Abstract P4-07-45: Treatment strategies for advanced triple negative breast cancer patients as per routine clinical practice: analysis from the observational study GEICAM/2014-03 (RegistEM)

Background: Triple negative breast cancer (TNBC) is well known for its more aggressive course and poorer prognosis compared to other BC subtypes. RegistEM study provides real world data to understand the distribution of BC subtypes in the advanced setting, being its primary objective. Biological samples collection is part of its procedures. This is a non-interventional cohort study and 1,907 patients (pts) have been enrolled up to now (females and males) with advanced BC (ABC), diagnosed from Jan-2016 to Dec-2019, either after recurrence or as first BC diagnosis, in 38 Spanish sites. These pts will be followed for at least 5 years.

Methods: In the current analysis (cut-off date 08/April/2022, database ongoing), we describe characteristics, treatment patterns and outcomes, including comparison between recurrent and de novo disease, of 157 pts with advanced TNBC included in the RegistEM study. Those pts represent the 10% of pts available in the database at the cut-off date and with ABC diagnosis up to December 2018 (n=1559). The BC clinical subtypes were histologically confirmed on the most recent tumor lesion (metastatic [M] or primary BC) before starting with the 1st-line therapy.

Results: At first ABC diagnosis, 73% pts had recurrent early BC (EBC), 26% de novo MBC and 1% unresectable locally ABC (ULABC). Median age was 57 years (range 30-88), all pts were women, 98% Caucasian and 65% postmenopausal. Family history of BC and/or ovarian cancer was reported in 37% pts, and a hereditary-risk genetic test was performed in 59 of 147 pts. Germline BRCA1/2 and TP53 were the most frequently mutated genes, 21% (6/28) and 47% (8/17) pts, respectively. Visceral involvement was present in 69% pts (similar between recurrent EBC and de novo ABC, although brain metastases were only present in the recurrent EBC group), and ≤ 2 metastatic locations in 59%. In 61% (70/115) pts with recurrent EBC, the subtype was assessed in metastatic lesions, and 39 pts of them also had TN subtype in primary BC. In terms of the most frequent therapies by line: 1) 1st-line: chemotherapy (CT) (60%) and CT/biological therapy (BT) (39%). Of the 87 pts with CT alone, monotherapy was the preferred option in 57% pts (capecitabine 25%, taxanes 16%, and eribulin or vinorelbine, 5% each). Bevacizumab was the most frequent BT (79%) combined with CT (single agent in 56% pts, mostly taxanes and capecitabine). Progressive disease (PD) was reported in 85% pts (similar in pts with both recurrent and de novo MBC or ULABC); 2) 2nd-line: CT (79%) (monotherapy capecitabine, eribulin, taxanes) and CT/BT (17%) (CT-containing bevacizumab 82%). Progression was reported in 92% pts; 3) 3rd-line: CT (90%) (eribulin 33%, platinum-based 25%) and CT/BT (9%) (CT-containing bevacizumab 67%). Progression was reported in 88% pts. At database cut-off date, death was reported in 133 (85%) pts, mainly because of PD. Overall survival (OS) was similar between both groups, recurrent and de novo MBC.

Conclusion: In this population of Spanish TNBC pts with ABC, three quarters had recurrent disease. De novo ABC pts had a higher proportion of non-visceral metastases, with absence of brain involvement at the first diagnosis. Single-agent CT and CT plus bevacizumab were the most frequent therapies, and OS was similar between recurrent and de novo MBC pts, although numerically higher in the later group.

miR-7, miR-10a and miR-143 Expression May Predict Response to Bevacizumab Plus Chemotherapy in Patients with Metastatic Colorectal Cancer

Purpose

Bevacizumab is a monoclonal antibody that binds to vascular endothelial growth factor A. It is currently used in combination with chemotherapy to treat metastatic colorectal cancer. This therapy is not equally effective in every patient; in some, mechanisms of resistance arise that remain poorly understood. The aim of the present work was to determine whether the expression of 26 miRNAs could be associated with the effectiveness of bevacizumab plus chemotherapy, with progression-free survival (PFS), and with overall survival (OS) in metastatic colorectal cancer.

