Early Deaths in Childhood Cancer in Romania—A Single Institution Study

(1) Background: Survival in childhood cancer has improved significantly over the last decades. However, early deaths (EDs) represent an important number of preventable deaths. Our aim was to provide more insight intoEDs in developing countries. (2) Methods: We conducted a retrospective analysis of patients aged 0–18 years with childhood cancer diagnosed between 1996 and 2008 and admitted in the Institute of Oncology “Prof. Dr. Ion Chiricuta” Cluj-Napoca (IOCN), Romania. After exclusion of patients (pts) older than 18 years at diagnosis, pts with a missing personal identification number and pts with unconfirmed diagnosis of malignancy, we included 783 pts in the final analysis. We defined ED as survival of less than one month after cancer diagnosis. We divided pts in groups according to age, major tumour categories and treatment time periods. (3) Results: ED was registered in 20 pts (2.55%). A total of 16EDs were registered in haematologic malignancies and 4 in solid tumours. Statistical analysis was performed on pts diagnosed with haematological malignancies. A statistically significant higher proportion of patients with performance status (PS) 3 and 4 died within one month after diagnosis (24.1%) than patients admitted with PS 0–2 (1%)—p < 0.01. We found no statistically significant difference regarding ED when comparing male versus female (p = 0.85), age at diagnosis or between the threeperiods of diagnosis (p = 0.7). (4) Conclusions: PS at admission is an important risk factor associated with ED in pts with haematologic malignancies. ED in our institution reflects frequent late presentation for medical care, late diagnosis and referral to specialised centres.

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Glioblastoma (GBM) in elderly patients: A randomized phase III trial comparing survival in patients treated with 6-week radiotherapy (RT) versus hypofractionated RT over 2 weeks versus temozolomide single-agent chemotherapy (TMZ).

Journal of Clinical Oncology ◽

10.1200/jco.2010.28.18_suppl.lba2002 ◽

2010 ◽

Vol 28 (18_suppl) ◽

pp. LBA2002-LBA2002 ◽

Cited By ~ 28

Author(s):

A. Malmstrom ◽

B. H. Grønberg ◽

R. Stupp ◽

C. Marosi ◽

D. Frappaz ◽

...

Keyword(s):

Elderly Patients ◽

Survival Data ◽

Treatment Time ◽

Performance Status ◽

Treatment Options ◽

Single Agent ◽

Tumor Resection ◽

Phase Iii ◽

Primary Study ◽

Significant Difference

LBA2002 Background: Despite treatment advances, survival of elderly GBM patients (pts) is usually < 12 months. Hypofractionated RT is advocated in order to shorten treatment time, and chemotherapy has been proposed as an alternative to RT. In a randomized trial we compared two different RT schedules with single-agent TMZ chemotherapy. Methods: Newly diagnosed GBM pts age ≥ 60 years with PS 0-2, were randomized to either standard RT (60 Gy in 2 Gy fractions over 6 weeks) or hypofractionated RT (34 Gy in 3,4 Gy fractions over 2 weeks) or 6 cycles of chemotherapy with TMZ (200 mg/m2 day 1-5 every 28 days). Follow-up including quality of life, symptom checklist, and steroid dosing was completed at 6 weeks, 3 months, and 6 months after start of treatment. The primary study end point was overall survival (OS). Results: A total of 342 pts were included. 291 pts were randomized between the 3 treatment options, 51 pts between hypofractionated RT and TMZ. Median age was 70 years (range 60-88), 59% were male and 72% had undergone tumor resection, the remaining 28% had a diagnostic biopsy only. Performance status was 0-1 for 75% of pts. Survival data are available for 334 pts (98%), with 11 pts (3%) being alive. There was no significant difference in OS between the three treatment arms, with median survival being 8 months for TMZ, 7.5 months for hypofractionated RT and 6 months for 6 weeks RT (p=0.14). Conclusions: Elderly patients with GBM have a short survival. Time-consuming therapy that does not offer longer survival should therefore be avoided. Our study showed no advantage of standard 6 weeks RT compared to hypofractionated RT over 2 weeks or 6 cycles of TMZ chemotherapy. These results indicate that standard RT should no longer be offered to the elderly pt population with GBM. Exclusive TMZ chemotherapy may be an alternative to RT. Subgroup analyses and determination of molecular markers is ongoing. Whether outcome could be improved by concomitant chemoradiotherapy is subject of ongoing clinical trials. [Table: see text]

