Explore the vast range of titles available.

In patients with urothelial carcinoma, the addition of nivolumab to platinum-based chemotherapy resulted in longer median overall survival than platinum-based chemotherapy alone (21.7 months vs. 18.9 months).

Background: Vascular endothelial growth factor action in tumour angiogenesis is well characterised; nevertheless, it functions as a key element in the promotion of the immune system’s evasion by tumours. We sought to investigate the possible direct effect of VEGF on T-cell activation and through which type of VEGF receptor it exerts this effect on cells isolated from ovarian cancer patients’ ascites. Methods: T cells isolated from the ascites of ovarian cancer patients were cultured with anti-CD3 and IL-2, with or without VEGF for 14 days and the number of viable T cells was counted. Cytotoxic activity of cultured T cells and expression of VEGF receptor-2 (VEGFR-2), was assayed. Results: The addition of VEGF in cultures significantly reduced the number and proliferation rate of T cells in a dose-dependent manner and CD3 + T cells expressed VEGFR-2 on their surface upon activation. Experiments with specific anti-VEGFR-2 antibodies revealed that the direct suppressive effect of VEGF on T-cell proliferation is mediated by VEGFR-2. We also showed that VEGF significantly reduced the cytotoxic activity of T cells. Conclusion: Our study showed that ascites-derived T cells secrete VEGF and express VEGFR-2 upon activation. Vascular endothelial growth factor directly suppresses T-cell activation via VEGFR-2.

PurposeCutaneous toxicities from novel anticancer treatments are an emerging problem in dermato-oncology. However, the prevalence of those toxicities and necessity of skin consultations are currently unknown. The purpose of our study was to perform an epidemiologic analysis of cutaneous toxicities that were referred to our cutaneous toxicity clinic in Athens, Greece.MethodsAll patients examined at the oncodermatology department over a 42-month period were included. Gender, age, type of cancer, type of antineoplastic treatment, and type of toxicity were recorded and analyzed.ResultsFour hundred fifty-nine patients (182 males, 277 females) with mean age (SD) 60.6 years (13.05) were included in the analysis. Six hundred seventy-two cutaneous toxicities were recorded. Chemotherapy-induced toxicities were the most commonly recorded incidents, with taxanes being the most commonly involved agent. Immune-related adverse events (IRAEs) have steadily increased over the past 3 years. Treatment modifications due to skin toxicities were more common in patients treated with targeted agents and immune checkpoint inhibitors than in those treated with chemotherapy. The toxicities that led to the most treatment modifications were acneiform eruptions and perionychias. The most common IRAEs recorded were psoriasis in 11 patients, followed by pruritus, macular rash, and lichenoid-type eruptions. In addition, 4 interesting cases of IRAEs are discussed.ConclusionAntineoplastic treatments can lead to a wide range of cutaneous toxicities. Our study underlines the need for a multidisciplinary approach in oncologic patients. The dermatologists’ role is crucial in effectively managing those reactions and preventing antineoplastic drug dose adjustments or discontinuation of treatment.

Introduction/BackgroundSpecific pathologic characteristics of nodal metastases may have prognostic implications on their own. The aim of this study is to identify whether pathologic characteristics of pelvic and para-aortic nodal metastases in high grade endometrial carcinomas affect recurrence and survival.MethodologyWe conducted a retrospective study of patients with stage IIIC1 and IIIC2 high grade endometrial carcinomas (endometrioid, serous and clear cell type) from 2005 to 2012, evaluating the size of lymph node metastases (≤10 mm or >10 mm), number (≥1) and location (pelvic or para-aortic) of lymph nodes involved, duration of follow-up and length of time to recurrence. Cox regression analysis was used.ResultsThe study included 68 women with mean age 61.9 years. Thirty were classified as high grade endometrioid, 24 serous and 14 clear cell. Fifty patients had Stage IIIC1 disease and the remaining IIIC2. The mean follow up period was 4.5 years. 52.9% of the patients had a recurrence. Twenty four patients (35.3%) died during the follow up. Advanced local disease as indicated by cervical stroma invasion and adnexa involvement were associated with greater hazard for recurrence (HR=2.83, 95% CI: 1.09–7.32, p=0.032 and HR=3.13, 95% CI: 1.24–7.94, p=0.016 respectively). Cervical Involvement was also associated with worse survival (HR=7.40, 95% CI: 1.57–34.84, p=0.011). The pathologic characteristic related with negative prognostic implications was the presence of metastases in >1 lymph nodes. It was associated with greater hazard for recurrence (HR=2.89, 95% CI: 1.10–8.01, p=0.025) and worse survival (HR=3.50, 95% CI: 1.41–18.72, p=0.014). The other variables were not statistically associated with recurrence or survival.ConclusionIn patients with high grade endometrial carcinomas where >1 lymph nodes involved with metastases, were associated with poorer prognosis. In contrary, size and location of lymph node metastases did not affect survival or recurrence.DisclosureNothing to disclose.