Patients and Methods

Paraffin-embedded biopsies from 76 patients with metastatic colorectal cancer were collected to isolate miRNAs. The expression of 26 miRNAs was analyzed by quantitative RT-PCR. For the purpose of analysis, patients were classified as either “responders” (PFS ≥6 months since beginning treatment) or “non-responders” (PFS <6 months). For the analysis of PFS and OS, patients were classified into two groups using the median gene expression value as the cut-off point (“high” [≥50% percentile] or “low” [<50% percentile]). Time-to-event data were analyzed using the Kaplan–Meier method and compared by the log rank test. Cox regression was used to estimate hazard ratios (HR) and their 95% confidence intervals.

Results

miR-7-5p and miR-10a-5p were more strongly expressed in non-responders than responders (p=0.049 and p=0.043, respectively), and OS was poorer in patients showing these higher expression levels (HR=2.54, 95% CI 1.42–4.55, p=0. 001, and HR=1.81, 95% CI 1.02–3.20, p=0.039, respectively). The overexpression of miR-143-3p, however, was associated with a better prognosis and significantly better PFS (HR=0.57; 95% CI: 0.33–0.96; p=0.033).

Conclusion

High expression values for miR-7-5p and miR-10a-5p might be considered markers of a poorer prognosis in patients with metastatic colorectal cancer treated with bevacizumab plus chemotherapy, while the same for miR-143-3p might be a marker of better outcomes.

Abstract PS5-22: Mutational profile from circulating tumor DNA in triple negative breast cancer: Results from the prospective registry of unresectable locally advanced or metastatic breast cancer GEICAM/2014-03 (RegistEM)

Background: The RegistEM is a non-interventional cohort study enrolling 1,867 patients (pts) (males or females) with advanced breast cancer diagnosed from January 2016 to December 2019, either after recurrence or as first diagnosis, in 38 Spanish sites. Triple negative BC (TNBC) is clinically defined based on lack of expression of both estrogen and progesterone receptors, and HER2 overexpression, and constitutes approximately 16% of BC cases. It is a particularly proliferative and aggressive BC subtype characterized by higher rates of relapse, greater metastatic potential, and shorter overall survival compared with other BC subtypes. Recent studies have shown hormone receptor status can change from the primary (P) to the recurrence tumor (M) in a proportion of cases, inducing a switch to TNBC in the recurrence, while other remains TNBC both in the P and M setting. This feature might impact survival and treatment options. Methods: We selected TNBC pts from the RegistEM study with ctDNA plasma samples available from the relapse. TNBC pts were classified into 2 groups according to clinical subtype (CS): 1) CS-converted (CS-C), with a discordant phenotype (TN subtype in M but not in P); and 2) CS-non-converted (CS-NC), with TN phenotype in P and M. To compare the mutation profiles of the 2 groups, next-generation sequencing (NGS) was performed using the AVENIO Expanded ctDNA Analysis Kit (Roche Sequencing Solutions, Inc; 77 genes; SNPs, indels, fusions and CNVs). Genomics alterations at individual level and grouped by pathway were explored for pathogenic and probably pathogenics variants. Genomics findings were correlated with clinicopathological data and outcomes, in terms of progression-free survival (PFS) and response to first line chemotherapy treatment. Kaplan-Meier estimator and Cox regression model were used to analyze PFS, and Fisher’s test to analyze contingency tables. Bonferroni correction was used for multiple testing. Results: NGS data was available from 32 (17%) TNBC pts; 22 (69%) pts CS-NC and 10 (31%) CS-C. The time from diagnosis to relapse was 29.2 months (m) for CS-NC and 60.2m for CS-C (HR=4.81, 95% confidence interval (CI) (1.59-14.59), p=0.0055; adjusted for confounders: menopausal status, grade, stage). In the metastatic setting, CS-NC had similar PFS than CS-C (8.3m CS-C vs 5.3m CS-NC; HR=1.63, 95% CI (0.71-3.72), p=0.2442). A median of 3 genomic alterations were found, similar in both groups. The most frequent somatic alterations were TP53 (50%), MAP2K1 (25%) and APC (25%). CS-C were enriched for MAP2K1 (60% vs. 9% in CS-NC; p=0.0243). No single genomic alteration was associated with outcome. Forty-percent of tumors harbored at least 1 mutation in PI3K-AKT-mTOR pathway (PIK3CA, PIK3R1, AKT1, AKT2, PTEN or MTOR genes), with similar incidence between CS-NC and CS-C. Pts with an altered PI3K-AKT-mTOR pathway had poor PFS (3.9m mutant vs 6.7m wild-type (WT); HR=3.02, 95% CI (1.4-6.56), p=0.0033) and a trend to worse response (complete or parcial response and stable disease: 23% mutant vs 77% WT, p=0.1581). CS-C tumors presented an altered MAPK-ERK pathway (mutations in KRAS, NRAS, BRAF, MAP2K1 or RAF1 genes) more frequently in comparison to CS-NC (60% vs 23%, p=0.0557), with no differences in response or PFS. Finally tumors with a high mutation allele frequency (≥mean) showed poor PFS (HR=3.64, 95% CI (1.52-8.75), p=0.0038). Conclusion: Analysis of ctDNA reveals diverse mutational spectrum in metastatic TNBC, suggesting that the presence of PI3K-AKT-mTOR pathway alterations associates with worse outcome and poor response to standard therapies. The clinical subtype conversions from luminal primary tumor are enriched in MAPK-ERK pathway alterations.

