Overal Survival Research Articles

The effect of albumin to alkaline phosphatase ratio on survival in patients with metastatic bone sarcomas

Objective: To investigate the effect of albumin to alkaline phosphatase ratio (AALPR) at survival in patients with metastatic bone sarcomas.
 Patients and Methods: 60 patients with metastatic bone sarcomas were included in the study. The relationship between AALPR before chemotherapy and overal survival (OS) and progression free survival (PFS) was evaluated with Cox regression multivariate analysis.
 Results: Of the patients in the study, 25 (58.3%) were osteosarcoma, 16 (26.7%) Ewing's sarcoma, 5 (8.3%) chondrosarcoma and 4 (6.7%) giant cell bone tumor. AALPR was 0.039 obtained in ROC analysis. The median PFS and OS at AALPR ≥ 0.039 group was statistically significantly higher than the group with

Expression and clinical significance of ECHS1 in gastric cancer.

Background: Gastric cancer (GC), as one of the most common malignant tumors and the 3rd primary cause of death by cancer globally, poses a great threat to public health. Despite many advancements have been achieved in current treatment avenues for GC, the 5-year survival rates of GC patients remain substandard. Short-chain enoyl-CoA hydratase (ECHS1) exerts pro- or anti-cancer activities in different cancer backgrounds. However, its clinical significance and biological role in GC remain vague and need further investigation. Methods: The expression of ECHS1 in GC tumors and adjacent normal tissues was examined using the GEPIA platform and clinical samples. The effects of ECHS1 on GC cell proliferation and migration were evaluated using colony formation and transwell migration assays. Results: ECHS1 was upregulated in GC tumor tissues in both mRNA and protein levels and increased ECHS1 was markedly linked with tumor location, depth of tumor invasion, lymph node metastasis (LNM), and tumor-node-metastasis (TNM) stage of GC patients. High ECHS1 expression was also linked with a shorter overal survival (OS), first progression (FP) and post progression survival (PPS). Further subgroup analysis showed that OS was significantly shorter in GC patients with high ECHS1 expression compared to those with low ECHS1 expression belonging to tumors with T3 stage, N2 stage or in instestinal Lauren subgroup. In addition, cytological experiments showed that there was higher ECHS1 expression in GC cell lines compared to the normal gastric epithelium (GES-1) cells, and ECHS1 can promote GC cell proliferation and migration in vitro. Conclusion: ECHS1 plays an oncogenic role in GC and might be a promising therapeutic target for GC.

Efficacy and safety of mFOLFOX6 with apatinib as postoperative adjuvant chemotherapy in stage IIIB or IIIC colorectal cancer.

3613 Background: Antiangiogenic therapy has shown benefit in metastatic colorectal cancer. However, the role of apatinib in adjuvant treatment of stage IIIB and IIIC colorectal cancer remains unclear. Methods: Patients received modified FOLFOX6 once every 2 weeks for a 6-month period (control group) or modified FOLFOX6 for 6 months plus apatinib (500mg) once a day for a 12-month period (experimental group). Progression free survival (PFS), overal survival (OS) and treatment-related adverse events were evaluated in two groups. Results: 63 patients have been enrolled in this study. This trial reported a 3-year PFS of 74.2% for modified FOLFOX6 plus apatinib vs. 61.5% for modified FOLFOX6 ( P< 0.05). 5-year OS was significantly improved in the experimental group compared with the control group (86.3% vs. 72.5%; P< 0.05). The most common grade 3 adverse events were hypertension and hand–foot syndrome. No treatment-related grade 4 adverse events or treatment-related deaths were observed. Conclusions: Apatinib can prolong PFS and OS when added to adjuvant chemotherapy in resected stage IIIB and IIIC colorectal cancer. The toxicities associated with apatinib were generally acceptable. Clinical trial information: NCT03365765 .

The Role of Lymph Node Ratio in Predicting Survival in Patients with Esophageal Squamous Cell Carcinoma

Background: This study aimed to evaluate the role of lymph node ratio (LNR) in the prediction of Overal Survival (OS) of patients with Esophageal Squamous Cell Carcinoma (ESCC). Methods: Patients with ESCC who underwent radical esophagectomy and radical lymph node dissection were entered into the study. The survival rate of patients was determined using the Kaplan–Meier estimator. Also, the effect of LNR and other variables on the OS of patients was assessed applying COX proportional hazards regression model. Based on its mean, LNR was divided into two groups of ≤0.25 and >0.25. Results: In total, 116 patients were entered into the study. The univariate and multivariate analyses showed that LNR was an independent prognostic factor for the prediction of the OS of patients with ESCC. An increase of LNR more than 0.25 led to an increase in the mortality risk by 1.57 times. Also, the five-year survival of patients was 26% with LNR≤0.25 and 5% with LNR>0.25. Conclusion: LNR can be used as an independent prognostic factor in determining and predicting the OS of patients with ESCC. There was a relationship between the increase of this factor and the worsening of patients’ OS.