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Significance of MYC rearrangement and chemotherapy type on survival outcomes of patients with central nervous system lymphoma.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.7548 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 7548-7548

Author(s):

Natalie Sophia Grover ◽

Allison Mary Deal ◽

Stephanie Mathews ◽

Ashley Freeman ◽

Christopher Dittus ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Statistical Significance ◽

Performance Status ◽

Central Nervous System Lymphoma ◽

B Cell Lymphoma ◽

Poor Performance Status ◽

High Dose ◽

Single Institution ◽

Significant Difference

7548 Background: Central nervous system lymphoma (CNSL) has a poor prognosis and an optimal treatment regimen has not been established. Due to the rarity of this disease and frequently poor performance status at diagnosis, there have been few prospective therapeutic clinical trials in this patient population. We therefore performed a retrospective analysis of prognostic factors and treatment outcomes of patients with CNSL treated at a single institution. Methods: Pathology records were used to identify patients diagnosed with CNSL from 1/1/2005 to 9/1/2016 at the University of North Carolina Cancer Hospital. Information about demographics, disease characteristics, treatment, and outcomes was gathered from the electronic medical record. Overall (OS) and progression free survival (PFS) were estimated using the Kaplan-Meier method. Results: We identified 100 patients with CNSL. 49% had primary CNSL (PCNSL). 78% of cases were diffuse large B cell lymphoma. Out of 51 patients evaluated for MYC translocation by FISH, 13 were positive (3 PCNSL and 10 secondary CNSL). Out of 74 patients treated with chemotherapy, 51% received methotrexate (MTX), procarbazine, and vincristine (MPV), with or without rituximab, 28% were treated with other high dose MTX based regimens, with or without rituximab, and 20% received a non-MTX based regimen. There was no significant difference in OS between PCNSL and secondary CNSL (13.7 vs 7.9 months, p = 0.97). Patients with MYC translocation had a worse OS compared to those without MYC translocation (5.1 vs 29.5 months, p = 0.004). Patients treated with MPV had a longer PFS compared to those treated with other high dose MTX based regimens or those who were treated with a non-MTX based regimen (19.1 vs 10.9 vs 3.9 months, p = 0.05), but difference in OS did not reach statistical significance (29.5 vs 22.4 vs 10.6 months, p = 0.12). Conclusions: In this single institution analysis of CNSL, MYC translocation was associated with worse survival. MPV was associated with improved PFS compared to other chemotherapy regimens. Further prospective studies are needed comparing MPV to other MTX-based regimens in CNSL.

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PTLD: Survival and analysis of prognostic factors in a cohort of 138 patients from a single institution.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e19048 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e19048-e19048

Author(s):

Rohit Bishnoi ◽

Ravneet Bajwa ◽

Aaron J Franke ◽

Niraj Patel ◽

William Paul Skelton ◽

...

