ESTRO 2022 - Abstract Book
S1246
Abstract book
ESTRO 2022
Prostate
5.0 4.5 4.8 1.4
5.4 3.7 2.6 1.1
Same
Breast Other
18% 46% 21%
Palliative
Table 1. Delay mean value for each localization and year Finally, regarding the type of unscheduled interruptions, 25% of the patients suffered at least one interruption for machine breakdown during 2018. This value was 30% for the patients treated in 2019. Conclusion Introducing treatments over the weekend is a solution to prevent or manage unplanned prolongation of radiotherapy treatments. Also, the prioritizations of patients whose radiotherapy treatments have been interrupted are essential to compensate for the anticipated prolongation. Patients with higher priorities (more risk) result in a higher decrease of the OTT.
PO-1467 Pegylated Liposomal Mitomycin C Lipidic Prodrug and Palliative Radiotherapy– a Phase 1B Study
E. Sapir 1 , R. Pfeffer 2 , M. Wygoda 3 , A. Levy 3 , B. Corn 4 , P. Ohana 5 , A. Gabizon 6
1 Assuta Ashdod University Hospital, Radiation Oncology, Ashdod, Israel; 2 Assuta Medical Center, Tel Aviv, Israel, Radiation Oncology, Tel Aviv, Israel; 3 Hadassah Hebrew University Medical Center, Radiation Oncology, Jerusalem, Israel; 4 Shaare Zedek Medical Center, Radiation Oncology, Jerusalem, Israel; 5 Lipomedix Pharmaceuticals, Clinical Trials , Jerusalem, Israel; 6 Shaare Zedek Medical Center, Oncology department, Jerusalem, Israel Purpose or Objective Mitomycin C (MMC) is a well-established radiosensitizer. However, MMC is associated with severe hematological and renal toxicity limiting its use. Early clinical studies indicate that a novel formulation of pegylated liposomal MMC lipidic prodrug (Promitil®) is safe and effective with limited hematotoxicity compared with MMC. Furthermore, in preclinical studies, it had promising radiosensitizing activity. The primary objectives of this phase 1B study of Promitil ® with radiotherapy (RT) were to evaluate safety and tumor response in the irradiated field in patients requiring palliative RT. Secondary objectives were to determine plasma prodrug (MLP) levels after each Promitil ® infusion and systemic anti-tumor response Materials and Methods The protocol was approved by the respective IRBs. 19 eligible pts with metastatic (18) or inoperable (1) disease, received a combination of Promitil ® and standard of care RT. Most pts (16) were diagnosed with advanced GI tract cancer. The treatment included two Promitil® doses, at 21-day intervals, and RT initiated 1-3 days after the first Promitil ® dose and completed within 2-weeks. Ten fractions of conventionally fractionated RT or 5 SBRT fractions were allowed. The study consisted of 3 dose-escalation cohorts of Promitil ® of 6 patients each: 1.25 mg/kg, 1.5 mg/kg, and 1.8 mg/kg. Dose escalation proceeded if no dose-limiting toxicities (DLT) were recorded by study day 43 in more than 1/6 patients. Patients were assessed weekly during the Promitil ® cycle (42 days after last dose of Promitil ® ). Status of the irradiated and non-irradiated lesions, if present, was reevaluated by CT between days 43-50, and every 6 weeks thereafter. In addition, MMC prodrug plasma levels were analyzed 1 h and 1 day after each dose of Promitil ® Results 18/19 pts completed two Promitil ® infusions and the entire RT course. No DLT was reported. Two SAEs were reported, one considered non-related and one possibly related Grade 4 neutropenia . Most of the AEs were deemed mild or moderate. The most common AEs - possibly related to the study drug - were thrombocytopenia, fatigue and vomiting. No severe RT- related reaction was reported. 18/19 pts were evaluable for efficacy. 16/18 patients were free of disease progression in the irradiated target lesion (1 complete response, 9 partial response, 6 stable, 2 progressive disease). Median survival of patients in the 3 cohorts was 103 weeks. Plasma analysis showed high level of MLP correlating with the increase in dose level and a similar profile before and after RT. About 50 % of MLP was still in circulation 24h after Promitil ® infusion. No free MMC was detectable in plasma Conclusion Promitil ® combined with RT is safe at a dose of 1.8 mg/kg every 3 weeks with a high rate of tumor control in a variety of tumor types. Drug clearance is not affected by radiation. Promitil ® is a novel and attractive option for radiosensitization that should be evaluated in future randomized studies in the palliative (and possibly the curative) setting
PO-1468 LATTICE radiotherapy: A one institution experience
J. Germain 1 , A. Ciafre 1 , O. Prato 1 , I. Solero 1 , M. Borras 1 , F. Celada 1 , N. Tejedor 2 , G. Jose 2
1 Hospital Universitari i Politècnic La Fe, Radiation Oncology, Valencia, Spain; 2 Hospital Universitari i Politècnic La Fe, Radiation Oncology (Physics), Valencia, Spain Purpose or Objective LATTICE Radiotherapy (LRT) emerges as an innovative approach for treatment of voluminous tumors not suitable for resection. We aim to evaluate the tumor response and safety of this technique in a cohort of patients with bulky tumors treated in our institution.
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