Introduction/BackgroundEndometrial clear cell carcinomas (ECCC) are rare but aggressive subtype of uterine carcinomas. Several clinicopathological characteristics have been associated with poorer prognosis. The aim of this study is to determine the value of different clinicopathological parameters in predicting prognosis.MethodologyWe retrospectively analyzed files of ECCC patients treated in our institution between 2005 and 2015. Clinicopahtological data and survival outcomes were collected. Our data were analyzed using Cox regression analysis.ResultsFifty- two patients with ECCC and mean age 65.7 years (range 38–90) were analyzed. Myometrial invasion >50% was present in 59.6% of the cases. Adnexal involvement, lymph node-pelvic and paraortic- metastasis and extra uterine metastasis were present at 21.2%, 7.7%, 17.3 and 32.7%, respectively. Cervical involvement was found in 34.6% of the patients. All patients received adjuvant treatment. The mean follow up period was 6.6 years.13.5% of the cases appeared with recurrent disease. Advanced stage (III and IV), positive peritoneal cytology, paraortic node involvement, extra uterine metastasis and omentum involvement were significantly associated with greater hazard for relapse in univariate Cox regression analysis. Mutlivariate analysis revealed that aortic node metastasis (p=0.013) and omentum involvement (p=0.030) were independent predictors of relapse. 63.4% of the patients were alive at 5 years. Advanced stage, peritoneal cytology, adnexal involvement, aortic node and extra uterine metastasis, omentum and vaginal involvement were associated with worse survival in univariate analysis, while in multivariate analysis peritoneal cytology (p=0.045), adnexal involvement (p=0.036) and aortic node metastasis (p=0.035) were independently associated with survival. Type of adjuvant treatment did not affect prognosis.ConclusionOur study suggests that adnexal, omentum and vaginal involvement in addition to aortic node, extra uterine metastases, peritoneal cytology and stage are predictive factors of worse prognosis.DisclosureNothing to disclose.

Background Kidney cancer is a lethal neoplasm that affects several thousands of people every year. Renal cell carcinoma (RCC) is the most common histologic type. Recent developments in the therapeutic approach include antiangiogenic targeted approaches and Immunotherapy. Thus, the therapeutic algorithm of RCC patients and the survival outcomes have changed dramatically. Methods Herein we present a retrospective study of the patients treated in our Department with an antiangiogenic agent -Axitinib, a tyrosine kinase inhibitor- as a third or further line treatment. Statistical analysis was performed with SPSS, including the available clinicopathological data of the patients included. Results Axitinib was found to be active in patients who received this treatment beyond second line. The toxicity profile of this regimen did not reveal any unknown adverse events. Conclusions Our real world data reflect that axitinib is a safe and effective option, even beyond the second line.

Introduction/BackgroundOvarian cancer (OC) is one of the most lethal gynecological malignancies. Primary Debulking Surgery (PDS) followed by chemotherapy has been the standard of care. However, two randomized trials have demonstrated that Neoadjuvant Chemotherapy(NACT) followed by Interval Debulking Surgery(IDS) is not inferior to PDS. Therefore, we conducted a retrospective analysis to determine patterns of practice in our institution.MethodologyMedical records of women with epithelial OC treated at Alexandra Hospital from 2011 to 2016 were retrospectively identified. Clinicopathological data, treatment and survival data were analyzed. Kaplan-Meier Survival curves were generated using IBM SPSS version 20; survival differences were estimated using the long-rank test.Results198 patients were identified. Median age was 60.8 years. 169 patients had serous carcinoma, 10 clear cell, 10 endometrial, 3 mucous and 4 adenocarcinoma. 171 had advanced (stage III/IV) disease. PDS was performed in 128 patients, while 70 received NACT. 48 performed IDS, while 6 had LDS. No surgery was performed in 16 patients. With a median follow-up of 27.3 months, mPFS was 21.8 months and mOS was 58.5 months. Patients treated with NACT-IDS had statistical significant shorter mPFS and mOS than those treated with PDS (PFS: 16.2 m vs 25.9 m P<0.001 and OS 44.4 m vs Not Reached, P=0.05). NACT-IDS retained its statistical significance as an adverse prognostic factor in multivariate analysis when controlled for stage, grade and histology of the disease (P=0.003). No statistical significant difference in the percentage of patients with platinum resistant disease among PDS and IDS was identified.ConclusionNACT followed by IDS is frequently used in the treatment of ovarian cancer patients in a tertiary centre in Greece and was correlated with adverse outcome. A selection bias favoring NACT for patients with high risk for perioperative morbidity may affect the results of this retrospective analysis. Large randomized trials to address this issue are underway.DisclosureNothing to disclose.