Keyword(s):

Prognostic Factors ◽

Pediatric Population ◽

Prognostic Score ◽

Performance Status ◽

Organ Transplant ◽

Final Analysis ◽

Treatment Modalities ◽

Secondary Outcome ◽

Line Treatment ◽

Single Institution

e19048 Background: The outcome and prognostic factors of post-transplant lymphoproliferative disorder (PTLD) varies in currently reported literature. We present one of the largest single institution retrospective analysis from University of Florida. Methods: Patient population was identified from EMR and charts were reviewed to collect data. Primary outcome was Overall survival (OS) and secondary outcome was identification of prognostic factors. Results: We identified 138 patients with PTLD from Sept 1994 to Feb 2016 (liver 34%, Kidney 23%, heart 21%, lungs 12%, kidney-pancreas 2% and BMT 6%). After survival analysis, 131 patients were further followed for secondary outcomes. 36% (n = 47) were less than 18 years of age, 60% (n = 83) were males. The median age of PTLD diagnosis was 44 years and the median duration from transplant to PTLD was 4.4 years. Pathology was early lesion 6% (n = 8), polymorphic 17% (n = 23), Monomorphic 71% (n = 93), Hodgkin/like 4.5% (n = 6). Extra-nodal site involvement was 61% (n = 80), most common being GI tract. Ann-Arbor stage distribution was stage I/II 50% (n = 65), stage III/IV 46% (n = 60). Initial treatment was immunosuppression (IS) reduction alone in 24% (n = 31), Rituximab (R) 24% (n = 31), chemotherapy (+/- R) 46% (n = 60). Most common chemo regimen was CHOP (+/-R) 27% (N = 36). After first line, 48% patients had complete remission (CR), 18% partial remission (PR) and 15% progressive disease (PD). Second line treatment was required in 33% (n = 44) and 10% (n = 13) patients required 3rdline treatment. Final analysis showed 61% (n = 80) achieved CR, 17% (n = 22) had PD, 56% (n = 74) patients were alive and 49% (n = 64) are alive without PTLD. Median OS was 14.99 years. Multivariate analysis identified transplant age, organ transplant recipients, PTLD diagnosis age, performance status, IPI score, graft rejection, history of malignancy and recipient EBV status as prognostic factors (p < .05). Conclusions: This study from a leading regional transplant center shows notable OS which is likely from improved immunosuppressive regimens, treatment modalities and large pediatric population. We identified various prognostic factors affecting survival and propose validation to generate prognostic score.

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427 The Effect of Malnutrition on Early Outcomes after Cancer Surgery: An International Prospective Cohort Study in 82 Countries

British Journal of Surgery ◽

10.1093/bjs/znab135.044 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

A Riad ◽

S Knight ◽

E Harrison

Keyword(s):

Colorectal Cancer ◽

Cohort Study ◽

Elective Surgery ◽

Final Analysis ◽

Cancer Surgery ◽

Postoperative Outcomes ◽

Disease Stage ◽

Severe Malnutrition ◽

Colorectal Cancer Surgery ◽

After Cancer

Abstract Background Malnutrition is a state linked to worse postoperative outcomes, and cancer patients are particularly vulnerable due to cachexia. We aimed to explore the effect of malnutrition on 30-day mortality following gastric and colorectal cancer surgery. Method GlobalSurg3 was multicentre international cohort study which collected data from consecutive patients undergoing emergency or elective surgery for gastric and colorectal cancer. Malnutrition was defined using the Global Leadership Initiative on Malnutrition (GLIM) criteria. Multilevel variable regression approaches determined the relationship between malnutrition and early postoperative outcomes. Results 6438 patients were included in the final analysis (1184 gastric cancer; 5254 colorectal cancer). Severe malnutrition was common across all income-strata, affecting 1 in 4 patients overall, with a higher burden in low and lower-middle income countries (64%). In patients undergoing elective surgery (n = 5709), severe malnutrition was independently associated with increased mortality (aOR = 1.62 (1.07-2.48, P = 0.024) after accounting for patient factors, disease stage and country effects. Conclusions Severe malnutrition represents a high global burden in cancer surgery, particularly within lower income settings. Malnutrition is an independent risk-factor for 30-day mortality following elective surgery for gastric and colorectal cancer, suggesting perioperative nutritional interventions may improve outcomes after cancer surgery.

