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model, which contributes less morbidity and mortality within
30 days after oncologic procedure
References
:
[1] Pope D, Ramesh H, Gennari R, Corsini G, Maffezzini M,
Hoekstra HJ, Mobarak D, Sunouchi K, Stotter A, West C,
Audisio RA. Pre-operative assessment of cancer in the
elderly (PACE): a comprehensive assessment of underlying
characteristics of elderly cancer patients prior to elective
surgery. Surg Oncol. 2006 Dec;15(4):189-97.
[2] Kristjansson SR, Farinella E, Gaskell S, Audisio RA. Surgical
risk and post-operative complications in older unfit cancer
patients. Cancer Treat Rev. 2009 Oct;35(6):499-502. Epub
2009 May 10.
[3] Audisio RA, Ramesh H, Longo WE, Zbar AP, Pope D.
Preoperative assessment of surgical risk in oncogeriatric
patients. Oncologist. 2005 Apr;10(4):262-8.
Disclosure of interest:
None declared
Keywords:
Elderly, oncologic surgery, geriatric assessment,
preoperative, surgical risk
P080
TREATMENT OF CHEMO-RESISTANT CANCERS IN THE
ELDERLY POPULATION: ROLE OF MOLECULAR TUMOR
PROFILING
M. Ghosn
1
, T. Ibrahim
1
, A. Ahmadie
1
, A. Saroufim
1
, C. Hanna
1
,
F. el Karak
1
, F. Farhat
1
, J. Kattan
1,
*
1
Hematology Oncology, Faculty of Medicine Saint Joseph University,
Beirut, Lebanon
Introduction:
Treatment of chemo-resistant cancers in
elderly patients is challenging especially in subjects with
good performance status. With the progress of biomedical
engineering, extensive molecular profiling (MP) of cancer cells
has become easily feasible and widely available. Theoretically
it could guide therapy in tumors refractory to several lines of
chemotherapy.
Objectives:
We aim to test the efficacy of MP in
individualizing cancer treatment in patients aged more than
65 years old after exhaustion of all recommended therapy
lines.
Methods:
This is a descriptive retrospective single center
study. Patients diagnosed with a refractory solid cancer at
Hôtel Dieu De France teaching hospital of the Saint Joseph
University were referred to Caris Life Science for MP in the last
3 years. Testing (including NGS, IHC and in situ hybridization)
were performed on formalin-fixed paraffin-embedded tumor
samples.
Results:
46 patients were included among whom 48%
females, with a median age of 70.5 years old (std. dev. 5.6).
Lung cancer was the most common primary (26%) followed
by breast, ovarian and colorectal cancers (10.9% for each).
Adenocarcinoma was the most common histologic subtype
(60.9%). Platinium based drugs were the most commonly
used chemotherapy prior to MP followed by gemcitabine and
fluorouracil. The majority of tumor samples (71.5%) sent for
MP were from recent biopsies performed after a median of
2 therapy lines. On MP, the median number of potentially
beneficial drugs was 17 (23.5% not used before) whereas the
median number of drugs lacking benefit was 16 (37.5% not
used before). Targeted, hormonal and oral therapies with a
potential benefitwerepresent in2,5and8patients respectively.
TP53 was the most commonly mutated gene. After a median
follow up of 6.2 months, MP based therapy was effective in
controlling the disease in 65.2% (CR in 3 patients-6.5%, PR in 7
patients-15.2% and SD in 20 patients-43.5%). Average duration
of response was equal to 4 months
Conclusion:
MP could be effective in finding adequate and
effective anti-cancer agents in elderly patients even after
exhaustion of recommended cytotoxic, hormonal or targeted
therapy. It would also prevent the use of pointless toxic drugs
if used early in the course of disease.
References
:
[1] Von Hoff DD et al. JCO. 2010;28:4877-83.
[2] Jameson GS et al. Breast Cancer Res Treat. 2014;147:579-88.
[3] Epelbaum R et al. BioMed Res Intl. 2015
[4] Ross JS. Biomarkers Med. 2011;5:277-9.
Disclosure of interest:
None declared
Keywords:
Chemo-resistant cancer, molecular profiling
P081
USING BIG DATA IN ONCOLOGY TO PROSPECTIVELY IMPACT
CLINICAL PATIENT CARE: A PROOF OF CONCEPT STUDY
V. Dougoud-Chauvin
1,
*, J. J. Lee
1
, E. S. Santos
2
, V. L. Williams
1
,
N. M. Battisti
1
, K. M. Ghia
1
, M. Sehovic
1
, W. Kramer
2
, C. Croft
1
,
J. Kim
1
, L. Balducci
1
, J. A. Kish
1
, M. Extermann
1
1
H. Lee Moffitt Cancer Center and Research Institute, Tampa,
2
Eugene M. & Christine E. Lynn Cancer Institute, Boca Raton, USA
Introduction:
Best oncology practice typically involves
use of evidence obtained from clinical trials. However, older
cancer patients are underrepresented in such trials. In fact,
systematic cohort reviews have shown that a significant
number of older cancer patients would not have matched
study eligibility criteria, limiting the external validity of the
guidelines based on these trials. Big Data such as Total Cancer
Care (TCC™) offers a unique opportunity to expand the base
of evidence on how to treat such patients.
Objectives:
The first aim was to check the availability of
similar patients in theTCC™database and to assess the impact
of such a consultation on the treatment plan. The second aim
was to obtain workload and staff/technical requirements
data for a randomized study as well as evaluation of time
constraints.
Methods:
After preliminary work showed the availability
of matching patients for clinical scenarios, we prospectively
tested the intervention with one community cancer center,
the Lynn Cancer Institute (LCI) in Boca Raton, Florida.
Patients aged 70 and older seen at LCI with a documented
malignancy were eligible. The first step was to conduct an
oncogeriatric screening using the Senior Adult Oncology
Program questionnaire version 2.0 (SAOP2). If positive for