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 23

A total of 5879 eligible patients were in the analysis. In OP, only those patients who had CRT, surgery-RT, and RT alone were included. Patients who were older and had higher CCI scores were less likely to receive “more intense” multimodality treatment across the three sites as estimated by the multivariable logistic regression approach. In OP cancer (n=2312), those who received RT had median OS of 2.1 years (95% CI: 1.8-2.5) compared to 3.9 years with CRT (95% CI: 3.3-4.5; HR=1.3, 95%CI: 1.2- 1.5, p<.001), and 4.1 years with surgery-RT (95% CI: 3.2- 5.3; HR=1.3, 95%CI: 1.1-1.5, p<.001). Grouping patients into 5-yr age at diagnosis intervals, the HR of death was consistently in the range 1.3-1.4 after RT alone compared with CRT. Importantly, in patients with CCI 0, 1 or 2+, the HR remained the same. There was a clear decline in the proportion of cases selected for CRT as a function of age from 43% in the 66-69 year group, to 28% in the 80+ group. In OC cancer (n=2376), older age and higher CCI were associated with poorer OS, and the primary treatment, single (1139 cases, 50%) vs multimodality, did not affect survival (p=0.20) as estimated by the multivariable Cox regression model. In laryngeal cancer (n=1191), we found that age at diagnosis, CCI, and primary treatment impacted survival. Patients who received RT only or surgery only (491 cases, 41%) had poorer survival than those who had multimodality treatment (HR=1.2, 95%CI: 1.1-1.4, p=0.003). Conclusion Elderly locally advanced HNSCC patients, particularly in the OP and larynx, who receive “less intense” therapy have poorer outcomes. While patient selection is likely a co-factor in explaining these results, our findings show an age-independent benefit of getting multimodality therapy. OC-045 Socioeconomic inequality in head and neck cancer survival– a population-based study from DAHANCA M.H. Olsen 1,2 , P. Lassen 1 , C. Rotbøl 1 , T.K. Kjær 2 , E.A.W. Andersen 3 , J. Overgaard 1 , S.O. Dalton 2 1 Aarhus University Hospital, Department of Experimental Clinical Oncology, Aarhus, Denmark; 2 Danish Cancer Society Research Center, Survivorship, Copenhagen, Denmark; 3 Danish Cancer Society Research Center, Statistics-Bioinformatics- and Registry, Copenhagen, Denmark Purpose or Objective Nations with free access to health care observe a large and increasing socioeconomic inequality in survival after cancer, particularly pronounced for Head and Neck Squamous Cell Carcinoma (HNSCC). We investigate where in the trajectory of HNSCC the socioeconomic inequality arises. Material and Methods Clinical information on all patients (n=15 248) diagnosed with larynx, pharynx, or oral cavity squamous cell carcinoma between 1992 and 2014 in Denmark, born >1920, aged ≥30 at diagnosis and registered in the nationwide and population-based clinical database DAHANCA (Danish Head and Neck Cancer Group) were linked to nationwide, administrative registries to obtain information on socioeconomic factors (education, income, cohabitation status, degree of urbanization) as well as vital status. By fitting cox proportional hazards and logistic regression models we estimated, separately for each cancer sub-site, the effect of socioeconomic position on HNSCC survival and a wide spectrum of prognostic and life style factors: stage at diagnosis, HPV-status,

dose levels at 5%, 10%, 15% and 22% of baseline tumor volume. Primary endpoints included the determination of recommended dose and early dose limiting toxicity (DLT). Presence of NBTXR3 in the surrounding healthy tissues and efficacy as per RECIST 1.1 tumor response were also evaluated. Results The inclusion was completed at all dose levels 22% (7 pts), 15% (5 pts), 10% (3 pts) and at 5% (3 pts). All patients that completed the DLT evaluation period did not present any early DLTs or serious adverse events (SAEs) related to NBTXR3 or the injection procedure. So far, two AEs (asthenia, grade 1; pain, grade 2) related to NBTXR3 were reported in patients at the 22% dose level. Additionally, four AEs related to the injection procedure (tumor hemorrhage, grade 1; oral pain, grade 2; asthenia, grade 1, hemorrhage, grade 1) occurred in patients at the 15% and 22% dose levels. Conclusion NBTXR3 was well tolerated even at the highest dose with an overall positive safety profile. As the last dose level was reached, a dose expansion group will start in this clinical setting once the recommended dose is identified. These results open a promising perspective in frail HNSCC pts with advanced age, which is a population not often evaluated in clinical trials. NBTXR3 was also evaluated in a phase II/III clinical trial in soft tissue sarcoma [NCT02379845] with positive results and is currently being evaluated in prostate cancer [NCT02805894], liver cancer [NCT02721056], rectal cancer [NCT02465593] and recurrent/metastatic HNSCC or metastatic non-small cell lung cancer [NCT03589339]. OC-044 Are elderly HNSCC patients undertreated? An analysis of outcomes using the SEER-Medicare database I. Suzuki 1 , K. Cullen 1 , S. Bentzen 2 , O. Goloubeva 2 1 University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Hematology and Oncology, Baltimore, USA; 2 University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Epidemiology and Public Health, Baltimore, USA Purpose or Objective Elderly patients with HNSCC face a dilemma when considering treatment options. Advanced age and comorbidities can limit their ability to tolerate more intense therapies. This study examined impact of choice of primary treatment on outcomes of elderly patients with oropharyngeal (OP), oral cavity (OC) and laryngeal SCC. Material and Methods We used the Surveillance Epidemiology and End Results (SEER)-Medicare linked database. We identified all patients 66 yrs and older with locally advanced cancers of the OP, OC and larynx from 1992 to 2011. We looked at age at diagnosis, comorbidities (Charlson comorbidity index, CCI), and primary treatment (therapy received within first 180 days of diagnosis). We compared outcomes between “less intense” (single modality) therapy to “more intense” (multimodality) therapy. The probability of receiving single modality vs multimodality treatment was estimated by logistic regression using age and CCI at diagnosis as explanatory variables. The multivariable Cox regression model was used to assess impact of treatment (radiotherapy (RT) alone vs surgery- RT or chemoradiation (CRT) in OP, and single modality vs multimodality in OC and larynx) on OS when adjusted for age and CCI at time of cancer diagnosis. Results