The role of metformin in the treatment of non-small cell lung cancer

Out of the all newly diagnosed lung cancers, non-small cell lung carcinoma (NSCLC) comprises 80-85%. When treating advanced stages of the disease, conventional therapy shows poor results, which implies that there is a need for new drugs that will improve the response to current therapy. Metformin, drug used to threat Diabetes mellitus showed promising results in preclinical and retrospective clinical studies. We have analyzed prospective clinical trials investigating the combined effect of conventional therapy and metformin in treating lung cancer, as well as preclinical studies investigating its possible mechanisms of action published in PubMed database in the last 10 years. Several studies indicated that combination therapy with metformin led to the improvement in categories like overal survival (OS) and progression-free survival (PFS). However, the number of studies is limited and is characterized by a low number of subjects, as well as by a reduced compliance in subjects using metformin. Preclinical studies suggest cytotoxic effects of metformin, activation of apoptosis, as well as synergistic effect with chemotherapeutics, radiotherapy and biological agents used. The relevance of determined results is questionable, taking into account high metformin concentrations used in vitro. Based on the clinical studies published in the last ten years, there is insufficient data to conclude whether metformin improves prognostic factors in comparison to the conventional therapy. It is also not clear which mechanisms are responsible for possible beneficial effects of metformin. Future preclinical studies thus have to be better designed in order to increase their translational potential, while clinical studies have to be better controlled with improved selection and higher number of subjects enrolled.

Abstract LB112: SAMHD1: A new Prognostic Marker in Breast Cancer (BC)

Abstract Introduction SAMHD1 is a triphosphohydrolase that catalyzes the degradation of deoxynucleoside triphosphates (dNTP), and its function is tightly linked to cell cycle progression and proliferation. SAMHD1 has been also related to the replication stress response, preventing chronic inflammation. Here, we explore the potential rol of SAMHD1 expression in metastatic breast cancer (MBC) Matherial and Methods SAMHD1 effect on cell differentiation and proliferation, efficacy of capecitabine and gemcitabine and sensitivity to DNA damaging agents was evaluated in vitro, using breast cancer cell lines modified to express or not SAMHD1. In patients, a cohort of capecitabine-treated MBC (n=46) patients were retrospectively selected to evaluate SAMHD1 expression by immunohistochemistry (anti-SAMHD1 polyclonal antibody 12586-1-AP, Proteintech) on tissue microarrays from primary tumour or metastasis. 28% of patients were diagnosed with metastàtic disease, 35% relapsed inthe first 5 years, and 37% after 5 years of follow up. Median time to progresion (TTP) to capecitabine in MBC cohort was 13 months (m) and median overal survival (OS) was 28.8 m. SAMHD1 positivity was defined as cellular positivity ≥1%. SAMHD1 gene was also sequenced from tumor biopsies in a subgroup of patients with none (n=10) or high (n=10) expression of the protein, to identify somatic mutations. Statistical analysis was performed using Chi-square test for qualitative covariables, Kaplan-Meier survival curves and log Rank function, considering a p < 0.05 as statistically significant. Results SAMHD1 knock-out cells showed higher sensitivity to carboplatin-induced cell death. Interestingly, in patients SAMHD1 positivity was strongly associated with ki67 >15% (Chi-Square test; p<0.001). and high grade of proliferation (Chi-Square test; p=.004). SAMHD1 positivity was associated with patients diagnosed with metastasic disease and those who presented early relapse (dissease free survival (DFS) ≤ 5 years) (Chi-Square test; p=.005). In multivariate analysis for DFS including ki67, histological Grade, and SAMHD1; SAMHD1 and ki 67 were the most important factors, being SAMHD1 the most significant. Interestingly, a higher proportion of gene mutations was found in sequences from SAMHD1 null patients. SAMHD1 positivity was also associated with worst OS from BC diagnosis (Chi-Square test; p=.001), and with worst OS from the diagnosis of metastàtic disease (Chi-Square test; p=.05). These diferences were mantained if we analyse diferent biological subgrups determined by inmunohistochemistry. SAMHD1 positivity was associated with worst overall response to Capecitabine (OR of 27% versus 52%; p=.001); and worst clinical benefit (CB of 44% versus 01%; p=.006). SAMHD1 positivity was not correlated with time to progression to capecitabine, but when we considered patients who progressed in the first six months of therapy with capecitabine; SAMHD1 positivity was associated with short TTP (p=.04). SAMHD1 positivity was also associated with worst 5 years OS from starting capecitabine (p=.014). Conclusions SAMHD1 expression may represent a new strong prognostic factor in breast cancer. Moreover, SAMHD1 expression modulates efficacy of capecitbine treatment both in vitro and in vivo. Thus, modulation of SAMHD1 function may constitute a promising target for the improvement of multiple cancer therapies. Citation Format: Mireia Margeli, Eudald Felip, Lucia Gutierrez Chamorro, Eva Riveira, Laura Layos, Teresa Moran, Margarita Romeo, Anna Matinez-Cardús, Ester Ballana. SAMHD1: A new Prognostic Marker in Breast Cancer (BC) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr LB112.

