ICHNO-ECHNO 2022 - Abstract Book

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ICHNO-ECHNO 2022

cognitive decay one patient each. PR and SD was observed in 6 pts (16%) and 21 (57%), respectively, with a 73% disease control rate (PR+SD). Ten pts (27%) experienced a disease progression. All 44 pts were evaluable for toxicity. At least one TRAE of any grade was recorded in 100% of pts. The most frequent TRAEs > G3 were hypertension (27%), stomatitis (21%), fatigue (18%). No G5 TRAEs were reported. Sixteen out of 44 pts (36.4%) received lenvatinib 24 mg/daily as starting dose and 28 patients (64%) required at least one dose reductions for side effects. The median follow-up from the start of lenvatinib was 5.8 months (95% CI: 4.6-8.3). PFS rate at 6-month was 79% and at last follow-up date, 14 pts (32%) were still on lenvatinib. Conclusion Our data, coming from the largest real-world, unselected pts’ population series confirmed the activity and the safety of lenvatinib in R/M ACC. Side effects were consistent with the drug profile, except for the high rate of stomatitis > G3. P. Rondi 1 , D. Smussi 2 , A. Esposito 2 , V. Rampinelli 3 , M. Ferrari 4 , T. Tartaro 5 , P. Castelnuovo 6 , M. Turri Zanoni 6 , B. Vischioni 7 , G. Calareso 8 , N. Facchinetti 9 , N.A. Iacovelli 10 , E. Orlandi 9 , L. Licitra 11 , C. Resteghini 11 , P. Nicolai 12 , P. Bossi 13 , R. Maroldi 14 , D. Farina 14 , M. Ravanelli 14 1 University of Brescia - Spedali Civili, Radiology, Brescia, Italy; 2 Università degli studi di Brescia - Spedali Civili, Medical Oncology, Brescia, Italy; 3 Spedali Civili, Otorhinolaryngology, Brescia, Italy; 4 Università di Padova, Otorhinolaryngology, Padova, Italy; 5 Ospedale di Circolo e Fondazione Macchi, Medical Oncology, Varese, Italy; 6 Università degli studi dell'Insubria, Otorhinolaryngology, Varese, Italy; 7 Fondazione CNAO, Medical Oncology, Pavia, Italy; 8 Fondazione IRCSS Istituto Nazionale Tumori, Radiology, Milano, Italy; 9 Fondazione CNAO, Radiation Oncology, Pavia, Italy; 10 Fondazione IRCSS Istituto Nazionale Tumori, Radiation Oncology, Milano, Italy; 11 Fondazione IRCSS Istituto Nazionale Tumori, Medical Oncology, Milano, Italy; 12 Università degli studi di Padova, Otorhinolaryngology, Padova, Italy; 13 Università di Brescia - Spedali Civili, Medical Oncology, Brescia, Italy; 14 Università di Brescia - Spedali Civili, Radiology, Brescia, Italy Purpose or Objective The aim of this study is to assess the value of volumetric analysis in predicting outcome of patients with sinonasal epithelial cancers treated by neoadjuvant chemotherapy (NAC) followed by surgery or chemo-radiotherapy within the prospective clinical trials SINTART-1 and SINTART-2. Materials and Methods Fifty patients treated within the SINTART-1 and -2 clinical trials (NAC followed by locoregional treatment in locally advanced sinonasal epithelial cancers) with pre-treatment, after 1 cycle of NAC, and at the best response (BR) magnetic resonance (MR) were selected. Tumors were measured uni-dimensionally (along three orthogonal vectors) and volumetrically (V). Unidimensional measurements were prospectively used to assess treatment response according to RECIST 1.1. Measurements were repeated by two radiologists to assess the interobserver variability. Furthermore, in order to test the possibility of speeding up the segmentation of V, an additional volumetric measurement using interpolation (Vi) between non-contiguous slices (maximum of 5 slices manually segmented) was used. The percentage changes in tumor metrics were used in the survival analysis (overall survival, OS; disease-free survival, DFS). Results Volume was the most repeatable measure in pre-treatment studies and in terms of percentage variation during treatment. Correlation between manual V and Vi was excellent. Differently from RECIST 1.1 and uni-dimensional measures, which did not provide any prognostic correlation, V change of more than 50% after 1 cycle of NAC (HR 0.33 and 0.31, p 0.02 and p 0.01, respectively) and at the BR (HR 0.33 and 0.41, p 0.01 and p 0.04, respectively) correlated with OS and DFS. Conclusion Volumetric assessment seems to be the most valuable tool to track response to NAC and to predict the outcome, outperforming RECIST 1.1. Tumor segmentation can be significantly speeded up by using interpolation methods. S. Zhou 1 , C. Chan 2 , H. Dyab 3 , R. Rulach 1 , F. Hendry 3 , M.F. Dempsey 4 , C. Maxfield 3 , A. James 1 , C. Lamb 1 , D. Grose 1 , S. Schipani 1 , C. Wilson 1 , Y.C. Lau 5 , C. Paterson 1 1 Beatson West of Scotland Cancer Centre, Clinical Oncology, Glasgow, United Kingdom; 2 University Hospital Ayr, General Medicine, Glasgow, United Kingdom; 3 NHS Greater Glasgow and Clyde, Radiology, Glasgow, United Kingdom; 4 West of Scotland PET Centre, Radiology, Glasgow, United Kingdom; 5 Royal Alexandra Hospital, Medicine, Glasgow, United Kingdom Purpose or Objective The PET-NECK study demonstrated non-inferiority of PET-CT surveillance compared to planned neck dissection (ND) in patients who achieve a complete response (CR) to primary chemoradiation. An immediate ND (IND) was mandated for those achieving less than a CR. It is now accepted that HPV-related tumours can take more than 12 weeks to involute completely and that 12-week PET-CT has low positive predictive value for residual disease in this group. An extended period of surveillance was shown to be a safe alternative to IND with acceptable short-term survival. However, late relapses are well recognised in HPV-positive disease and should also be assessed. The aim of this study was to evaluate the long-term safety of the omission of IND in patients with HPV-positive OPSCC achieving less than CR on 12-week PET-CT. OC-0010 Volumetry to assess response to neoadjuvant chemotherapy in 2 prospective trials in sinonasal cancer OC-0011 Long term safety of further surveillance in HPV+ OPSCC with equivocal response on 12-week PET-CT