Citation Format: Angel Guerrero-Zotano, Carlos Jara, Sara López-Tarruella, César A Rodríguez, Encarna Adrover, Catalina Falo, Purificación Martínez, Silvia Antolín, Mireia Margeli, Josefina Cruz, Alvaro Rodríguez-Lescure, Vega Iranzo, César Gómez-Raposo, Jose Juan Illarramendi, Diego Malón, Jose Luis Alonso, Antonio Antón, Raquel Andrés, Jesús Herranz, Susana Bezares, Rosalía Caballero, Isabel Álvarez, Federico Rojo. Mutational profile from circulating tumor DNA in triple negative breast cancer: Results from the prospective registry of unresectable locally advanced or metastatic breast cancer GEICAM/2014-03 (RegistEM) [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS5-22.

Abstract PS7-35: Geicam/2014-03 (registem): A prospective registry of advanced breast cancer: A subset of triple negative breast cancer patients with her2 low expression

Background: The RegistEM study will provide prospective data from advanced breast cancer (ABC) patients (pts). Understanding the real distribution of BC subtypes is its primary objective. A new nomenclature has been proposed for those cases with HER2 1+ or 2+ by immunohistochemistry and negative in situ hybridization, HER2-low BC. In clinical practice, these tumors are reported as HER2 negative. Methods: This is a non-interventional study that will enroll approximately 1,867 pts with ABC diagnosed from January 2016 to December 2019, either after recurrence or as 1st diagnosis, in 38 Spanish sites. Biological samples (primary and/or metastatic tumor lesions, and blood) collection is part of its procedures. In this analysis (cut-off date 01/April/2020, database ongoing), we describe the characteristics of pts with Triple Negative (TN) subtype and HER2-low expression (as mentioned above). Biomarkers, including HER2, were determined in either primary tumor (PT), M1 or in both, PT and M1. Results: This subset of pts make up 37.4% (n=49) of TN pts considered for this analysis (n=131). Their distribution within the three groups (PT, M1 and PT/M1), was 46.9% (n=23), 42.9% (n=21) and 10.2% (n=5), respectively. These pts were diagnosed with early BC (EBC) and at recurrence, 91.7% presented distant metastases. Median time from EBC diagnosis until recurrent disease in terms of ABC was 29.8 months (mo), with the majority of pts recurring at &gt;12 mo (95.9%), similar to the whole TN subset. Most pts were Caucasian (98%), and at diagnosis of ABC, the median age was 60 years (range 31-84) and 65.3% were postmenopausal. A change of BC subtype was documented in 15/49 (30.6%) pts, with the higher rate in M1 group (52.4%); as opposed to the TN subset, a change to HER2+ disease was reported in 6/15 (40.0%) pts and just after the TN subtype in all cases. Family history of BC and/or ovarian cancer was reported in 42.9% pts and any genetic test to assess the hereditary risk was performed in 30.6% pts. Similarly to TN subset, lung (36.7%), lymph nodes and bone (34.7% each) and liver (24.5%) were the most frequent metastatic locations; central nervous system metastases were developed by 14.3% pts. Visceral involvement was present in 66.7% pts, being this rate lower in M1 compared to PT and PT/M1 groups. The most frequent 1st-line therapies were chemotherapy (CT) (44.9%) and CT/biological therapy (BT) (36.7%). Type of CT mainly included capecitabine (36.4%), taxanes (27.3%), eribulin (13.6%) and platinum-based combinations (13.6%). Most pts received CT as monotherapy (86.4%). Bevacizumab (BVZ) was the most frequent BT associated to CT (77.8%), mainly with capecitabine and/or paclitaxel (72.2%). Progressive disease to 1st-line therapy in the whole group was reported in 73.5% pts (higher than in TN subset), with a median time to progression (TTP) of 5.7 mo (range 1.7-15.0); PT was the group with a higher PD rate. A 2nd-line therapy was reported in 63.3% pts. Similarly to 1st-line setting, the most frequent 2nd-line therapies were CT (74.2%) and CT/BT (12.9%) (with BVZ in 75.0% pts). CT in monotherapy was reported in 69.6% pts (capecitabine 31.3%, eribulin 25.0%). Median duration of this line therapy was 3.0 mo (range 0.6-15.8), PD has been reported in 96.8% pts (similar between groups), and 3rd-line therapy in 25/49 (51.0%) pts.

Conclusions: In TN/HER2-low ABC pts, lung, lymph nodes and bone were the most frequent metastatic locations. As opposed to TN subset, HER2+ disease is part of the subtype changes reported. Although the main 1st- and 2nd-line therapies were CT and CT/BT, similarly to TN subset, the rate of pts with PD to 1st- and 2nd-line therapies is higher, and also those pts treated in the 3rd-line setting.

Citation Format: Carlos Jara, Isabel Álvarez, César A Rodríguez, Purificación Martínez, Raquel Andrés, Álvaro Rodríguez-Lescure, Diego Malón, Jose Luis Alonso, Encarna Adrover, María José Echarri, Mireia Margeli, Ariadna Tibau, Judith Ramírez, Silvia Antolín, Ruth Campo, Juan José Miralles, Susana Bezares, Federico Rojo, Sara López-Tarruella, Angel Guerrero-Zotano. Geicam/2014-03 (registem): A prospective registry of advanced breast cancer: A subset of triple negative breast cancer patients with her2 low expression [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS7-35.

Genetic Variants of ANGPT1, CD39, FGF2 and MMP9 Linked to Clinical Outcome of Bevacizumab Plus Chemotherapy for Metastatic Colorectal Cancer

Angiogenesis pathway genes show substantial genetic variability causing inter-individual differences in responses to anti-angiogenic drugs. We examined 20 single nucleotide polymorphisms (SNPs) in 13 of these genes to predict tumour response and clinical outcome measured as progression free survival (PFS) and overall survival (OS) in 57 patients with metastatic colorectal cancer (mCRC) given bevacizumab plus chemotherapy. SNPs were detected (iPLEX® Assay) in genomic DNA extracted from formalin-fixed paraffin-embedded tumour specimens. The variant allele CD39 rs11188513 was associated with a good tumour response (p = 0.024). Patients homozygous for the wild-type allele FGF2 rs1960669 showed a median PFS of 10.95 months versus 5.44 months for those with at least one variant allele-A (HR 3.30; 95% CI: 1.52–7.14; p = 0.001). Patients homozygous for wild-type MMP9 rs2236416 and rs2274755 showed a median PFS of 9.48 months versus 6 and 6.62 months, respectively, for those with at least one variant allele (p = 0.022, p = 0.043, respectively). OS was also lengthened to 30.92 months (p = 0.034) in carriers of wild-type ANGPT1 rs2445365 versus 22.07 months for those carrying at least one variant allele-A. These gene variants were able to predict clinical outcome and tumour response in mCRC patients given bevacizumab-based therapy.

