36 / 154
S6
A B S T R A C T S
S13
CCL
Paolo Ghia
Università Vita-Salute San Raffaele, Division of Experimental
Oncology, Milano, Italy
CLL has undergone an enormous change in the therapeutic
approaches that are mirrored in the recent publication (and
subsequent update) of the ESMO guidelines for treatment of
CLL patients. Fromthe timewhere only a handful of drugswere
approved for CLL, we have now a full array of compounds and
combinations thereof that can help to better tailor the most
appropriate treatment for each of our patients. Studies showed
that the combination of Fludarabine, cyclophosphamide
and Rituximab is able to achieve complete remission and
negativity for minimal residual disease (MRD) when used in
young fit patients who, in particular those carrying mutated
Immunoglobulin genes, can enjoy a disease-free status for
more than a decade. Less fit, typically elderly patients with
comorbidities, can now experience as well the possibility to
achieve MRD negativity with the better tolerated combination
of Chlorambucil and rituximab but in particular together
with the novel anti-CD20 Obinutuzumab. Very recently, also
the first-in-class BTK inhibitor, Ibrutinib, has been approved
by EMA for the treatment of CLL patients in first line,
achieving long progression-free survivals with limited non-
hematological toxicity. Despite all these achievements, the
majority of CLL patients still relapse after the first treatment,
but they have now a number of possibilities for subsequent
treatments, including Ibrutinib and the PI3K-
inhibitor
Idelalisib in combination with Rituximab both inducing
rapid responses in terms of lymph nodes shrinkage and bone
marrow function recovery in the relapsed/refractory setting.
Similar responses can be also obtained in so-called high risk
patients i.e. those carrying TP53 abnormalities.
Additional drugs are appearing on the horizon and these
include the BCL2-inhibitor Venetoclax, already approved by
FDA for the treatment of relapsed patients with deletion 17p,
that appears to be able to induce deep responses with MRD
negativity. We are not yet definitely eradicating the disease
but the future lies in the combination of these drugs with the
hope of finally curing CLL.
Disclosure of interest:
Honoraria/advisory boards: AbbVie,
Adaptive Biotechnologies, Gilead, Janssen, Roche. Research
grants: GSK, Gilead, Janssen, Roche
S14
Marine Gilabert
The speaker abstract has not been received at the time of
publication.
S15
LUNG CANCER IN THE ELDERLY PATIENTS
Cesare Gridelli
"S.G. Moscati" Hospital, Medical Oncology, Avellino Italy
The talk will report the basis of new immunotherapy in the
treatment of advanced non-small-cell lung cancer specifically
related to treatment of elderly patients.
Disclosure of interest:
Honoraria as speaker bureau and
advisory board member for Roche, BMS, MSD.
S16
GERIATRIC ASSESSMENT: NEXT BIG CHALLENGES
Marije E Hamaker
Diakonessenhuis, Geriatric Medicine, Utrecht, Netherlands
Pioneers in the field of geriatric oncology have focussed
on demonstrating that geriatric impairments are prevalent in
elderly patients, and oftenmissed in a standard oncologicwork-
up. Prior research has shown that many of these impairments
can have impact on prognosis, the course of treatment or can
be amenable to interventions that improve treatment tolerance
or quality of life. However, many questions still remain before
geriatric assessment-driven cancer treatment becomes the
standard of care. This presentation will address some of the
next big challenges that need to be addressed.
Disclosure of interest:
None declared
S17
Janice Tsang
The speaker abstract has not been received at the time of
publication.
S18
PERSPECTIVES FROM NORTH AMERICA
Holly Holmes
University of Texas Health Science Center, Division of Geriatric and
Palliative Medicine, Houston, USA
This presentation will discuss the challenges of providing
high quality, patient-centered end-of-life care for older
adults with cancer, with a focus on the US and the unique
opportunities and challenges within the healthcare system.
The focus will include the overuse of care at the end of life
and the implications such care has for dying with dignity.
Disclosure of interest:
None declared