Pilot prospective study of Frailty and Functionality in routine clinical assessment in allogeneic hematopoietic cell transplantation.

A Frailty and Functionality evaluation for alloHCT was implemented using existing resources. We describe the implementation of this evaluation across all ages and at first consultation, and correlate results with posttransplant outcomes in 168 patients. The evaluation consists of: Clinical Frailty Scale (CFS), Instrumental Activities of Daily Living (IADL), grip strength (GS), timed up and go test (TUGT), self-rated health question (SRH), Single question of Falls, albumin and C-Reactive Protein (CRP) levels. Median time to perform the evaluation was 5-6 min. Median age was 58 years (range: 19-77) and median follow-up was 5.3 months. TUGT > 10 s (HR 2.92; p = 0.003), raised CRP (HR 4.40; p < 0.001), and hypoalbuminemia (HR 2.10; p = 0.043) were significant risk factors for worse overal survival (OS). CFS ≥ 3 (HR 3.11; p = 0.009), TUGT > 10 s (HR 3.47; p = 0.003), GS (HR 2.56; p = 0.029), SRH (<excellent) (HR 3.8 × 106; p < 0.001), elevated CRP (HR 11.8; p < 0.001), and hypoalbuminemia (HR 4.6; p < 0.001), were significant predictors for worsenon relapse mortality (NRM). On multivariable analysis, TUGT > 10 s and raised CRP were significant predictors for worse OS and NRM. SRH (<excellent) was a significant predictor for higher NRM. Frailty and Functionality can be assessed in routine clinical practice in alloHCT and may be predictive of short-term outcomes.

Fluconazole vs. voriconazole prophylaxis for prevention of invasive fungal infections post haploidentical stem cell transplant.

e19504 Background: IFIs are one of the most detrimental complications of profound and prolonged neutropenia post-allogeneic SCT. Prophylaxis with broad spectrum azole antifungals has become standard of care given favorable outcomes associated with their use in this setting. Nonetheless, the choice of antifungal agent varies between institutions due to absence of consensus guidelines in patients undergoing haploidentical SCT. Methods: Non-interventional retrospective study seeking to compare efficacy of fluconazole vs. voriconazole for prevention of IFI post haploidentical SCT for hematologic malignancies. SCT databases at two academic insitutions (one uses fluconazole and other uses voriconazole) were queried to identify patients who underwent allogeneic SCT from April 2012 until March 2018, and received prophlaxis with either voriconazole (group I) or fluconazole (group II). Patients with intent to start prophylaxis with fluconazole or voriconazole were included, even if antifungal agent was changed later. Primary endpoint was cumulative incidence of breakthrough IFIs (based on MSG criteria) on day +100 and +180. Fisher exact test was used to compare rates of breakthrough IFIs between two cohorts. Secondary endpoint was overal survival (OS). Kaplan Meiers analysis was performed to compare OS on day +180 and 1-year post SCT. Results: The cohort included 141 patients (group I: 75 and group II: 66). Percentage of patients who underwent transplant for leukemia was higher in group I compared to group II (77.3% vs. 56.1%, p &lt; 0.001). A haploidentical SCT was performed in 62.7% of patients in group I compared to 100% in group II (p &lt; 0.001). All patients received non-myeloablative conditioning. There was no statistically significant difference in rates of IFIs between two groups on day +100 (0% in I vs. 4.5% in II, p = 0.9) and +180 (1.4% vs. 4.6%, p = 0.2). A significant difference in OS was noted on day +180 and at 1-year in univariate analysis (Table). Conclusions: Our findings suggest that prophylactic use of either voriconazole or fluconazole after haploidentical SCT is associated with low rates of IFIs. However, survival data favored voriconazole over fluconazole. [Table: see text]

Abstract P3-08-58: Ratio of CD8 +/ FOXP3, number of FOXP3 + cells and the presence of PTEN labeling in tumor cells and association with survival in triple negative breast cancer

