55 / 154
A B S T R A C T S
S25
the completion of 4-cycles chemotherapy without dose
reduction/treatment delay (odds ratio: 1.12; 95% CI: 0.93~1.34;
p=0.2). Baseline IADL dependency was associated with higher
chemotoxicity (OR 0.79; p=0.02). The ADL score (p=0.042),
social activity score (p=0.002), and quality of life (FACT-O) score
(p=0.004) improved with chemotherapy, while neurotoxicity
score worsened (p=0.011).
Conclusion:
Carboplatin and low-dose weekly paclitaxel,
a standard chemotherapy regimen for women with ovarian
cancer, is well tolerated in this elderly population with most
able to complete four cycles of treatment without dose
modification/delay. Baseline IADL dependency was associated
with higher chemotherapy toxicity.
Disclosure of interest:
W. Tew: None declared, H. Huang:
None declared, V. Von Gruenigen: None declared, A. Hurria
Grant/Research Support from: Celegene; Novartis, Consultant
for: GTx, Inc.; Boehringer Ingelheim Pharmaceuticals;
Carevive; Sanofi, T. Herzog: None declared, L. Landrum: None
declared, R. Salani: None declared, S. Lele: None declared,
M. Pearl: None declared, A. Alvarez Secord: None declared, J.
Fiorica: None declared, T. Rizack: None declared, W. Richards:
None declared, G. Fleming: None declared
Keywords:
Geriatric assessment, gynecologic cancers,
ovarian cancer, quality of life
O04
TAXANE-BASED ADJUVANT TREATMENT IN ELDERLY
WOMEN WITH BREAST CANCER. A POOLED ANALYSIS OF
5 RANDOMIZED TRIALS FROM THE HELLENIC ONCOLOGY
RESEARCH GROUP
A. Karampeazis
1,
*, S. Kallianteri
1
, L. Vamvakas
1
,
N. Kentepozidis
1
, P. Katsaounis
1
, N. Vardakis
1
, K. Kalbakis
1
,
V. Georgoulias
1
1
Hellenic Oncology Research Group (HORG), Athens, Greece
Introduction:
Taxane-based adjuvant chemotherapy confers
benefit to patients with high-risk early breast cancer (BC).
Objectives:
To examine the safety and efficacy of taxane-
containing regimens in the treatment of older women.
Methods:
Data from 5 randomized trials that included a
taxane-containing regimen for the adjuvant chemotherapy
for BC were analyzed. We examined differences in treatment
outcome and toxicity for women aged
65 years.
Results:
Among 3026 patients, 701(23%) were
65 years old
(median age 69; range 65-80). Surgical treatment was breast
conservative for 45% of patients while 77% had node-positive
and 75% had hormone receptor-positive disease. A higher
number of elderly patients compared to younger patients
discontinued treatment (5.7% vs 2.9%; p<0.001) mainly due to
toxicity (60% vs 79%; p=0.013) whereas there was no difference
regarding the treatment refusal and the disease progression.
The incidence of grade 3 and 4 neutropenia (36.4% vs 29.6%;
p=0.006) and thrombocytopenia (0.9% vs 0.3%; p=0.049) was
higher in elderly compared to younger patients; however
there was no difference in terms of febrile neutropenia
(3.4% vs 2.3%; p=0.107) and non-hematological toxicity. After
a median follow-up of 5 years, there was no difference in 3
years disease-free survival (DFS) (90% vs 89%; p=0.945) and
5 years overall survival (OS) (92% vs 93%; p=0.202) between
older and younger patients, respectively. Within the cohort
of older patients, taxane-based combinations were superior
to 5-fluoruracil, epirubicin and cyclophosphamide (FE
75
C)
regimen in terms of 3-years DFS (93% vs 78%; p<0.001) and
5-years OS (95% vs 75%; p<0.001), respectively.
Conclusion:
Taxane-based adjuvant chemotherapy offers
significant benefit in elderly breast cancer patients similarly
to younger patients with increased but manageable toxicity.
Disclosure of interest:
None declared
Keywords:
Breast cancer, elderly women, taxane-based
O05
TRANSCRIPTION FACTORS AND CHECKPOINT
INHIBITOR EXPRESSION WITH AGE: NEW MARKERS OF
IMMUNOSENESCENCE?
L. Dang
1
, K. Willard-Gallo
2
, S. Garaud
2
, H. Duvillier
1
,
J.-N. Lodewyckx
2
, C. Solinas
2
, P. De Silva
2
, C. Gu-Trantien
2
,
C. Sibille
3
, D. Bron
1,
*
1
Hematology,
2
Molecular Immunology Unit,
3
Antatomo-pathology,
Institut Jules Bordet, Brussels, Belgium
Introduction:
Aging is characterized by a progressive decline
in immune surveillance that favors tumor development. One
mechanismto escape immune surveillance is the upregulation
of inhibitory immune checkpoint molecules, such as PD-1 and
PD-L1. Another process associated with aging is genetic or
epigenetic modifications of tumor suppressor genes (TSGs).
Objectives:
This study examined the expression of specific
checkpoint molecules (PD-1 and PD-L1) and transcription
factors (BACH2 and PRDM1) in lymphocyte subpopulations,
for their potential use as markers of immunosenescence.
Methods:
Lymphocyte subpopulations were analyzed
using multi-color flow cytometry to quantify CD3, CD4, CD5,
CD8, CD16, CD19, CD25, CD27, CD45, CD45RA, CD56 and CD197
surface expression. Individual lymphocyte subpopulations
(CD3+/CD4+; CD3+/CD8+ and CD19+) were isolated for
subsequent molecular analyses using the MACS technology
(Miltenyi), with the purity of each lymphocyte subpopulation
between 95 and 99%. PD-1 (
PDCD1
), PD-L1 (
CD274
),
IL4
,
IFNG
,
BACH2
and
PRDM1
(Blimp1) mRNA transcripts were quantified
in the purified subpopulations using qRT-PCR. BACH2 and
PRDM1 protein expression was examined byWestern blotting.
Results:
Peripheral blood lymphocytes (PBL) were obtained
from 40 healthy donors (HDs) aged 20 to 90 yrs, subdivided
into <50 (median 36) yrs and
50 (median 61) yrs. PBL from 30
untreated patients with chronic lymphocytic leukemia (CLL)
were comparatively analyzed. Absolute lymphocyte counts
did not vary between the two groups but balance between
lymphocyte subpopulations was altered. The number of naïve
T cells (CD45RA
+
) and CD8
+
cytotoxic T cells were significantly
reduced in the older group (p=0.01 and 0.002). The CD4:CD8
ratio and effector T cell numbers increase significantly with
age (p<0.0001 and 0.01, respectively).