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A B S T R A C T S
geriatric assessment tool should be used appropriately to
determine the vulnerability of each elderly patient in clinical
trial.
Conclusion:
This is first questionnaire study in Japan about
the patterns of care of elderly breast cancer patients in a large
cooperative group. Physicians considered different regimen
and dosage of anti-cancer drug for elderly breast cancer
patients according their
fragile.Weare planning a prospective
trial to establish a standard chemotherapy regimen focusing
on elderly HER2 positive advanced or metastatic breast cancer
patients, which include the use of comprehensive geriatric
assessment tools.
References:
[1] Kurebayashi J, et al. Clinicopathological characteristics of
breast cancer and trends in the management of breast
cancer patients in Japan: Based on the Breast Cancer
Registry of the Japanese Breast Cancer Society between
2004 and 2011. Breast Cancer. 2015;22:235-44.
[2] Wildiers H, et al. Management of breast cancer in elderly
individuals: recommendations of the International Society
of Geriatric Oncology. The Lancet Oncology. 2007;8:1101-15.
[3] Swain SM, et al. Pertuzumab, trastuzumab, and docetaxel
in HER2-positive metastatic breast cancer. N Engl J Med.
2015;372:724-34.
[4] Miles D, et al. Treatment of older patients with HER2-
positive metastatic breast cancer with pertuzumab,
trastuzumab, and docetaxel: subgroup analyses from a
randomized, double-blind, placebo-controlled phase III
trial (CLEOPATRA). Breast Cancer Res Treat. 2013;142:89-99.
[5] Ando M, et al. Efficacy of docetaxel 60 mg/m2 in patients
with metastatic breast cancer according to the status of
anthracycline resistance. J Clin Oncol. 2001;19:336-42.
Disclosure of interest:
None declared
Keywords:
HER2-positive, practice in Japanese, questionnaire
survey
P003
SERUM METABOLOMIC PROFILES FOR DISCRIMINATING
EARLY FROM METASTATIC DISEASE IN ELDERLY PATIENTS
WITH COLORECTAL CANCER
E. Mori
1,2
, A. R. A. Mislang
2,
*, A. Vignoli
3
, S. Di Donato
2
,
C. Biagioni
2
, S. Vitale
1,2
, C. Hart
2
, D. Becheri
4
, F. Del Monte
2
,
C. Luchinat
3
, A. Di Leo
2
, G. Mottino
4
, L. Biganzoli
2
, L. Tenori
5
1
University of Siena, Siena,
2
Medical Oncology Department, Nuovo
Ospedale-Santo Stefano Instituto Toscano Tumori, Prato,
3
Magnetic
Resonance Center (CERM), University of Florence, Sesto Fiorentino,
4
Geriatric Medicine Department, Nuovo Ospedale-Santo Stefano
Instituto Toscano Tumori, Prato,
5
Consorzio Interuniversitario
Risonanze Magnetiche di Metallo Proteine (CIRMMP), Sesto
Fiorentino, Italy
Introduction:
Accurate stratification of patients at high
risk for relapse and may benefit from adjuvant chemotherapy
following curative surgery is crucial for improving survival
outcomes in early-stage colorectal cancer (CRC). Serum
metabolomic profiles may act as biomarkers differentiating
early from metastatic disease in the elderly. This clear
distinction may substantially influence decision-making,
eliminating unnecessary treatment, particularly in the elderly
population who are at higher risk of toxicity.
Objectives:
This study aims to identify a metabolomic
“signature” that differentiates early (eCRC) from metastatic
disease (mCRC) in elderly patients.
Methods:
Serum samples from 103 elderly patients (aged
70 years) with CRC (48 mCRC and 55 eCRC with
5 years
follow-up) were pooled from 4 previous clinical trials. These
were analyzed via Proton Nuclear Magnetic Resonance (NMR)
and the spectra were used to characterize the metabolic
profiles of the two cohorts. Principal component analysis
(PCA) and canonical analysis (CA) were applied to obtain
the supervised separation of eCRC and mCRC spectra. The
K-nearest neighbors (k-NN) method was applied to the
PCA-CA scores, for classification. Wilcoxon signed-rank test
and Benjamini & Hochberg correction method were used
to compare the levels of 34 quantified metabolites between
eCRC and mCRC patients.
Results:
Themedian age was 78 years (range 70-89) for eCRC
and 77 years (range 70-87) for mCRC. Out of 55 patients with
eCRC, 44% received adjuvant chemotherapy and 27% (n=15)
had relapsed. PCA-CA-kNN classification of NMR spectra was
able to discriminate eCRC and mCRC with an accuracy of 74%.
A clear distinction was noted between eCRC without relapse
and mCRC. Of the 15 eCRC patients who relapsed, 9 had
metabolomic profiles similar to the metastatic group. Four
metabolites (2-methylbutyrate, 2-methylsuccinate, histidine
and formate) were found to differ significantly (p < 0.05)
between eCRC and mCRC metabolomic profiles.
Conclusion:
NMR metabolomic profiles can discriminate
early andmetastatic CRC in elderly
patients.Asa next step, our
team will work on a model to assess the likelihood of relapse,
based on the degree an eCRC serum profile resembles the
metastatic profiles and correlate this with clinical outcomes.
Disclosure of interest:
None declared
Keywords:
biomarkers, colorectal cancer, elderly, serum
metabolomics
P004
OUTCOMES OF HYPO FRACTIONATED RADICAL
RADIOTHERAPY IN PATIENTS WITH NON SMALL CELL
LUNG CANCER (NSCLC) OVER THE AGE OF 80
A. Cree
1,
*, J. Haston
1
, A. McPartlin
1
, L. Joseph
2
, H. Sheikh
1
,
M. Harris
1
, J. Coote
1
, R. Stout
1
, N. Bayman
1
, L. Lee
1
, C. Chan
1
,
C. Favre Finn
1
, L. Pemberton
1
1
Clinical Oncology, The Christie NHS Foundation trust, Manchester,
2
Clinical Oncology, Leeds Cancer Institute, Leeds, United Kingdom
Introduction:
In the UK, 27% of patients diagnosed
with lung cancer are 80 years or over [1]. Around 40% of
patients present with stage 1-3 disease. Many are unsuitable
for surgery due to disease stage, performance status or
comorbidities. In our institution these patients are treated
with radical hypofractionated radiotherapy (55Gy in 20 once