims data on almost the entire Taiwan population, and the Taiwan National Cancer Registry. Patients having at least one hospital record with a primary ICD-9 or ICD-10 code of GC/GEJC were selected from Jan 1st, 2013 through Dec 31st, 2018. The first date of GC/GEJC diagnosis was defined as the index date. Patients were followed for a minimum ± 30 days from the index date and were stratified by staging, clinical presentation [i.e. resectable vs. unresectable advanced metastatic (UAM)]. Key characteristics such as demographics, clinical parameters, medication utilization, health care resource utilization, costs incurred, and survival were tracked for the overall population and both cohorts.

Results

A total of 3736 UAM GC patients were identified with a mean age of 68.0 (sd=15.2) years, with most patients being male (n=2248, 60.2%). The majority of UAM GC patients were Stage 4 (n=2270, 60.8%) and most patients were identified as having adenocarcinoma (n=2847, 76.2%). Nearly half the patients received 1st line (1L) therapy (n=1846, 49.4%) with the most common 1L therapies being Capecitabine + Oxaliplatin (n=604, 32.7% of 1L), S-1 (n=280, 15.2% of 1L) and Capecitabine monotherapy (n=209, 11.3% of 1L). Only 38.2% (n=1428) of patients survived 1 year with the annualized post-index GC-related costs being New Taiwan (NT) $ 396,590 (sd = NT$ 412,523).

Conclusions

The most common 1L chemotherapeutic treatments for UAM GC patients were Capecitabine + Oxaliplatin, S-1 and Capecitabine. In Taiwan, UAM GC patients appear to have poor survival and incur high GC-related costs, which suggests the need for new treatment options.

Legal entity responsible for the study

Bristol-Myers Squibb Pharmaceuticals Corp.

Funding

Bristol-Myers Squibb Pharmaceuticals Corp.

Disclosure

C.J. Chang, Y. Tsai, H.S. Friedman, P. Navaratnam: Research grant/Funding (self): Bristol-Myers Squibb. J. Gricar, H. Xiao: Shareholder/Stockholder/Stock options, Full/Part-time employment: Bristol-Myers Squibb.

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e-Poster Display Session (ID 87) Poster Display

253P - Non-Epithelial Tumours of Ovary, An Experience from Qatar (ID 936)

Presentation Number
253P
Lecture Time
09:00 - 09:00
Speakers
  • Ammar Madani (Doha, Qatar)
Location
On-Demand e-Poster Display, Virtual Meeting, Virtual Meeting, Singapore
Date
20.11.2020
Time
09:00 - 20:00

Abstract

Background

Nonepithelial ovarian cancers constitute about 10 % of all ovarian cancers. They are divided into sex-cord stromal tumours (SCST) and germ cell tumours (GCT). The Aim is to report the experience at National Centre for Cancer Care and Research (NCCCR) in Qatar.

Methods

This is a retrospective study reviewing records of all patients who presented with a histopathologically diagnosed ovarian SCST and GCT at NCCCR between January 2010 and December 2016. Clinical data including age, stage at diagnosis, histopathology, treatment modalities, disease recurrence and status at last follow up was extracted.

Results

A Total of 25 women with Non Epithelial Ovarian Tumours were identified. 13 women were diagnosed with Ovarian SCST. 12 had granulosa cell tumour , 1 with steroid cell tumour and none of them had Sertoli-Leydig cell tumor. Median age at presentation was 43 years (Range 16-58). 12 patients (92 %) had stage I and 1 patient (8 %) had Stage III. 9 patients had TAH + BSO . 4 patients had conservative surgery without hysterectomy. 2 patients received Adjuvant chemotherapy .4 patients had recurrence. The 5 years Overall Survival (OS) was 100% and the 5 years Event Free Survival (EFS) was 69% with P value of 0.02.

GCT was diagnosed in 12 women. The median age at presentation was 24 years (Range 16 – 44). 7 patients (59 %) had teratoma, 4 patients (33 %) had Dysgerminoma and 1 patient had Yolk sac tumour (8 %). 9 patients ( 75 % ) had Stage 1, 2 patients had Stage 2 ( 17 % ) and 1 patient ( 8 % ) had Stage 4 disease .6 patients ( 50 % ) underwent U/L Oopherectomy .5 patients ( 42 % ) underwent U/L salpingoOopherctomy and Chemotherapy( BEP ) .1 pt. ( 8 % ) with Stage IV disease received only chemotherapy. There was 1 recurrence in the Retroperitoneal LNs in patient with Stage 2 disease. 5 years OS was 100 % and 5 years EFS was 83 % with P value of 0.14.

Conclusions

Survival in our study of SCST was excellent with all patients alive and disease free at last follow up. We recommend Complete Surgery (TAH + BSO) particularly if high grade, Stage 1C and above or completed child bearing to minimize recurrence.

GCTs have very good prognosis in all stages and even in recurrence. Fertility Sparing Surgery is appropriate for all patients with Stage 1 and most of patients with Stage 2 disease who desire fertility preservation.

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e-Poster Display Session (ID 87) Poster Display

137P - Clinical utility of circulating tumour DNA (ctDNA) in resectable gastric cancer (GC) (ID 974)

Presentation Number
137P
Lecture Time
09:00 - 09:00
Speakers
  • Mikhail Fedyanin (Moscow, Russian Federation)
Location
On-Demand e-Poster Display, Virtual Meeting, Virtual Meeting, Singapore
Date
20.11.2020
Time
09:00 - 20:00

Abstract

Background

Circulating tumor DNA (CtDNA) has shown its negative prognostic value in a number of studies, however, data on the role of ctDNA in resectable gastric cancer (GC) are lacking. The aim of our study was to determine the prognostic value of ctDNA at various stages of the disease using our simple and cheap test.