Abstract Introduction: Triple-negative mammary carcinomas (CMTN) correspond to about 15 to 20%, the subtype being more aggressive when compared to the others. The interaction between immune system cells and cancer plays a crucial role in tumor development and progression. However, it is still unclear whether the presence of CD8 cytotoxic lymphocytes provides any prognostic information in breast cancer. Objective: To evaluate the prognostic significance of tumor-associated FOXP3 regulatory T cells (Tregs) and CD8 cytotoxic T lymphocytes (CTLs) in invasive breast carcinomas Method: This is an observational, descriptive retrospective cohort study were evaluated 76 patients diagnosed with non metastatic (stages I, II and III) TNBC. A tissue microarray (TMA) was constructed containing two cores from each tumor block. The expression of CD4, CD8, FOXP3, CD20, CD68, CD163, PD-1, PD-L1, PTEN and phosphoSTAT1 was determined by immunohistochemistry in the TMA. Results: We observed that the inflammatory infiltrate in TNBC is enriched for M2 macrophages and T lymphocytes (CD4+, CD8+ and FOXP3+). In our sample, we observed better survival associated with a higher CD8 + (p = 0.054) and CD4 + (p = 0.082) cell counts, but with no statistical significance in both situations. However, when we analyzed the association of overal survival (OS) with the ratio between the number of CD8 + cells and FOXP3 + (p = 0.007) and CD4 + and FOXP3 + (p = 0.034) and CD4 (p = 0.058) cells, we found that a higher relative proportion of CD8 + or CD4 + lymphocytes in relation to lymphocytes FOXP3 + was associated with an increase in OS. Together, these data suggest that infiltration by T lymphocytes into the tumor microenvironment should exhibit antirumor activity and promote growth control and tumor progression, as opposed to events favoring immunosuppression (regulatory lymphocyte infiltration). The number of FOXP3+ cells and the presence of PTEN staining in tumor cells were associated with OS. Conclusion: We did not observe improvement in survival, with an increase in CD8 and CD4 alone, so we found an improvement in survival, the higher the ratio between CD8 / FOXP3 being statistically significant. The number of FOXP3+ cells and the presence of PTEN staining in tumor cells were associated with OS. Citation Format: Monique C Tavares, Geraldine E Lima, Cristina D Sampaio, Victor P Andrande, Daniel G Gonçalves, Mariana P Macedo, Vladmir C Lima. Ratio of CD8 +/ FOXP3, number of FOXP3 + cells and the presence of PTEN labeling in tumor cells and association with survival in triple negative breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P3-08-58.

Outcomes of patients with limited-stage aggressive large B-cell lymphoma with high-risk cytogenetics

AbstractThere is a paucity of data regarding outcomes and response to standard therapy in patients with limited-stage (LS) agressive B-cell lymphoma (LS-ABCL) who harbor MYC rearrangement (MYC-R) with or without BCL2 and/or BCL6 rearrangements. We conducted a multicenter retrospective study of MYC-R LS-ABCL patients who received either rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), or more intensive immunochemotherapy (IIC) plus or minus consolidative involved-field radiation therapy (IFRT). One hundred four patients from 15 academic centers were included. Forty four patients (42%) received R-CHOP, of whom 52% had IFRT. Sixty patients (58%) received IIC, of whom 40% had IFRT. Overall response rate was 91% (84% complete response [CR]; 7% partial response). Patients with double-hit lymphoma (DHL; n = 40) had a lower CR rate compared with patients with MYC-R only (75% vs 98%; P = .003). CR rate was higher in the IFRT vs no-IFRT group (98% vs 72%; P < .001). Median follow-up was 3.2 years; 2-year progression-free survival (PFS) and overal survival (OS) were 78% and 86% for the entire cohort, and 74% and 81% for the DHL patients, respectively. PFS and OS were similar across treatment groups (IFRT vs no IFRT, R-CHOP vs IIC) in the entire cohort and in DHL patients. Our data provide a historical benchmark for MYC-R LS-ABCL and LS-DHL patients and show that outcomes for this population may be better than previously recognized. There was no benefit of using IIC over R-CHOP in patients with MYC-R LS-ABCL and LS-DHL.