Phase III study to evaluate patient's preference of subcutaneous versus intravenous trastuzumab in HER2-positive metastatic breast cancer patients: Results from the ChangHER study (GEICAM/2012-07)

OBJECTIVE

We compared patients' preferences for intravenous (IV-t) versus subcutaneous (SC-t) trastuzumab administration.

METHODS

Phase III, open-label, multicentre study in HER2-positive metastatic breast cancer. Patients were receiving IV-t for at least 4 months without progression. Randomisation was 1:1 to administer 2 cycles of SC-t with vial followed by 2 cycles with single injection device (SID) or the reverse sequence (600mg SC-t every 3 weeks for 4 cycles).

PRIMARY OBJECTIVE

patients' preference for IV-t versus SC-t; secondary objectives: patients' preference for vial versus SID, healthcare professional (HCP) preference and safety.

RESULTS

We randomised 166 patients in 26 sites. Median number of previous lines of chemotherapy and/or endocrine therapy was 1 (1-7). Median duration of prior IV-t was 1.8 years (0.3-14). Of the159 patients completing the questionnaires, 86.2% preferred SC-t, 6.9% preferred IV-t, and 6.9% had no preference. Patients preferred SID (59.2%) over vial (26.3%). Most (87.2%) HCP preferred SC-t of whom 51.3% and 28.2% preferred SID and vial respectively. Related adverse events included G1-2 injection site reactions in 18 patients (10.8%), G1 pain in 8 (4.8%), G1-2 allergic reaction in 2 (1.2%), one G3 heart failure and 1 G2 ejection fraction decrease.

CONCLUSIONS

SC-t is preferred with no safety impact.

Efficacy of bevacizumab-containing chemotherapy in metastatic colorectal cancer and CXCL5 expression: Six case reports

BACKGROUND

In metastatic colorectal cancer (mCRC), the anti-vascular endothelial growth factor drug bevacizumab (BVZ) plus chemotherapy significantly improves progression-free survival compared to chemotherapy (CT) alone. This benefit is not, however, observed in all patients. While increased chemokine CXCL5 gene expression promoting angiogenesis has been proposed as a prognostic mCRC biomarker, few studies have examined its relationship with drug efficacy. This study sought to analyze tumor CXCL5 gene expression in six patients with different efficacy of BVZ-containing CT in terms of the tumor response to treatment.

CASE SUMMARY

We report six cases of stage IV KRAS-mutated mCRC. Patients were given first line treatment with BVZ-containing chemotherapy in University Hospital of Fuenlabrada. The six patients differed in terms of primary tumor location (right/left side), tumor burden (mostly hepatic and peritoneal disease) and clinical disease course. Before treatment onset, total RNA was isolated from paraffinated tumor biopsy specimens and CXCL5 gene expression quantified through conventional RT-qPCR procedures. Our main finding was that CXCL5 expression levels were several times higher in three patients with lower progression free survival (under 6 mo) from the start of treatment.

CONCLUSION

A higher expression of CXCL5 was observed in the three patients showing worse tumor response to treatment.

Abstract P4-21-16: Phase III trial to evaluate patient´s preference for subcutaneous versus intravenous trastuzumab administration in patients with HER2 positive advanced breast cancer (ABC) under IV trastuzumab (IV-t) treatment for at least 4 months. ChangHER-SC study (GEICAM/2012-07)

Background: Patients with HER2-positive ABC, receive anti-HER2 treatment for several months or even years. IV-t is administered weekly or 3-weekly, mandating patients to visit the hospital on a regular basis to receive infusions. This has inconveniences for patients and increase treatment costs. Subcutaneous administration could improve convenience of trastuzumab therapy. This study was designed to evaluate patient's preference for IV-t or SC trastuzumab (SC-t) in ABC patients.

