ESTRO 37 Abstract book

S905

ESTRO 37

Purpose or Objective It is important to have a good overview of the cancer research efforts. Therefore, we have evaluated interventional clinical trials portfolio for 15 malignancies with highest mortality rates in both sexes on a global scale. Material and Methods We have searched ClinicalTrials.gov database for trials started in 10-year period (January 2006 - December 2016). We have evaluated portfolio across evaluated malignant entity, their reported global mortality, trial design characteristics, trial status and primary sponsors. Results 19538 unique trials were detected. 76% trials evaluated only one, 21% two and 3% evaluated three or more cancer entities. 4 disease entities represent more than 54% of the complete portfolio, namely colorectal cancer was reported in 15% of all registered trials, followed by breast cancer (14%), lung cancer (13%) and leukemia (12%). A complete distribution of trials according to malignant disease is shown in figure 1. 34% of all trials were completed in the time of analysis, 42% was active and 18% were stopped prematurely. Majority of trials were in phase 2 (n=7026, 36%), non-randomized (n=11983,61%) and single arm (n=10585,54%). Median sample size was 51 patients. Primary purpose of 78% (15314) trials was the evaluation of cancer treatment efficacy. 7% (1317) was labeled as diagnostic trials, 5% (1020) as supportive care evaluation, 4% (802) evaluate preventive measures and 6% (1085) has other purposes. Number of newly started trials shows linear trend with 10-year growth rate of 4.42% annually. Industry was reported as primary sponsor in 25% of all trials, United States Institute of Health in 4%, United States Federal Government in 0.2%. 71% (n=13796) of all primary sponsors were classified as others, mainly academic centers or collaborative groups.

weekly neuro-oncology (NO) MDT discusses all intracranial tumours, lasts 2 hours and covers a population of 4 million. We assessed outcomes of patients with new diagnoses of BM and the current practice of our regional NO MDT as a basis for establishing a dedicated BM MDT. Material and Methods A cross-sectional audit of intracranial imaging was performed to identify new cases of BM within our trust over a one month period. These new cases’ records were accessed to look at their individual management and outcomes. A second audit of neuro-oncology MDT decisions from a 4 month period was performed to assess current practice. Results A total of 1,557 CT brain scans and 942 MRI head scans from a one month period (December 2013). Fifteen patients were identified as having a new diagnosis of BM with a further 15 having known BM. Of the new BM, 4 were discussed at the neuro-oncology MDT (1 biopsy, 1 shunt and 2 no treatment). Two patients were referred elsewhere for SRS, though these patients had not been discussed at the NO MDT. Only 8/15 had been prescribed steroids at diagnosis. Four patients died on the same admission as diagnosis and median survival of the group was 34 days (range 2-457 days). The 2 who received SRS were the longest survivors (335 & 457 days). Of the 11 patients who were discharged there was 18 admissions over the 1669 days of cumulative survival (1 admission per 92.7 days survival) including 6 admissions for one patient who received SRS (1 admission per 55.8 days). Decisions from 15 NO MDTs were accessed. There were 776 patient discussions meaning average patient discussion time was 2.3 minutes. Of these, 127 (16.4%) were about patients with BM. Their outcomes are listed below. MDT Outcome N=127 (%) Refer for SRS opinion 38 (29.9%) Surgery (incl. biopsy, shunt and resection) 11 (8.7%) No specific intervention recommended 42 (33.1%) Best supportive care 10 (7.9%) Rediscuss 10 (7.9%) WBRT 8 (6.3%) Post histology discussion 6 (4.7%) Imaging opinion given post SRS 2 (1.5%) No data was available on performance status or extra- cranial. All decisions for SRS were based on size, number & volume of lesions only. Conclusion A significant proportion of patients discussed at the regional neuro-oncology MDT have BM. These patients form a heterogeneous group with often complex histories and varied outcomes. Current practice means clinicians have little time to discuss complex cases and decide on treatment. A regional, fully supported, BM MDT would allow more comprehensive individualised patient discussions. We feel there is sufficient evidence for the establishment of such a service and have secured funding to do so in our hospital. EP-1683 Clinical trials in 15 malignancies with highest mortality rate on global scale E. Vlaskou Badra 1 , A. Tsikkinis 1 , N. Cihoric 1 1 Insel Gruppe- Inselspital- Universitätsspital Bern, Radiation-Oncology, Bern, Switzerland

Conclusion Oncological clinical trials are mainly driven by academic centers or collaborative groups. They are mostly in early stage, with low sample size. Almost 1/5 of all trials are ended prematurely. The number of trials for specific disease entity do not corresponds to global burden of disease. In order to respond toward real life needs, portfolio of the cancer-related trial requires adjustments.