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Body mass index and clinical outcomes in patients with intracerebral haemorrhage: results from the China Stroke Center Alliance

Stroke and Vascular Neurology ◽

10.1136/svn-2020-000534 ◽

2021 ◽

pp. svn-2020-000534

Author(s):

Zhentang Cao ◽

Xinmin Liu ◽

Zixiao Li ◽

Hongqiu Gu ◽

Yingyu Jiang ◽

...

Keyword(s):

Body Mass Index ◽

Hospital Mortality ◽

Body Mass ◽

Intracerebral Haemorrhage ◽

Final Analysis ◽

Normal Weight ◽

Discharge Disposition ◽

Increased Risk ◽

Significant Difference ◽

Stroke Center

Background and aimObesity paradox has aroused increasing concern in recent years. However, impact of obesity on outcomes in intracerebral haemorrhage (ICH) remains unclear. This study aimed to evaluate association of body mass index (BMI) with in-hospital mortality, complications and discharge disposition in ICH.MethodsData were from 85 705 ICH enrolled in the China Stroke Center Alliance study. Patients were divided into four groups: underweight, normal weight, overweight and obese according to Asian-Pacific criteria. The primary outcome was in-hospital mortality. The secondary outcomes included non-routine discharge disposition and in-hospital complications. Discharge to graded II or III hospital, community hospital or rehabilitation facilities was considered non-routine disposition. Multivariable logistic regression analysed association of BMI with outcomes.Results82 789 patients with ICH were included in the final analysis. Underweight (OR=2.057, 95% CI 1.193 to 3.550) patients had higher odds of in-hospital mortality than those with normal weight after adjusting for covariates, but no significant difference was observed for patients who were overweight or obese. No significant association was found between BMI and non-disposition. Underweight was associated with increased odds of several complications, including pneumonia (OR 1.343, 95% CI 1.138 to 1.584), poor swallow function (OR 1.351, 95% CI 1.122 to 1.628) and urinary tract infection (OR 1.532, 95% CI 1.064 to 2.204). Moreover, obese patients had higher odds of haematoma expansion (OR 1.326, 95% CI 1.168 to 1.504), deep vein thrombosis (OR 1.506, 95% CI 1.165 to 1.947) and gastrointestinal bleeding (OR 1.257, 95% CI 1.027 to 1.539).ConclusionsIn patients with ICH, being underweight was associated with increased in-hospital mortality. Being underweight and obese can both increased risk of in-hospital complications compared with having normal weight.

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Comparative study to evaluate dosimetric differences in patients of locally advanced carcinoma cervix undergoing intracavitary brachytherapy under two different anaesthesia techniques: an audit from a tertiary cancer centre in India

Journal of the Egyptian National Cancer Institute ◽

10.1186/s43046-019-0003-2 ◽

2019 ◽

Vol 31 (1) ◽

Author(s):

Divyesh Kumar ◽

G. Y. Srinivasa ◽

Ankita Gupta ◽

Bhavana Rai ◽

Arun S. Oinam ◽

...

Keyword(s):

Day Care ◽

Treatment Time ◽

Locally Advanced ◽

Effective Alternative ◽

External Beam Radiation ◽

Intracavitary Brachytherapy ◽

High Dose ◽

Carcinoma Cervix ◽

Beam Radiation ◽

Significant Difference

Abstract Background Carcinoma cervix is amongst the leading causes of mortality and morbidity in women population worldwide. High-dose-rate intracavitary brachytherapy (HDR-ICBT) post external beam radiation therapy (EBRT) is the standard of care in managing locally advanced stage cervical cancer patients. HDR-ICBT is generally performed under general anaesthesia (GA) in operation theatre (OT), but due to logistic reasons, sometimes, it becomes difficult to accommodate all patients under GA. Since prolonged overall treatment time (OTT) makes the results inferior, taking patients in day care setup under procedural sedation (PS) can be an effective alternative. In this audit, we tried to retrospectively analyse the dosimetric difference, if any, in patients who underwent ICBT at our centre, under either GA in OT or PS in day care. Results Thirty five patients were analysed 16/35 (45.71%) patients underwent HDR-ICBT under GA while 19/35 (54.28%) patients under PS. In both groups, a statistically significant difference was observed between the dose received by 0.1 cc as well as 2 cc of rectum (p < 0.05), while the bladder and sigmoid colon had comparable dosages. Conclusion Though our dosimetric analysis highlighted better rectal sparing in patients undergoing HDR-ICBT under GA when compared to patients under PS, PS can still be considered an effective alternative, especially in centres dealing with significant patient load. Further studies are required for firm conclusion.

