6th ICHNO Abstract Book

page 20 6 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 16 – 18 March 2017 Barcelona, Spain __________________________________________________________________________________________ ADCC activity and the total number of circulating NK cells, and the interaction between iNKT and ADCC. Material and Methods patients to have similar outcome compared to younger ones albeit with high burden of toxicities. No subsite- related differences were specifically investigated ever. Material and Methods 6th ICHNO

In a multi-step proof of concept project we investigate the impact of individual ADCC activity in pts treated with cetuximab and radiotherapy (BRT) on the following outcome by itself or in function of EGFR expression. Additional analyses are also considered. A population of pts treated with chemo-radiotherapy (CRT) is considered as no formal control. ADCC was measured in vitro by LDH release, using purified NK cells from fresh peripheral blood of pts. NK count in peripheral blood iNKT count in peripheral blood CD3+ count in peripheral blood Results A total of 58 pts treated with cetuximab + RT (43) or with CDDP + RT are evaluated. In a previous paper we reported that complete responses did not correlate with either ADCC or EGFR expression. However, using a mixed score considering both ADCC and EGFR expression, they correlate with CR (p=0.04) in BRT treated pts. Additionally, pts showing both high basal ADCC and EGFR+++ achieved a 4-year OS of 100% compared with the others (p=0.02). No differences were observed in CRT treated patients. Additional analyses here reported show that changes of ADCC induced by treatment do not correlate with outcome and basal ADCC remains the only prognosticator in patients treated with BRT. We also observed that the basal value of ADCC is more important than the basal number of NK. This observation, made at baseline, suggests the presence of an impaired NK cell population in HNC pts, and that impairment is not treatment related. We evaluate the combined role of iNKT and high basal ADCC activity since we observed a significant impact on outcome in colon cancer pts harbouring both high iNKT and high ADCC compared to other (p=0.0075). Analysis is under progress and results will be presented at the conference. Conclusion Our data show that ADCC plays an important role in cetuximab activity and, if confirmed in prospectic analysis, suggest that patients with high basal ADCC and EGFR+++ should be treated with cetuximab and RT PD-034 Subsite-dependent prognostic impact of age in patients with nasopharyngeal and oropharyngeal cancer E. Orlandi 1 , G. Infante 2 , R. Granata 3 , N. Iacovelli 1 , R. Miceli 2 , A. Cavallo 4 , S. Alfieri 3 , C. Bergamini 3 , C. Resteghini 3 , D. Galbiati 3 , L. Locati 3 , S. Tana 1 , S. Naimo 1 , C. Fallai 1 , L. Licitra 3 , P. Bossi 3 1 Fondazione IRCCS Istituto Nazionale dei Tumori, Radiation Oncology Department, Milan, Italy 2 Fondazione IRCCS Istituto Nazionale dei Tumori, Unit of Medical Statistics- Biometry and Bioinformatics- Unit of Clinical Epidemiology and Trial Organization, Milan, Italy 3 Fondazione IRCCS Istituto Nazionale dei Tumori, Head and Neck Medical Oncology Department, Milan, Italy 4 Fondazione IRCCS Istituto Nazionale dei Tumori, Medical Physics Unit, Milan, Italy Purpose or Objective Outcome results in elderly head and neck cancer (HNC) patients (pts) treated with concurrent chemoradiation are controversial. Comparative effectiveness analyses showed a lack of benefit in multimodal treatment; however, retrospective highly selected series reported older The following analyses were performed: treatment. ADCC EGFR basal value and during status by IHC

Consecutive locally advanced oropharyngeal (OPC) and nasopharyngeal cancer (NPC) pts treated at our institution with concurrent platinum based chemotherapy (CHT) and intensity modulated radiation therapy (IMRT) techniques from 2004 to 2015 were retrospectively evaluated. Overall survival (OS) and Relapse Free Survival (RFS) Kaplan-Meier curves were estimated and compared with the log-rank test; acute toxicity rate > G3 according to Common Toxicity Criteria Adverse Event v4.0 was also analyzed, distinguishing between patients >65 years old (elderly) and ≤65 old. HPV status was recorded in all OPC patients. Results Globally, 375 pts received IMRT-CHT, 215 in OPC and 160 in NPC cohort. Elderly pts represented 26% and 11% of OPC and NPC pts, respectively. OPC HPV positive cases were similarly represented in older (73% of the cases) and younger pts (66%); HPV positivity maintained a significant prognostic role independently of age and also across different age group. On the contrary, age did not significantly impact on survival in OPC. Five-years RFS was 68% in older versus 76% in younger patients (p=0.391); the corresponding figures for OS were 93% versus 87% (p=0.541). There was no significant difference in cumulative acute toxicity rate ≥ G3 (39% in elderly vs 36% in younger, Fisher test p =0.778). When analyzed separately, no difference was shown for what concerns dysphagia and mucositis. NPC pts showed a different outcome according to age both in terms of RFS (5-years probabilities 41% in elderly vs 80% in younger pts, p <0.001) and OS (48% vs 90%, p <0.001), which turned out to be a negative prognostic factor in this disease. Also for NPC pts, the two age subgroups did not significantly differ in acute toxicity rate ≥ G3 (56% vs 61%, p = 0.800). Conclusion We observed a subsite-specific impact of age on treatment outcome: older NPC pts showed markedly worse survival than the younger counterparts, while in OPC pts such an effect was inconsistent. HPV status was confirmed to be a positive prognostic factor independently of age. Head and neck cancers are essentially being treated with conventional treatments including surgery, radiotherapy and chemotherapy. EGFR is the only target that underwent clinical translation with the use of cetuximab, a monoclonal antibody targeting EGFR, either in combination with radiotherapy in the locally advanced setting or in combination with chemotherapy in first-line metastatic and/or recurrent setting. More recently, immune check point inhibitors targeting PD1 have been demonstrated to improve survival in second line metastatic and/or recurrent setting with a more favorable safety profile. Many clinical trials are now ongoing with these agents in first-line metastatic and/or recurrent setting and in the locally advanced setting. The question is whether there is still a role for targeted thérapies in head and neck cancer treatments beyond EGFR. Several targets have been identified in head and neck cancers. We aim to to review in this talk the results of the trials that have evaluated these targeted thérapies, as Symposium: New developments in systemic treatment SP-035 Is there still a role for targeted signaling agents in head and neck cancer? C. Le Tourneau 1 1 Institut Curie, Medical Oncology, Paris, France Abstract text