Methods:This is a phase III, open label, multicenter study inpatients with HER2 positive ABC, receiving IV-t for at least 4 months and without evidence of disease progression. Patients received 600 mg of SC-t, either from a vial or from a single injection device (SID), every 3 weeks for 4 cycles. Before starting SC-t, patients received an additional IV-t cycle. Patients were randomized 1:1 to arm A, receiving 2 cycles of SC-t with vial followed by 2 cycles with SID or arm B, receiving the opposite sequence. After cycle 4, patients decided to continue with IV-t or SC-t till disease progression. Stratification criteria were the associated therapy (Chemotherapy, Hormone-therapy or none) and its administration route (IV, oral or none). Patients completed a questionnaire of experiences and preferences at three time points: before starting SC-t, after cycle 2 and after cycle 4. Health Care Professionals completed a satisfaction questionnaire every 5 patients. The primary objective was to evaluate patient´s preference for IV-t or SC-t (after cycle 2) and, secondary objectives were, to evaluate patient´s preference between the two SC-t administrations (vial or SID) after cycle 4, Health Care Professional satisfaction, associated costs of the administration options (Time and Motion pharmacoeconomic study) and safety.

Results: From September-13 to July-15, 166 patients were randomized (81 arm A, 85 arm B) in 26 Spanish sites from GEICAM. Median age was 60 years (35-93), 88% of patients were postmenopausal and 123 and 42 had an ECOG PS of 0 and 1, respectively. The median duration of prior IV-t for ABC was 1.8 years (range: 0.3-14). Patients received a median of 2 previous lines of Chemotherapy and/or Hormone-therapy (range: 1-9). Twenty patients were receiving pertuzumab at inclusion. According to patient questionnaires completed after cycle 2, 137 patients preferred the SC-t (66 arm A, 71 arm B), 11 the IV-t (6 arm A, 5 arm B), 11 didn't have a preference (4 arm A, 7 arm B), and 7 didn't answer (3 progressed, 2 withdrew participation before cycle 2 and 2 unknown reason). Three of the 11 patients choosing IV-t were receiving IV treatment as accompanying therapy; after cycle 4 five of these 11 patients finally continued with SC-t, 5 with IV-t and 1 progressed. From the 11 patients without any preference 7 received SC-t, 2 receive IV-t and 2 progressed; from the 137 patients preferring SC-t, 125 actually received it, 3 received IV-t and 9 progressed.

Conclusions: Our study shows that 82.5% of patients preferred the SC-t over the IV-t. Treatment choice was not influenced by the accompanying therapy.

Citation Format: Ciruelos EM, Montaño Á, Rodríguez CA, González-Flores E, Lluch A, Garrigós L, Quiroga V, Antón A, Malón D, Chacón JI, Velasco M, Gonzalez-Cortijo L, Jolis L, Pascual T, Amigo Y, Casas M, Cámara MC, Carrasco E, Casas A. Phase III trial to evaluate patient´s preference for subcutaneous versus intravenous trastuzumab administration in patients with HER2 positive advanced breast cancer (ABC) under IV trastuzumab (IV-t) treatment for at least 4 months. ChangHER-SC study (GEICAM/2012-07) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-21-16.

Abstract P3-08-17: Objectively measured physical activity in breast cancer survivors

Background: Obesity and physical inactivity are poor prognostic indicators for breast cancer (BC). Cardiorespiratory fitness (VO2max) is a good predictor of survival. Despite preserved LVEF, cardiorespiratory function is impaired in women with breast cancer after the completion of adjuvant therapy. International organizations recommend at least 150 minutes per week of moderate-vigorous physical activity (MVPA). Some studies show that a minority of cancer survivors are meeting the PA recommendations. A limitation of physical activity (PA) research has been the use of self-reported measures.

Eligibility criteria: 1) Age 18-79, 2) Able to walk a mile, 3) More than one year from diagnosis, 4) More than 3 months since the last therapy, 5) No evidence of disease.

Aims: Objective assessment of physical activity in breast cancer survivors. Adherence to international recommendations.