Introduction/BackgroundTreatment of elderly patients with neoplasia is challenging due to the frailty of the patients, existing comorbidities and increased number of concomitant medications. In addition, elderly patients are usually underrepresented in clinical trials. Age is a known prognostic factor in ovarian cancer but optimal treatment of elderly patients has not been determined. We undertook a retrospective analysis to determine clinical practice in advanced stage ovarian cancer patients older than 75 years of age.MethodologyMedical records of women with high grade serous and endometrial ovarian cancer, stage III and IV, treated at Alexandra Hospital from 2011 to 2016 were retrospectively identified. Clinicopathological data, treatment and survival data were analyzed. Kaplan-Meier Survival curves were generated using IBM SPSS version 20; survival differences were estimated using the long-rank test.ResultsIn total, 158 patients were identified with a median age of 61.1 years. Among them 20 (12.7%) were older than 75 years of age at diagnosis (range 75.03–92.72 years). First line Progression Free Survival (PFS) and Overall Survival (OS) were statistically significant worse in elderly patients in comparison to the younger ones (mPFS 13.4 months vs 21.9 months, P<0.001 and mOS 25.3 months vs 51,5 months, P<0.001). However, elderly patients were characterized by worse ECOG-PS, more frequent treatment with Neoadjuvant Chemotherapy followed by Interval Debulking Surgery, more frequently denied debulking surgery, and received monotherapy with platinum as frontline treatment, while were less frequently tested for BRCA mutations. In contrast, there was no statistical significant difference in the outcome of the debullking surgery in comparison to the younger patients. Age over 75 years retained its statistical significance for OS when adjusted for all other reported prognostic factors.ConclusionElderly ovarian cancer patients have worse prognosis independent of treatment. Comprehensive geriatric assessment should be performed for the optimal treatment of these patients.DisclosureNothing to disclose.

Introduction/BackgroundUterine Carcinosarcomas (UCs) are composed of both malignant epithelial and mesenchymal components, account for <5% of all gynecological neoplasms and have a highly aggressive clinical course. The aim of this retrospective study was to evaluate the recurrence patterns as well as the clinical and histopathological characteristics of UCs.MethodologyWe retrospectively reviewed the clinical and pathology data from 46 patients who underwent surgery between 2012 and 2018 and obtained a diagnosis of UCs. Data analysis included histologic subtype, grade, presence of homologous/heterologous elements, depth of myometrial invasion (MI), disease - free interval (DFI), site of recurrent disease, and overall survival (OS). Data was analyzed using Cox-regression and Kaplan - Meier survival analyses.ResultsThe median age of our patient sample was 69.9 (range 35–91 years), and median tumor size was 6.4 cm. MI >50% was observed in 68.7%, LVI in 45.6%, and lymph node (LN) metastasis in 19.5%. 60.8% of the patients were diagnosed with stage I disease, 10.8% with stage II, and 28.2% with stage III disease. Serous carcinoma was the predominant carcinomatous component (56.5%), while heterologous elements (43.4%), particularly rhabdomyoblastic differentiation (RMB) (85%) was the most common sarcomatous component. 28% and 65% of patients received adjuvant radiotherapy or chemotherapy, respectively. Median DFI and OS were 10 and 16 months respectively. LN metastasis, tumor size >5 cm, MI >50%, LVI, advanced stage and positive cytology correlated with shorter DFI and worse 3 year OS (p<0.5 respectively). Recurrence developed outside the abdomen in 56.5%. Patients with tumors with sarcomatous histology upon recurrence and predominant sarcomatous component in primary tumor (≥50%) had shorter DFI (p< 0.5%).ConclusionUCs represent a distinct subtype of uterine malignancy, where, according to our data, LN metastasis, tumor size, MI, stage and sarcomatous (RMB in particular) component have a significant prognostic role.DisclosureNothing to disclose.

A randomized trial involving patients with metastatic prostate cancer whose disease progressed after receipt of docetaxel and hormonal therapy showed that cabazitaxel was superior to an androgen-signaling–targeted agent in extending imaging-based progression-free survival, overall survival, and PSA response.