7th ICHNO Abstract book

page 88 7 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 14 – 16 March 2019 Barcelona, Spain __________________________________________________________________________________________ 7th ICHNO

centre the 11% were treated with exclusive surgery, 85% with postoperatory radiotherapy and only 2 patients were treated with best supportive care. The dose of radiotherapy used to deliver was 60 Gy (22%) and ≥ 66Gy (62%). Results With a median follow-up of 65 months (range: 15-177 months), the number of men (26) and women (29) evaluated was roughly equal (47% and 53% respectively), with a median of 58 years-old (range: 24 - 84 yo) and 60% were Stage III-IV. The salivary glands were the most common site of origin for ACC (47%). Other locations were: oral cavity 18%, paranasal sinuses 15%, pharynx 4%, larynx and trachea 2%. Perineural invasion was diagnosed in 81%. The immunochemistry was evaluated in 7 patients: the presence of progesterone and estrogen receptors, Her-2, Ki-67, S100, Actin and CD117. The hormonal receptors were not detected in any of the tumors and the most Ki- 67 identified was around 20-25%. 59% had close or positive margins (R1). We had found metastases in 21 (38%), 18 of them were in the lungs (85%) followed by the liver (19%) and bones (10%). A Kaplan-Meier analysis estimated 5- years overall survival (OS), disease-free survival (DFS) and locoregional control (LRC) were: 83%, 58% and 81% respectively. Conclusion Although immunohistochemistry has been evaluated in a small sample, the result has been negative in all cases that we had studied. It will be necessary to evaluate prospectively the markers to determine their prognostic value. More patients are necessary to be able to detect find predictive factors in survival or local control in ACC and more long-term follow-up is necessary. PO-167 3D printing of biocompatible polymers for personalized skull-base reconstruction: proof of concept D. Mattavelli 1 , F. Doglietto 2 , M. Ferrari 1 , A. Fiorentino 3 , S. Agnelli 3 , L.F. Rodella 4 , R. Maroldi 5 , P. Nicolai 1 1 Spedali Civili-University of Brescia, Unit of Otorhinolaryngology- Head and Neck Surgery- Department of Surgical Specialties- Radiological Sciences- and Public Health, Brescia, Italy ; 2 Spedali Civili- University of Brescia, Unit of Neurosurgery- Department of Medical and Surgical Specialties- Radiological Sciences- and Public Health, Brescia, Italy ; 3 University of Brescia, Mechanical and Industrial Engineering, Brescia, Italy ; 4 University of Brescia, Anatomy and Physiopathology- Department of Clinical and Experimental Sciences, Brescia, Italy ; 5 Spedali Civili-University of Brescia, Unit of Radiology- Department of Surgical Specialties- Radiological Sciences- and Public Health, Brescia, Italy Purpose or Objective To develop an efficient, personalized, universally working, and relatively easy algorithm for skull base reconstruction of large and geometrically complex defects after extended endoscopic resection of skull base tumors. Material and Methods Clival defect after endoscopic transnasal resection was chosen as research model. Three cadaver heads underwent cone beam CT. The clival defect was predicted and contoured on DICOM images. The plug was segmented and modeled on the predicted defect with 3D slicer® and Materialise®, respectively; handles were added. Printing was obtained with the fused deposition modeling technique. Polylactic acid was chosen in view of its biodegradability; its physical and mechanical

Purpose or Objective Prognosis of pts with recurrent or metastatic (R/M) disease depends mainly on histological type and clinical stage. In preclinical models, the VEGF pathway seems to contribute to tumor aggressiveness as well as to distant metastatization. Axitinib is a potent VEGFR specific- inhibitor approved for renal cancer. Activity of axitinib was observed in a phase II on adenoid cystic carcinoma (ACC). We aimed to test the activity of axitinib in a larger pts population with R/M salivary gland carcinomas, even including non-ACC patients. Material and Methods No previous systemic treatments for R/M disease were allowed. Axitinib was administered at a starting dose of 5 mg BID, followed by 7 mg BID and then 10 mg BID until tumor progression or unacceptable toxicity. A 2-stage Simon design was applied: one response within the first 15 enrolled pts allowed us to complete the enrolment until 26 subjects. Null hypothesis would be rejected if less than 3/26 responses would be observed. Results Twenty-six pts were treated (13 men): 6 ACC, 20 non-ACC. Best overall response rate (ORR) was 8%: 2/26 partial response (PR), 13/26 stable disease (SD), 11/26 progressive disease (PD). In the only 2 responding pts (1 ACC and 1 poorly differentiated carcinoma) duration of response (DoR) was 1.5 and 6.6 months (median 4.1). With a 29.9-month median follow-up, median PFS and median OS were 5.5 months (95% CI 1.9-8.4) and 43 months (95% CI 12.4-NR), respectively. All pts had at least one drug related adverse event (AE): stomatitis (69%), fatigue (58%), arterial hypertension (54%), diarrhea (50%), hypothyroidism (31%) and hand-foot syndrome (27%) were the most frequent. Hypertension (31%) and weight loss (8%) were the most common grade≥3 AEs. Neither bleedings nor grade 5 AEs were observed. After a 5 mg starting dose, 8 pts underwent dose escalation to 7 mg (3 further increase to 10 mg, 3 maintained 7 mg, 2 reduced to 5 mg), 16 pts maintained a 5 mg dose and 2 pts needed a dose reduction after the 5 mg starting dose. Conclusion This phase 2 clinical trial did not meet its primary endpoint. Even though the study was not statistically powered to assess differences between ACC and non-ACC, a slightly higher ORR was observed in the ACC group (1/6 PR). Safety profile is in line with the scientific literature. PO-166 The impact of immunohistochemical markers of the adenoid cystic carcinoma (acc) of Head and Neck M. Laplana Torres 1 , I. Linares Galiana 1 , S. Almendros Sanchez 1 , J. Gonzalez Viguera 1 , J. Mases Rosines 1 , I. Guix Sauquet 1 , A. Navarro Martin 1 , C. Arranz Obispo 2 , M. Goma Gallego 3 , A. Lozano Borbalas 1 1 Institut català d´Oncologia ICO-L'Hospitalet de Llobregat, Radiation Oncology, Barcelona, Spain; 2 Hospital de Bellvitge, Oral and Maxillofacial Surgery, Barcelona, Spain; 3 Hospital de Bellvitge, Anatomical Pathology, Barcelona, Spain Purpose or Objective To describe our series of 55 cases of Adenoid Cystic Carcinoma, related OS, DFS and LRC. Material and Methods From 1996 to 2016, 55 patients have been diagnosed at the Head and Neck Department of the Catalan Institute of Oncology (ICO) and Bellvitge's Hospital. The preferred treatment for localized ACC is surgery that results in complete resection and negative surgical margins. In our