Material and methods: PA was evaluated through accelerometry (600 minutes per day, 5 days per week, 2 week-end days were required to consider as valid accelerometry values). Cardiorespiratory fitness was assessed through the “one-mile test”.

Results: 92 women (W) with BC history were included. 86 W were evaluable for accelerometry. 85 W were evaluable for VO2max. Age: 54.02 years (33-77), BMI: 27.89 (SD 8.89), waist perimeter: 89.74 cm (SD 17.37), median time from diagnosis 3.94 years, treatment with anthracyclines 55 W (63.9%), radiotherapy 69 W (80.23%). Accelerometry (86W): Average weekly time MVPA 351.14 min/wk (SD: 168.98). 76 (88%) met international recommendations of PA. Women previously treated with anthracyclines (47 W; 340.25 min/wk), radiotherapy (59 w; 343 min/wk) and both (48 W; 331 min/wk) exercised less than women who did not receive these therapies (8 W; 386 min/wk). This association was not statistically significant.

Average VO2max was 24.8 ml/kg/min (SD: 7.6).There was a significant effect of anthracyclines for VO2 max. Women not treated with anthracyclines had a VO2max: 26.41 whereas treated W had VO2max 22.08 ml/kg/min.

Discussion: A cohort of Spanish women met international recommendations of PA when it was objectively assessed. This cohort exhibited a poor cardiometabolic and cardiorespiratory profile. Previous exposure to anthracyclines predicted a poorer cardiorespiratory fitness. Specific research to investigate the role of exercise to mitigate that dysfunction in breast cancer survivors is warranted.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-08-17.

Biliary cystadenocarcinoma with mesenchymal stroma

Hepatobiliary cystadenocarcinomas (BCACs) with mesenchymal stroma are a rare cystic lesion. This tumour needs to be distinguished from benign biliary cystadenoma, which is antecedent in most cases. The treatment of choice is radical excision of the mass. The diagnostic evaluation, surgical management, pathological characteristics, treatment and follow-up of one patient with hepatobiliary cystadenocarcinoma with ovarian stroma is described. Preoperative diagnosis of BCACs is often difficult, because their clinical manifestations are similar to those of other hepatic cystic lesions. MRI is suitable for accurate characterisation of cystic biliary lesions, but distinguishing between cystadenoma and cystadenocarcinoma remains difficult on the basis of imaging findings. Complete surgical excision gives a relatively good chance of long-term survival because of the slow growth rate of these tumours.

The era of oral drugs in oncology: What do patients think about their efectiveness?

e20600

Background: With the growing number of drugs available for the treatment of cancer, most of them of oral administration, some aspects of the everyday clinical practice are changing. Interesting is the opinion of the patients (pts) about oral therapy. Methods: We researched differences in preference, tolerance, effectiveness, and safety by means of the delivery of a survey to (pts) who had received oral and intravenous (IV) treatment. One hundred and ninety (pts) were enrolled from September to November 2008. Results: Seventy percent of the (pts) studied were women, the median age at diagnosis was 60 years (range, 28 - 91 years). Fifty percent had gynaecologic tumors; thirty percent digestive; eighteen percent lung cancer and two percent other tumors, with a median of 3 different lines of therapy (range, 1 to 9). Patients preferred the oral route over the IV (76% vs. 20% respectively; P<0.001) and four percent had no preference. Tolerance was better with oral therapy (64%) than with (IV) chemotherapy (CT) (36%; P<0.001). When the (pts) were asked for effectiveness, sixty percent of them considered the (IV) chemotherapy more effective, while eleven percent chose oral therapy and twenty-nine percent found both equally effective (p<0.001). Sixty one percent of the (pts) evaluated as more secure (IV) chemotherapy, while eight percent did so with oral therapy and thirty one percent did not think that differences existed with one or another route of administration (p< 0.001). Conclusions: The constant evolution in cancer therapy and the increasing participation of (pts) in therapeutic decisions makes it imperative to know the opinion of (pts) on these new treatments. When patients are asked for tolerance or preference, the majority of them choose the oral route. However, when asked about important issues such as effectiveness or safety that offers a treatment, most of them prefer the intravenous route.

No significant financial relationships to disclose.