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Echocardiography for the 10-year prediction of cardiomyopathy in long-term survivors of childhood cancer

European Heart Journal ◽

10.1093/ehjci/ehaa946.3254 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

J.M Leerink ◽

H.J.H Van Der Pal ◽

E.A.M Feijen ◽

P.G Meregalli ◽

M.S Pourier ◽

...

Keyword(s):

Childhood Cancer ◽

Median Time ◽

Cancer Diagnosis ◽

Predictive Value ◽

Validation Cohort ◽

Funding Source ◽

Derivation Cohort ◽

After Cancer ◽

Radiotherapy Dose

Abstract Background Childhood cancer survivors (CCS) treated with anthracyclines and/or chest-directed radiotherapy receive life-long echocardiographic surveillance to detect cardiomyopathy early. Current risk stratification and surveillance frequency recommendations are based on anthracycline- and chest-directed radiotherapy dose. We assessed the added prognostic value of an initial left ventricular ejection fraction (EF) measurement at >5 years after cancer diagnosis. Patients and methods Echocardiographic follow-up was performed in asymptomatic CCS from the Emma Children's Hospital (derivation; n=299; median time after diagnosis, 16.7 years [inter quartile range (IQR) 11.8–23.15]) and from the Radboud University Medical Center (validation; n=218, median time after diagnosis, 17.0 years [IQR 13.0–21.7]) in the Netherlands. CCS with cardiomyopathy at baseline were excluded (n=16). The endpoint was cardiomyopathy, defined as a clinically significant decreased EF (EF<40%). The predictive value of the initial EF at >5 years after cancer diagnosis was analyzed with multivariable Cox regression models in the derivation cohort and the model was validated in the validation cohort. Results The median follow-up after the initial EF was 10.9 years and 8.9 years in the derivation and validation cohort, respectively, with cardiomyopathy developing in 11/299 (3.7%) and 7/218 (3.2%), respectively. Addition of the initial EF on top of anthracycline and chest radiotherapy dose increased the C-index from 0.75 to 0.85 in the derivation cohort and from 0.71 to 0.92 in the validation cohort (p<0.01). The model was well calibrated at 10-year predicted probabilities up to 5%. An initial EF between 40–49% was associated with a hazard ratio of 6.8 (95% CI 1.8–25) for development of cardiomyopathy during follow-up. For those with a predicted 10-year cardiomyopathy probability <3% (76.9% of the derivation cohort and 74.3% of validation cohort) the negative predictive value was >99% in both cohorts. Conclusion The addition of the initial EF >5 years after cancer diagnosis to anthracycline- and chest-directed radiotherapy dose improves the 10-year cardiomyopathy prediction in CCS. Our validated prediction model identifies low-risk survivors in whom the surveillance frequency may be reduced to every 10 years. Calibration in both cohorts Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Dutch Heart Foundation

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GCT-27. CLINICAL FEATURES AND PROGNOSTIC FACTORS OF NONGERMINOMATOUS GERM CELL TUMORS IN 111 CONSECUTIVE PATIENTS IN A SINGLE INSTITUTION: IMPACT OF IRRADIATION AND CHEMOTHERAPY CYCLES ON SURVIVAL

Neuro-Oncology ◽

10.1093/neuonc/noaa222.247 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii333-iii333

Author(s):

Lei Wen ◽

Juan Li ◽

Qingjun Hu ◽

Mingyao Lai ◽

Cheng Zhou ◽

...