Clinical Analysis of the Predictors for Intravesical Recurrence After Laparoscopic Radical Nephroureterectomy in Japanese Patients

Objectives: In this study, we evaluate the clinicopathological independent prognostic factors which to predict IVR in patients who underwent Laparoscopic-assisted radical nephroureterectomy (LRNU) for upper urinary tract carcinoma (UTUC). Methods: Between April 2008 to February 2019, we analyzed 100 japanese patients who were underwent LRNU and 92 patients who were underwent open radical nephroureterectomy (ORNU) at our institutions by retrospectively. The Patients characteristics factors, the clinicopathologic factors were collected. The intravesical recurrence free survival (IVRFS) were analyzed using the Kaplan-Meier method and Univariate and multivariate method by using the Cox proportional hazards regression models were performed to identify independent risk factors for IVR after LRNU. Results: In LRNU group, IVR was observed in 39 cases (39%), and it was not significant difference compare with ORNU (P: 0.36). Tumor location (P=0.002), Tumor size (P=0.001), preoperative urine cytology (P<0.0001), the pneumoperitoneum time (P: 0.0005) and adjuvant chemotherapy (P=0.019) showed significant association with postoperative IVR. In the multivariate Cox hazard models, the tumor location (P=0.0003), positive preoperative urinary cytology (P=0.003), and absence of adjuvant chemotherapy (P=0.003) were independent risk factors for subsequent IVR. There were not associated with smoking, Brinkman index, hydronephrosis and ureterorenoscopy before RNU for IVR. Overal survival (OS) was not significant association for experience IVR (P=0.15). Conclusion: In this study, LRNU was not shown to have a significantly higher IVR compared to ORNU. Patients with ureteral cancer and positive preoperative urinary cytology had a higher risk of IVR after LRNU. The adjuvant chemotherapy was significantly decreased the risk for postoperative IVR.

ERG expression can predict the outcome of docetaxel combinedwith androgen deprivation therapy in metastatic hormone-sensitiveprostate cancer

BackgroundOur study aimed to analyze the potential association between clinical parameters and ERG expression and the outcome of docetaxel chemotherapy among patients with metastatic hormone-sensitive prostate cancer. Patients and MethodsFifty-five patients with metastatic hormone-sensitive prostate cancer were treated with docetaxel in addition to androgen deprivation therapy. Patient characteristics, clinical factors, and tumor expression of ERG by immunohistochemistry were analyzed with respect to therapeutic response and survival data. ResultsRelapse free survival (RFS) and overal survival (OS) were 10.5 and 40.4 months, respectively, and both correlated with PSA response (RFS: 16.8 with a ≥50% decrease in PSA vs. 5.9 months in the case of <50% decrease, P < 0.001; OS: 40.4 vs. 11.6 months, respectively, P < 0.001). There was an association between OS and early progression (OS: 40.4 months with progression after 12 months vs. 17.9 months with progression within 12 months, P = 0.009). ERG expression was detected in 21 (42%) samples. ERG positivity was associated with favorable RFS (ERG pos. vs. neg.: 26.0 vs. 11.4 months, P = 0.003). ConclusionERG expression may have a potential predictive value with respect to the effectiveness and outcome of docetaxel chemotherapy combined with androgen deprivation therapy.

First-line continual EGFR-TKI plus local ablative therapy demonstrated survival benefit in EGFR-mutant NSCLC patients with oligoprogressive disease.

Introduction: The effect of local ablative therapy (LAT) for oligoprogressive epidermal growth factor receptor (EGFR) mutation non-small cell lung cancer (NSCLC) remains undetermined. This study aimed to investigate the survival benefit of addition of LAT to EGFR-TKIs in EGFR-mutant NSCLC patients with oligoprogression during TKI therapy.Materials and Methods: Patients with stage IIIB/IV EGFR mutant NSCLC who had oligoprogressive disease during the first-line EGFR-TKI therapy from March 2011 to February 2016 were identified. The primary research point were progression-free survival1 (PFS1), defined as time of initiation of TKI therapy to Response Evaluation Criteria in Solid Tumours (RECIST) 1.1 defined progress disease (PD) or death and PFS2, defined as time of initiation of TKI therapy to off-TKI PD. The second research piont inclued overal survival (OS) and safety.Results: A total of 206 patients were included. The median follow-up time was 42 months (20.0-69.6 months). The median PFS1, median PFS2 and median OS for the related cohort were 10.7 months (95% CI, 10.1-13.3 months), 18.3 months (95% CI, 17.4-19.2 months) and 37.4 months (95% CI, 35.9-38.9 months) respectively. Survival rates of 1 year, 2 years and 3 years were 94.1%, 78.9%, and 54.7%, respectively. Multivariate analysis revealed that female, EGFR exon 19 mutation, one metastatic lesion, partial or complete response to prior EGFR TKIs therapy were the independent prognostic factors. No unexpected toxicities were observed.Conclusion: The current study suggested that the addition of LAT to EGFR-TKI could provide satisfactory survival benefit for EGFR-mutant NSCLC patients with oligoprogression during first-line EGFR-TKI treatment.

