7th ICHNO Abstract book

page 96 7 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 14 – 16 March 2019 Barcelona, Spain __________________________________________________________________________________________ 7th ICHNO

Head and Neck Tumours, Milano, Italy; 5 IRCCS Centro di Riferimento Oncologico CRO National Cancer Institute, Division of Medical Oncology, Aviano, Italy; 6 IRCCS European Institute of Oncology, Division of Otolaryngology and Head and Neck Surgery, Milano, Italy; 7 S. Maria degli Angeli General Hospital, Division of Otolaryngology, Pordenone, Italy; 8 S. Martino Hospital, Division of Radiation Oncology, Belluno, Italy; 9 IRCCS European Institute of Oncology, Scientific Directorate, Milano, Italy Purpose or Objective To evaluate the role of baseline neutrophil-to-lymphocyte ratio (NLR) and other haematological biomarkers and ratios such as neutrophil, lymphocyte, platelet and monocyte count, Lymphocyte to monocyte ratio (LMR) and Platelet to Lymphocyte ratio (PLR) as prognostic markers in locally advanced squamous cell carcinoma of the oropharynx (OPC) treated with definitive chemo- A retrospective analysis of 125 patients, affected with locally advanced OPC and treated between 2010 and 2015 at two tertiary cancer centers in Northen Italy (European Institute of Oncology, Milan and Centro di Riferimento Oncologico, Aviano) was performed. Inclusion criteria were: age>18 years, stage III or IV (TNM 7 th ed.), definitive CxRT. Progression-free survival (PFS) and overall survival (OS) curves were evaluated using the Kaplan-Meier method. Multivariate Cox proportional hazard models were applied to obtain hazard ratios adjusted for other prognostic factors and confounders. Results Median age was 61 (42-77) years and 94 (75.2%) patients were male. HPV status was available in 102 (81.6%) patients and among them 77 (61.6%) pts had HPV/p16+ related OPC. Therapeutic choice consisted in sequential, concurrent and induction followed by concurrent CxRT schedule was delivered to 43 (34.4%), 71 (56.8%) and 11 (8.8%) pts, respectively. Median follow up was 50 months (range 5 - 95 months). A value of NLR≥3 was associated with poorer OS with almost a triple increased risk of death: HR=2.7 (95%CI:1.2, 6.2; p=0.02, adjusted for age, gender, chemotherapy, HPV status and ECOG performance status). Two-years OS was 91% and 81% in pts with NLR<3 and ≥3, respectively (figure 1). No correlation was found between other haematological parameters and prognosis. When restaged with TNM 8 th edition, NLR confirmed prognostic role with increased significance (p=0.03). radiotherapy (CxRT). Material and Methods

PO-183 Pilot study on immunomodulation role of radiotherapy in oropharyngeal cancer: preliminary results L. Belgioia 1 , F. Missale 2 , S. Negrini 3 , G. Filaci 4 , A. Bacigalupo 5 , D. Fenoglio 4 , F. Incandela 2 , S. Vecchio 6 , G. Peretti 2 , R. Corvò 7 1 University of Genoa, Department of Health Science DISSAL and Radiation Oncology, Genoa, Italy ; 2 University of Genoa, Department of Otorinolaringology- Head and Neck Surgery, Genoa, Italy; 3 University of Genoa, U.O. Immunologia Clinica - Centro di Eccellenza per le Ricerche Biomediche CEBR- U.O. Clinica di Medicina Interna ed Immunologia Clinica, Genoa, Italy ; 4 University of Genoa, U.O. Immunologia Clinica - Centro di Eccellenza per le Ricerche Biomediche CEBR, Genoa, Italy ; 5 IRCCS Ospedale Policlinico San Martino, Radiation Oncology, genoa, Italy; 6 IRCCS Ospedale Policlinico San Martino, Medical Oncology, genoa, Italy ; 7 University of Genoa, Department of Health Science DISSAL and Radiation Oncology, Genoa, Italy Purpose or Objective The discovery of the key role of the immune system in the pathogenesis of tumors prompted studies aimed at identifying immunological prognostic biomarkers. The encouraging results of immunotherapy in recurrent non- resectable head and neck cancer may indicate its potential efficacy, combined to conventional therapies, also as primary treatment. The aim of our study is to perform a comprehensive analysis of the circulating and intratumoral T cell compartments in patients affected by Oropharyngeal Squamous Cell Carcinoma (OSCC) to search for new prognosticators and to get insights on new possible immunotherapeutic strategies. Material and Methods From May to November 2017 14 untreated patients affected by moderately to advance stage OSCC and treated by radiotherapy or chemoradiotherapy have been enrolled in the study; 6 healthy subjects have been included as control group. Analysis of the peripheral and intratumoral immunophenotype was performed by immunofluorescence and flow cytometry in order to analyze the frequency of CD4 + and CD8 + T cell subsets and to evaluate the expression of PD-1 and CTLA-4 immune checkpoints on T cells. Results Oncologic patients and controls showed, among circulating CD3 + T cells, comparable frequencies of CD8 + (42.0% vs 39.9%; p=0.99) and CD4 + (57.8% vs 59.5%;p=0.99) T cell subsets. With respect to control subjects, OSCC patients showed a reduction of naïve CD8 + (33.3% vs 47.5%; p=0.01) and effector memory CD4 + (22.3% vs 35.2%;p=0.01) T cells associated with an increase of terminal effector memory CD8 + cells (32.8% vs 12.1%;p=0.02) and central memory CD4 + (38.5% vs 21.5%,p=0.01) T cells. Moreover, the frequency of circulating CD3 + PD-1 + T cells was significantly higher in cancer patients than in healthy subjects (29.8% vs 14.5%; p=0.04): interestingly, the frequency of CD3 + PD-1 + and CD3 + CTLA-4 + T cells was remarkably more elevated at the tumor site than in the circulation (86.6% vs 29.8% p<0.001 and 29.2% vs 8.8% p=0.002, respectively). Conclusion Our data, showing alterations of circulating T cell subsets in OSSCC patients, corroborate the concept of the strong interplay between tumors and immune system. In this context, the significant increase of PD-1 expression by patients’ T cells has a twofold relevance: it envisages

Conclusion In our cohort, a baseline NLR≥3 at treatment initiation represented a negative prognostic marker for OPC treated with definitive CxRT. Our results are in line with literature data and confirmed after re-staging with last TNM. Therefore, this inexpensive and readily available marker could be considered for risk stratification of pts with locally advanced OPC.