7th ICHNO Abstract book

7th ICHNO 7 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 14 – 16 March 2019 Barcelona, Spain __________________________________________________________________________________________ page 17

1 Rigshospitalet- University of Copenhagen, Department of Otorhinolaryngology- Head and Neck Surgery and Audiology, Copenhagen, Denmark; 2 Rigshospitalet- University of Copenhagen, Department of Clinical Physiology- Nuclear Medicine and PET- PET and Cyclotron Unit, Copenhagen, Denmark; 3 Rigshospitalet- University of Copenhagen, Department of Pathology, Copenhagen, Denmark; 4 Rigshospitalet-University of Copenhagen, Department of Oncology- Section of Radiotherapy, Copenhagen, Denmark Purpose or Objective Usually cancer related immunohistochemical (IHC) biomarkers rely on single tumor biopsies. However, single tumor biopsies cannot detect intratumor heterogeneity and it is not realistic to routinely biopsy the entire tumor to access intratumor heterogeneity nor biopsy all lesions within a patient to assess inter-tumor heterogeneity. Ideally non-invasive modalities such as multiparametric functional imaging can assess both intratumor and inter- tumor heterogeneity. If a spatial correlation between functional imaging and molecular biology can be established this would have an impact on both diagnostic methods and treatment possibilities. The purpose of this study is to investigate if heterogeneity in head and neck squamous cell carcinoma (HNSCC) as seen in functional multiparametric imaging with 18 F-FDG-PET/MRI correlates with biologic heterogeneity in surgical specimens measured with immunohistochemical biomarkers. Material and Methods Thirty-one patients with HNSCC were scanned on an integrated PET/MRI scanner (Siemens Biograph mMR) with the PET tracer FDG prior to surgery in this prospective study. FDG uptake was quantified with the standardized uptake value (SUV). Diffusion was estimated with the apparent diffusion coefficient (ADC) and perfusion was estimated with K trans . A 3D morphometric scan of the specimen was used to co-register the patient scan and the specimen scan. All specimens were sectioned in consecutive slices and six slices were selected randomly from each tumor (Figure 1). A 3 mm wide core biopsy was performed to construct tissue microarray blocks for IHC staining (Figure 2) with the following biomarkers: p53, GLUT1, EGFR, VEGF, Bcl-2, p53, KI-67, CAIX and PD-L1. The spatial correlation between the imaging biomarkers (SUV, ADC and K trans ) and the IHC biomarkers was assessed with a partial correlation analysis.

Purpose or Objective Background: oral mucositis (OM)is one of the most important adverse event (AE)in head and neck cancer treatment. The objective of the trial was to evaluate the safety and efficacy of melatonin (MLT) oral gel in the prevention and treatment of oral mucositis (OM) in H&N cancer patients. We present the results in patients treated for oral cavity and oropharyngeal cancer (OCOC). Material and Methods Methods: Multicenter, prospective, randomized, double- blind, placebo-controlled study. Eligible patients were randomly assigned (1:1 ratio) to receive 3% MLT or matching placebo (PLC) oral gel. Patients received once daily (5 days/week) IMRT radiation therapy (total dose ≥ 66 Gy). Concurrent systemic treatments were cisplatin Q3W or cetuximab Q1W. All patients received concomitant standard symptomatic treatment for OM. Efficacy analyses were performed on a mITT population (patients receiving at least one medication dose) or ITT. Efficacy endpoints were either RTOG or NCI CTCv4, G3-4 oral mucositis (SOM) and G2-4 ulcerative oral mucositis (UOM). Comparison of incidence rates of SOM/UOM: Fisher exact test; comparison of duration of SOM/UOM: U Mann-Whitney test. No stratification by location was done. Results Results: 79 patients were included in the mITT population (40 MLT/39 PLC). Oropharynx and oral cavity (OCO) were the most frequent locations (n=58; 73%), larynx and hypopharynx (n=11; 14%), and nasopharynx (n=10; 13%). In patients with OCO tumours, concurrent systemic treatments were cisplatin Q3W (n=36, 19 in MLT group and 17 in PCB group) and cetuximab Q1W (n=22, 12 in MLT group and 10 in PCB group). The efficacy results in patients diagnosed with oral cavity and oropharynx tumors were as follows:

MLT also significantly reduced the duration of UOM (median of days) in patients treated with cisplatin (53 days vs 76 days, p < 0.05), and clinically reduced the UOM duration in cetuximab treated patients (58 days vs 74 days, p=0.28). Conclusion Treatment with MLT in patients diagnosed with tumors of the oropharynx and oral cavity decreases the incidence of severe oral mucositis. Patients treated with cisplatin are significantly benefited ones although patients treated with cetuximab presented a clinical reduction of SOM and UOM duration. PD-030 Does multiparametric imaging with FDG- PET/MRI capture intratumor heterogeneity in histopathology? J. Rasmussen 1 , A. Olin 2 , G. Lelkaitis 3 , A.E. Hansen 2 , H.H. Johannesen 2 , A. Kjær 2 , I.R. Vogelius 4 , L. Specht 4 , I. Wessel 1 , C.V. Buchwald 1 , B.M. Fishcer 2