Keyword(s):

Prognostic Factors ◽

Germ Cell ◽

Chinese Population ◽

Germ Cell Tumors ◽

Tumor Diameter ◽

Limited Data ◽

Single Institution ◽

Large Institution ◽

Significant Difference

Abstract BACKGROUND Limited data is available in intracranial nongerminomatous germ cell tumors (NGGCTs) in Chinese population. Here we aimed to retrospectively assess the clinical-pathological and prognostic factors of NGGCTs in a single large institution in China. METHODS From June 2003 to December 2018, 111 consecutive NGGCTs were treated in Guangdong Sanjiu Brain Hospital, China. RESULTS The median follow-up was 36.2 months (range, 1.2 to 131.2 months). Three-year EFS and OS for 111 NGGCTs patients were 78.5%±4.5% and 82.8%±4.0%, respectively. 98 patients received CSI plus boost yielded better survival than those who received reduced-volume radiotherapy or no radiotherapy (3y OS, 86.7% vs. 51.4%, p=0.007). Patients had at least four cycles of chemotherapy were strongly associated with improved 3-year OS, compared to those received less than 4 cycles (94.1% vs. 63.6%, p＜0.001). There was no significant difference in survival of patients stratified by age, surgery, hydrocephalus, as well as tumor diameter. Multivariate analysis identified chemotherapy cycles less than 4 was the only prognostic factor that conferring a worse OS (p=0.003). Patients both received CSI and at least 4 courses of chemotherapy were correlated with lower incidence of relapse (p=0.044). CONCLUSIONS Multimodal approach including CSI and enough courses of chemotherapy was effective and should be recommended for the treatment of newly diagnosed NGGCTs in Chinese population.

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Potency of Three Botanical Oils Against the Aphis Craccivora Koch (Homoptera: Aphididae) Nymphs Under Laboratory Conditions

SAARC Journal of Agriculture ◽

10.3329/sja.v19i1.54785 ◽

2021 ◽

Vol 19 (1) ◽

pp. 139-154

Author(s):

MA Hossain ◽

MS Yasmin ◽

MAA Bachchu ◽

MA Alim

Keyword(s):

Treatment Time ◽

Probit Analysis ◽

Aphis Craccivora ◽

Tween 20 ◽

Laboratory Conditions ◽

Significant Difference ◽

Aphis Craccivora Koch ◽

Insect Mortality ◽

Oil Repellent ◽

Swietenia Mahagoni

Botanicals are promising and attractive alternatives for pest management. In the present study, three botanical oils namely neem (Azadirachta indica), karanja (Pongamia pinnata) and mehogony (Swietenia mahagoni) were tested against the nymphs of Aphis craccivora Koch to evaluate the toxic and repellent effects under laboratory conditions (25 ± 5oC, 65-75% RH). Four concentrations (0.5, 1.0, 1.5, and 2.0%) along with control were maintained with distilled water and tween-20 was used as emulsifier. Leaf dipped method were used for insect bioassay. Insect mortality was recorded at 24, 48 and 72 hours after intervals while repellency was carried out at 2 hours after intervals upto 10th hours and the collected data were analyzed through MSTAT-C program. Results indicated that all the tested oils had toxic and repellent effects against the A. craccivora nymphs. Among the tested botanical oils, no significant difference was observed in terms of mortality over treatment time. But significant difference was noticed over level of concentrations exerted by the botanical oils. The average highest mortality (28.62%) was recorded by the application of mehogony oil whereas neem oil showed the lowest mortality (27.21%) against the A. craccivora and the mortality was directly proportional to the level of concentrations and hour after treatment (HAT). Probit analysis showed the lowest LD50 values of mehogony oil which revealed the highest toxic effect against the nymph of bean aphid. The highest repellent effect (77.33%) was found in mehogony oil (repellent class IV) among all the botanical oils applied. On the contrary, neem (57.33%) and karanja (55.00%) oils belonged to the same repellent class that is repellent class II. Although all the tested botanical oils evaluated showed toxic and repellent effects but mehogony oil performed as the best potent oil against the nymphs. We therefore suggested using the mehogony oil for the management of bean aphid. SAARC J. Agric., 19(1): 139-154 (2021)

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Differential response rates in early-phase cancer clinical trials (EPCCT).