P2.15-22 Optimal Glycemic Control Improves Prognosis for Lung Cancer Patients with Diabetes Mellitus

Diabetes mellitus (DM) is a common comorbidity in patients with lung cancer (LC). This study aimed to evaluate the prognostic value of DM comorbidity for LC patients with DM and to assess whether an optimal glycemic control improves survival. A total of 4390 patients diagnosed with LC between 2012 and 2013 at Shanghai Chest Hospital were retrospectively reviewed, 491 patients with DM and 3899 without DM. The relationship between hemoglobin A1c (HbA1c) level and the overal survival (OS) was plotted by a smooth curve. LC patients with DM were subdivided into the well-controlled group (HbA1c < 7%, n=438) and uncontrolled group (HbA1c ≥ 7%, n=53). OS differences among patients without DM, with well-controlled DM, and uncontrolled DM were evaluated by multivariate Cox regression analysis with adjustment for stage, sex, age, histology, smoking history and EGFR mutation status. The survival benefit of well-controlled DM was compared across subgroups. The median follow-up of the entire cohort was 35.8 months. DM patients (11.2%) had a significantly worse OS than nondiabetic patients [median (95% CI): 47.5 (39.0-56.1) vs. 73.6 (54.8-92.4) months, P<0.001]. The risk of mortality increased along with the elevation of HbA1c level. Uncontrolled DM patients tended to be male, elder, non-adenocarcinoma, with smoking history, wide-type EGFR mutations and advanced stage. Well-controlled DM patients had a worse OS [HR (95% CI): 2.3 (1.9-2.7), P<0.001] compared to nondiabetic patients without adjustment but a similar OS with adjustment for stage, sex, age, histology, smoking history and EGFR mutation status [HR (95% CI): 0.9 (0.8-1.1), P=0.185]. Benefit of well-controlled DM was more obviously seen in patients with advanced stage (III-IV) [HR (95% CI): 0.8 (0.6-1.1), P=0.130] or EGFR mutations [HR (95% CI): 1.2 (0.9-1.5), P=0.262]. Elevated glycemic status negatively affected OS for patients with LC. LC patients with DM is recommended to have a glycemic control (HbA1c < 7%) especially for those with advanced stage and EGFR mutations.

P2.17-28 Real-World Data: Survival Outcomes of Chemotherapy Regimens Given Concurrently with Radiotherapy for Locally Advanced NSCLC

Initial management for inoperable Stage III non-small cell lung cancer (NSCLC) treated for curative intent is platinum-based chemotherapy with concurrent thoracic radiotherapy (TRT). However, a lack of consensus on the optimal chemotherapy regimen administered with TRT remains. In Alberta, Canada, cisplatin/etoposide (EP), given Days 1-5 + 8 of a 28-day cycle, and cisplatin/vinorelbine (VP), given Days 1 +8 of a 21-day cycle, have been the two regimens used preferentially. Weekly carboplatin/paclitaxel (CP) has historically been used as an alternative in patients (pts) with borderline performance status or contraindication to cisplatin. Here, we retrospectively compare survival outcomes of these chemotherapy regimens. The Alberta Cancer Registry identified pts diagnosed with locally advanced NSCLC between 2010 and 2015 and treated with EP, VP or CP chemotherapy with concurrent TRT. Patient and tumour characteristics were collected along with treatment parameters. Progression-free survival (PFS) and overal survival (OS) was determined for each chemotherapy regimen. Survival outcomes were compared using Kaplan-Meier analysis and Cox proportional hazard regression models adjusting for age, gender, tumour histological subtype (squamous vs. non-squamous NSCLC) and 7th edition TNM Stage (IIIA vs. IIIB). Of 148 pts reviewed, 44, 79, and 25 pts were treated with EP, VP, and CP, respectively, with median ages of 63, 62, and 68 years. Gender, tumour histological subtype, distribution of Stage IIIA vs. IIIB, and use of PET imaging for staging were balanced between regimens. Median PFS (EP 9.5 mo; VP 12.9 mo; CP 11.2 mo; p=0.875) and OS (EP 17.8 mo; VP 25.3 mo; CP 33.2 mo; p=0.509) were not significantly affected. Non-squamous median OS (EP 33.4 mo; VP 31.0 mo; CP 33.2 mo; p=0.997) and squamous median OS (EP 13.4 mo; VP 22.3 mo; CP not reached (N=11); p=0.406) also did not differ by regimen. Multivariate Cox regression analysis demonstrated Stage (IIIA vs. IIIB) as the only parameter that significantly altered PFS and OS. This retrospective analysis of real-word data from 2010 to 2015, in the absence of consolidation durvalumab, shows that PFS and OS in locally advanced NSCLC pts treated with concurrent chemoradiotherapy are similar for the EP, VP or CP regimens. Dose scheduling and respective toxicities will likely determine choice of chemotherapy regimen given with TRT. Further review of the CP regimen, given the small sample size in this study, and the use of next generation chemotherapy regimens such as platinum/pemetrexed for non-squamous NSCLC is warranted.

