ESTRO 2020 Abstract book

S95 ESTRO 2020

Data of 254 NSCLC patients from 19 Italian radiotherapy centers were analyzed. Patients were treated from 05/01/2007 to 29/11/2018. Median age was 65 years (range 33-86). A total of 499 BM were treated: 184 (72%) patients were treated in a single fraction while 70 (28%) with Hypo-Fractionated radiotherapy. The most used drugs were Nivolumab (22%), Pembrolizumab (16%), Erlotinib (15%), Gefitinib (13%) and Crizotinib (12%). Patients and treatments characteristics are summarized in Table 1. Eleven patients were lost during follow up (FUP). After a median FUP of 7 months L-PFS, D-PFS and OS were 48 months (range 30m-69m), 12 months (range 9m-16m) and 7 months (range 2m-15m) respectively. Nivolumab compared to Pembrolizumab seemed to show a better L- PFS (HR: 0.7 CI 95%: 0.14-3.04), D-PFS (HR 0.79 CI 95% 0.35-1.77) and OS (HR: 0.5 CI 95% 0.2-1.7) without reaching a statistical significance. Among TT Erlotinb compared to Gefitinb and Crizotinib showed a better OS while D-PFS showed a trend in favor of Gefitinib. Grade 2 and 3 Radionecrosis were reported in 10 (4%) and 2 (1%) patients, respectively. No other severe neurological toxicity were described.

local radiation treatment on LPFS, DPFS and OS add new evidence about SRT efficacy, which may help to refine the selection of patients who benefit more from this treatment and to establish the predictive scores evaluating the risk of local and distant progression after SRT. PD-0175 TTIRS trial:a retrospective analysis of the association between TT or IT and RS for BM from NSCLC E. Olmetto 1 , S. Scoccianti 1 , R. Di Franco 2 , P. Anselmo 3 , G. Beltramo 4 , C. Mantovani 5 , M.F. Osti 6 , V. Pinzi 7 , N. Giaj- Levra 8 , A. Bruni 9 , P. Matteucci 10 , S. Pedretti 11 , E. Giudice 12 , P. Tini 13 , M. Krengli 14 , P. Ciammella 15 , F. Pasqualetti 16 , M. Trignani 17 , A. Merlotti 18 , V. Borzillo 2 , D. Franceschini 19 , E. Maranzano 3 , R. Umberto 5 , N. Pierina 19 , V. Scotti 1 1 University of Florence, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, Firenze, Italy ; 2 Istituto Nazionale Tumori - Fondazione G. Pascale, Department of Radiotherapy, Naples, Italy ; 3 Radiotherapy Oncology Centre S. Maria Hospital, Department of Radiotherapy, Terni, Italy ; 4 Cyberknife Centro Diagnostico Italiano, Department of Radiothrapy, Milan, Italy ; 5 Radiotherapy unit- University of Turin, Department of Oncology, Turin, Italy ; 6 Uoc radioterapia Aou sant’Andrea facoltà medicina e psicologia Universita Sapienza, Department of Radiotherapy, Rome, Italy ; 7 Uo radioterapia Fondazione IRCCS istituto neurologico Carlo Besta, Department of Radiotherapy, Milan, Italy ; 8 IRCCS Ospedale Sacro Cuore Don Calabria, Deaprtment of advanced radiation oncology, Verona, Italy ; 9 Radiotherapy Unit- University Hospital of Modena, Department of Oncology and Hematology, Modena, Italy ; 10 Radioterapia Oncologica Campus Biomedico, Department of Radiotherapy, Rome, Italy ; 11 ASST Spedali Civili di Brescia e Università degli studi di Brescia- U.O. Radioterapia oncologica, Department of Radiotherapy, Brescia, Italy ; 12 UOC di Radioterapia- Policlinico Universitario Tor Vergata, Departmnt of Onco- Haematology, Rome, Italy ; 13 Radioterapy unit- University of Siena, Department of Radiotherapy, Siena, Italy ; 14 Radiation Oncology- University Hospital Maggiore della Carità, Department of Radiotherapy, Novara, Italy ; 15 Radioterapia Oncologica- AUSL-IRCCS Reggio Emilia, Department of Radiotherapy, Reggio Emilia, Italy ; 16 Radiation Oncology- Azienda Ospedaliero Universitaria Pisana, Department of Radiotherapy, Pisa, Italy ; 17 U.O.C. Radioterapia Oncologica- Ospedale Clinicizzato SS Annunziata- UniversitàChieti G.D'Annunzio, Department of Radiotherapy, Chieti, Italy ; 18 Radiation Oncology A.S.O. S.Croce e Carle, Department of Radiotherapy, Cuneo, Italy ; 19 Humanitas Research Hospital, Radiotherapy and Radiosurgery Department, Rozzano, Italy Purpose or Objective To investigate the association between concomitant RadioSurgery (RS) and Immunotherapy (IT) or Targeted Therapy (TT) for the treatment of brain metastases (BM) from Non Small Cell Lung Cancer (NSCLC). Aims of the study were Local Progression free Survival (L-PFS), Distant Progression Free Survival (D-PFS), Overall Survival (OS) and Safety. This a multicenter study by Brain and the Thoracic Oncology Group of Airo (Italian Association of Radiation Oncology) Material and Methods Data about patients treated with concomitant IT or TT and RS were retrospectively collected. Concurrent time was considered a period of 4 weeks. L-PFS and D-PFS were defined as the time from RS to local progression of the treated lesions and to the appearance of new BM, respectively. Patients should have at least a follow up of 3 months. Safety results were reported according to the CTCAE v4.1. Kaplan Meyer analysis of survival was performed. Results

Patient's Characteristics

Number 254 (%)

Gender MF

140

(55%)114

(45%)

Age MedianRange

65

years33-86

years

Smoke

(p/y)

Unknown 0 <10 10-20>20

164

(64.5%) (5.5%)

14

8

(3%)

6 (2%)62 (25%)

Histology Adenocarcinoma Squamous Cell Carcinoma

232 (91%)22 (9%)

Molecular

Biology

EGFR+ ALK+PDl-1> 1%

77 (30%) 41 (16%)53 (21%)

Stage

at

diagnosis

Unknown M0 M1Brain M1 0-1 1.5-2 2.5-33.5-4 molGPA

5

(2%)

94 (37%) 155 (61%)72 (28%)

Score

17

(7%)

105 (41%) 109 (43%)23 (9%)

Conclusion Our data suggest that RS and IT or TT for the treatment of BM from NSCLC is feasible and safe. Among IT Nivolumab seems to be associated with a better intracranial control and OS compared to Pembrolizumab, while there is not a clear difference in terms of outcomes between different targeted agents. Prospective data are needed to confirm our results.

Poster discussion: CL: Breast 1

PD-0176 Survival After Breast-Conserving Therapy Compared With Mastectomy in Stage I-IIA Breast Cancer I. Ratosa 1 , G. Plavc 1 , T. Zagar 2 1 Institute of Oncology Ljubljana, Department of Radiation Oncology, Ljubljana, Slovenia ; 2 Institute of Oncology Ljubljana, Department of Epidemiology and Cancer Registry, Ljubljana, Slovenia

Purpose or Objective