Methods

This prospective study included patients with diagnosis of GC who received treatment from 2017 to 2019. Tumor somatic mutations were determined by target sequencing of DNA from FFPE tumor blocks. Sequencing was performed using the custom NGS panel covering regions of frequent somatic mutations in 50 genes. Tumor-specific mutations were monitored by ddPCR in plasma samples taken before and after surgery in case of resectable GC (n=42) and before and during chemotherapy in case of advanced GC (n=13). The median time between surgery and blood sampling was 7 days (5-15 days, σ 2.3). The plasma sample was considered "positive” if the content of ctDNA was more than 0.5 copies of mutant DNA in ml plasma.

Results

Tumor-derived mutations were found in plasma with sensitivity of 74.5% (n=55): in stage IV (n=13) – 92.3%, stage III (n=24) – 70.8%, stage II (n=11) – 81.8% and in stage I (n=7) – 100%. In the group with resectable GC 24 (57.1%) pts received adjuvant or perioperative chemotherapy. Detection of ctDNA before surgery did not affect DFS (HR 0.7, 95%CI 0.04-11.5, p=0.8). In 10 (23.8%) cases ctDNA was determined after surgery. Progression of the disease was detected in 6/10 (50%) pts with ctDNA(+) and 6/32 (18.8%) - in ctDNA(-) pts (p = 0.012). One-year DFS in ctDNA(+) and ctDNA(-) pts with resectable GC after surgery were 25.4% and 73.2%, respectively. ctDNA positivity after surgery was an independent negative prognostic factor according to Cox regression model fitted to T, N, and adjuvant chemotherapy (HR 6.6, 95%CI 1.5-30, p =0.014).

Conclusions

A robust and economical assay of ctDNA detection is sensitive and demonstrates the prognostic significance of ctDNA persisting after surgery in pts with the early stage of the GC. Further clinical validation of this approach is required in trails with modifications of the perioperative treatment, in terms of escalation and de-escalation, according to the content of ctDNA.

Legal entity responsible for the study

The authors.

Funding

This research is conducted under the auspices of the experimental governmental assignment of the Ministry of Health of the Russian Federation and coordinated by the FSBI “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Ministry of Health of the Russian Federation.

Disclosure

All authors have declared no conflicts of interest.

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e-Poster Display Session (ID 87) Poster Display

418P - All EGFR mutations are (not) created equal: Focus on uncommon EGFR mutations (ID 995)

Presentation Number
418P
Lecture Time
09:00 - 09:00
Speakers
  • Ullas Batra (New Delhi, Rohini, India)
Location
On-Demand e-Poster Display, Virtual Meeting, Virtual Meeting, Singapore
Date
20.11.2020
Time
09:00 - 20:00

Abstract

Background

The treatment of NSCLC has changed drastically in the last decade since the discovery of biomarkers like EGFR, ALK, ROS etc. Most common EGFR mutations in NSCLC include del19 and exon 21 L858R mutations. However, approximately 10% of NSCLC patients have uncommon EGFR mutations (complex indels undetected by single gene testing, missense mutations involving G719, L861, & S768 codons, and exon 20 insertions) which do not respond as well to TKIs. Thus, it is very important to understand type of EGFR mutations in clinical practice. This retrospective study reviews prevalence of these mutations in an Indian NSCLC cohort along with the clinicopathologic characteristics.

Methods

A total of 470 EGFR mutated NSCLC were analyzed. Of these, cases harboring uncommon EGFR mutations (n=49), were reviewed retrospectively, for clinicopathologic features. This study was approved by ethics committee of the institute.

Results

Of the 470 cases, 49 (10.42%) were found to have uncommon EGFR mutations. The median age was 66 years (35-87years). Almost equal sex predilection with 25 (51%) males and 24 (49%) females. Among these, 39 (79.6%) were never smokers, 7 (14.3%) smokers. Intrathoracic metastases in form of lung-lung spread were noted in 20 patients (40.8%); lung-pleura in 38 (77.6%) patients. Extrathoracic metastases noted include brain (n=18, 36.7%), liver (n=14, 28.6%), bone (n=25, 51%), &adrenals (n=4, 8.2%). Thirteen cases had dual mutations in EGFR including L861Q and G719X in 3 patients, G719X and S768I in 1 patient, L858R and S768I in 1 patient, del19 and L8585R in 1 patient and additional T790M with del 19 and L858R in 4 and 2 patients respectively. The mutation profile of patients with single mutations included 4 cases of L861, 5 cases of S768,8 cases of G719, 1 case of exon 18 insertion and 14 cases of exon 20 insertion. Patients with L861Q were males (p<0.047) and never smokers (p<0.018). Exon 20 insertions were more common in females (p<0.024). Nine patients received TKI treatment; Seven were treated with afatinib and two with osimertinib (one patient had T790M mutation, the other had S768I mutation).

Conclusions

Rare and dual EGFR mutations are a heterogeneous group with distinct clinical features. This study highlights the same in an Indian cohort of EGFR mutated NSCLC.

Legal entity responsible for the study

Ullas Batra.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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