PS02.104: CLINICAL STUDY OF PROSPECTIVE RANDOMIZED CONTROLLED TRIALS ON ADJUVANT THERAPIES IN TREATMENT OF RESECTABLE PIB-III (PT2–4AN0–1M0) ESOPHAGEAL SQUAMOUS CELL CARCINOMA

Abstract Background Esophageal squamous cell carcinoma (ESCC) patients have relatively poor prognosis after operation. The study was designed to analyse the effect of surgery alone, surgery with adjuvant chemotherapy and surgery with chemoradiotherapy on prognosis in the patients with pathologic stage pIB-III (pT2–4aN0–1M0) who received radical esophagectomy. Methods We carried out the prospective randomized study. In this study, we analyzed 104 patients who had undergone minimally invasive esophagectomy for thoracic ESCC and been assessed as pathological stage pIB-III (pT2–4aN0–1M0) from January 2013 to October 2015 in our institute. 48 patients are treated with surgery alone (S group),33 patients received surgery and adjuvant chemotherapy (CT group), and 23 patients received surgery and adjuvant chemoradiotherapy (CRT group). We do the follow up for all the patients, collect the clilnical, patholigical data of them, and analyze the overal survival (OS) and disease-free survival (DFS) of them. Results The basic clinical characteristics of three groups were comparable. The average age was (52.1 ± 9.7) years old. The median follow‐up period was 39 months. The 3-year OS of the patients in the S group, CT group, and CRT group were 37.5%,18.8%, 65.2%, respectively. According to the follow-up data, both the 3-year OS and the 3-year DFS of the patients in the CRT group were better than those of the patients in the S group and CT group group (P &lt; 0.05). However, the incidence rates of side effects and complications in CRT group were higher than those in S group and CT group, without signicant differences. One patient died in S group in perioperative period, because of postoperaive pulmonary embolism, and no patients died in CT group and CRT group in peri-treatment period. Conclusion Our prospective, randomized controlled trial showed that surgery with adjuvant chemoradiotherapy could improve 3-year OS and DFS compared with treatment of surgery alone or surgery with adjuvant chemotherapy.The side effects and complications of surgery with adjuvant chemoradiotherapy were acceptable. However, because our study enrolled limited patients, and the follow-up time was not long enough, we need to collect more patients and longer follow-up to further comfirm our conclusion. Disclosure All authors have declared no conflicts of interest.

Prognostic models in advanced gastric cancer in first and second line chemotherapy treatment in Spanish population.

e15603 Background: No globally accepted prognostic score has been developed in advanced gastric cancer (AGC). The purpose of this study is to explore baseline host or tumor related prognostic factors in spanish AGC patients in first and second line chemotherapy treatment. In addition we compare our scores with previously published scores in asian and european population. Methods: A total of 166 patients with AGC treated in our institution between 2012 and 2016 were screened. 119 received first line chemotherapy (CT) and 47 of them also received second line CT and were included in the analysis. Prognostic factors were evaluated using the Cox proportional hazard model. We use as comparators four first line and three second line scores published in literature. Results: The overal survival (OS) in first line and second line patients were 9 and 5 months. To construct first line CT score we selected four risk factors: ECOG≥2, Her2 negative, Irinotecan based CT and albumin &lt; 3,6mg/dl. OS were 23 months in low risk group, who had zero or one risk points, 15 months for patients in the moderate risk group, who had two or three risk points, and 5 months for patients in the high risk group, who had all four risk points. In the second line CT score we included four risk factors: ECOG ≥2, albumin &lt; 3.6mg/dl, Hb &lt; 11.5mg/dl and CA19.9 reduction less than 30% after 2 CT cycles. OS were 30 months in low risk group, who had zero or one risk points, 16 months for patients in the moderate risk group, who had two or three risk points, and 3 months for patients in the high risk group, who had all four risk points. Conclusions: In the present study, we propose two new prognostic scores for patients with AGC developed in the same cohort and including HER2 status. This prognostic model could help clinicians choose and applicable treatment based on the stimated prognosis. [Table: see text]

Prognostic significance of alterations of pathways regulating autophagy in acute myeloid leukemia.