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.3133 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 3133-3133

Author(s):

Rozana Abdul Rahman ◽

Neethu Billy Graham Mariam ◽

Hitesh Mistry ◽

Sreeja Aruketty ◽

Matt Church ◽

...

Keyword(s):

Proportional Hazards ◽

Performance Status ◽

Objective Response ◽

Progression Free Survival ◽

Response Rates ◽

Primary Objective ◽

Cox Proportional Hazards ◽

Sustained Response ◽

Phase Ii Trials ◽

Significant Difference

3133 Background: The primary objective of EPCCT (phase I and non-randomised phase II trials) is to determine the safety and tolerability of new therapeutic agents. Response rates (RR) in these trials have typically been reported at around 10-15%. Increasingly RR and survival outcomes are now investigated in EPCCT as primary or secondary objectives. Methods: Retrospective data analysis was performed on patients (pts) enrolled onto an EPCCT between January 2018 and December 2019 at The Christie NHS Foundation Trust, UK. Data on demographics, prior systemic treatment, sites of disease, performance status, comorbidities, types of therapy, RR, progression free survival (PFS), and overall survival (OS) were collected. Statistical analyses were performed with univariable and multivariable models. Objective response rate (ORR) was defined as the proportion of pts with complete response (CR) and partial response (PR). Duration of response (DOR) was from initial response to progressive disease (PD). Disease control rate (DCR) was defined as CR+PR+ stable disease (SD). Results: A total of 247 pts were treated across 46 EPCCTs. Median age 61 years; 57% female. Sixty-six percent of pts had ≥2 lines of treatment and the majority were ECOG PS 0/1 (98%). Eighty-one percent of pts had ≥2 sites of metastatic disease, and 13 major tumour types were included. Monotherapy trials (159 pts) were predominantly targeted therapies (TT; 60%), or immunotherapies (IO; 20%). Combination therapy trials (88 pts) were TT-based (68%) or IO-based (32%). Data for RR analyses was available for 231 pts. ORR across all trials was 15% (CR 2%) and DCR was 63%. The median DOR was 8.3 months (mos) (95% CI: 7.0 – 9.7) with 28% of pts responding for >6 mos and 7% for >12 mos. ORR in pooled IO treated pts was 27%, DCR was 65% with sustained response >6 mos seen in 37% of these pts. ORR in pooled TT treated pts was 9.4%, DCR was 60% and sustained response > 6 mos seen in 25% of pts. ORR for IO v TT treated pts was significantly different, p=0.007 (pearson chi square), but no significant difference was seen for DCR. Median PFS for all patients was 5.0 mos (95% CI: 4.1 – 6.0) and OS was 10.4 mos (95% CI: 8.4 – 13.0). OS for those with a PR is not reached (HR for PR v PD, 0.006 (95% CI: 0.002 – 0.18). Pts with SD appear to have significantly better OS compared to those with PD (14.6 v 4.2 mos, HR 0.2 (95% CI: 0.1 – 0.3). Multivariable Cox proportional hazards analysis for OS was significant for male gender (HR 1.9, p=0.002), presence of liver metastasis (HR 2.0, p=0.001), low Hb (HR 0.8, p=0.03) and log (LDH) (HR 1.9, p<0.001). Conclusions: Two-thirds of pts enrolled on EPCCTs benefitted in terms of DCR with significant OS improvement in those with PR and SD. Higher ORR were seen in pts receiving IO-based treatments however DCR was similar in IO and TT pts. Gender, presence of liver metastases, Hb count and LDH level contributed significantly to survival differences.

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