7038 Background: Nowadays, science is debating if autophagy in cancer can lead to therapy resistance or it can favor apoptosis. Autophagy pathways are involved pro-apoptotic mechanism, or they can improve stresses survival eliminating damaged mitochondria and proteins. Levels and activity of pro-apoptotic and anti-apoptotic proteins (eg. bcl-2 and p53), high levels of cAMP, and a pink/park complex could play as fulcrum on this lever. Our study aims to define the role of autophagy in AML. Methods: We analyzed 148 consecutive non M3 AML with Affymetrix SNP array. We screened all patients for TP53, FLT3, NMP1 mutations. Patients was treated with intensive induction chemotherapy regimens. Survival data were collected prospectively, with a median follow-up of 18 months. Results: Autophagy alteration (gene group 1: ULK1 CHR11; ULK1 CHR17; BECN1; ATG14; AMBRA1; UVRAG; ATG9A; ATG9B; PIK3C3; PIK3R4) was related to lower Complete Remission rate (CR%) after induction in univariate (p &lt; .001) and multivariable regression model with age, karyotype, secondary AML, TP53 mutation (p = .014); autophagy alteration shown to confer worst Overal Survival (OS) (p &lt; .001) and was significantly associated with complex karyotype and TP53 mutation (p &lt; .001). We detected significant differences in term of survival independently both in gain and loss in group 1 genes (p &lt; .001). Alterations in genes in cAMP pathway (group 2: SESN1; PRKAA1 CHR 3; PRKAB1: PRKAA1 CHR 1: PRKAG1 CHR11; PRKAG1 CHR 7; PRKAG3; PRKAB1) and in genes that could be related to a switch from a physiological role of autophagy to a resiliency mechanism (group 3: CCND1; BCL2; PINK1; PARK2; TP53; MDM1; MDM4) showed to confer worst OS (p &lt; .001 in both groups); Alteration in group 2 and group 3 were related to lower CR% after induction (p &lt; .001 in both groups). Whole Exome Sequencing on 56 patients in our set did not found any significant mutation in genes we analyzed with the exception of TP53. Conclusions: Alterations in autophagy regulator genes are associated with poor prognosis and therapy resistance. A loss in autophagy could block apoptosis, a gain could confer cell resiliency. Acknowledgements: ELN, AIL, AIRC, Progetto Regione-Università 2010-12,FP7 NGS-PTL, HARMONY

Is Height of Prognostic Significance in Breast Cancer Cases?

Objective:The objective of this study was to investigate the correlation of height with prognosis and other prognostic factors in Turkish breast cancer cases.Materials and Methods:We retrospectively reviewed a total of 393 women aged between 26 and 88 years, diagnosed with stage 1-3 invasive ductal breast cancer, treated and followed-up in Kayseri Education and Research Hospital.Findings:The mean age at admission was 55.7 years; 77.6% were aged under 65, 56.7% were postmenopausal, 97.4% had undergone modified radical mastectomy, 47.3% were AJCC stage II, 36.8% N0, 46.0% grade II, 95.4% had received chemotherapy, 81.1% radiotherapy and 71.5% hormonotherapy. Height was under 151 cm in 20.8 %, 151-160 cm in 57.3 % and over 161 in 21.9 %. Follow-up duration differed between 0.3 and 195.3 months. Mean overal survival (OS) was 125.0 (65.6-184.3) months and progression free survival was 91.5 (37.7-145.2) months, with a tendency for better survival in taller individuals but no signficant variation between height groups. The 5 and 10-year OS rates were 74.5% and 56.4%, and PFS rates were 64.5% and 49.2%. Regarding association of height with other prognostic factors, a significant correlation was found between height and AJCC stage (p= 0.011) and estrogen status (ER) (p= 0.043).Conclusion:In conclusion, overal survival was found to be longer in patients with a height between 151 and 160 cm than those under 151 cm and over 161 cm. The reason for not obtaining significant results might be a relatively small number of patients and lack of the evaluation of clinical and pathologic characteristics together with anthropometric measurements in the patient population. Further studies are warranted to clarify any association.

Prognostic Significance of Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio in Diffuse Large B-Cell Lymphoma Patients Treated with R-CHOP

Objectives The both values of neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) were reported as indexes of systemic inflammation and readily available and inexpensive prognostic markers in patients with solid cancer. The objective of this study was to clarify whether the NLR and PLR were significant prognostic markers in Korean diffuse large B-cell lymphoma (DLBCL) patients treated with R-CHOP as a first line therapy. Methods : We retrospectively collected the clinical data of ninety nine DLBCL patients treated with R-CHOP from 2004 to 2012 and analyzed. NLR and PLR were calculated from complete blood count (CBC) and differential leukocyte count. Results : In univariate analysis, NLR was significantly associated with 5-year progression free survival(PFS) rate (P= 0.039), but not significantly associated with 5-year overal survival (OS) rate (P= 0.276). PLR was not significantly associated with 5-year PFS (P= 0.632) and OS rate (P= 0.855). In multivariate analysis, NLR was not a significant independent prognostic factor for 5-year PFS (P= 0.415) and OS rate (P= 0.991). Conclusion : The NLR can be considered a useful predictor of survival outcome. The PLR is not a valid predictor of survival outcome.