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Annals of Oncology significantly improved survival with an acceptable toxicity profile. However, more evidence is needed that current treatment options are tolerable and efficacious in older pts. Here, we assessed efficacy and safety according to age in the ML18147 study. Methods: Pts with unresectable, histologically confirmed mCRC who progressed
functioning scales. Exploratory analyses included the change from baseline QoL scores by severity of skin reactions, the change in reported symptoms from baseline according to tumor response and treatment, and the effect of symptomatic status at baseline on response and survival. Results: QoL was evaluable in 627/666 pts (94%) with KRAS wild-type tumors, 52% received FOLFIRI, and 48% FOLFIRI plus cetuximab. No significant differences for GHS/QoL (p = 0.12) and social functioning scores (p = 0.43) were found between the treatment arms. In pts receiving cetuximab, themeanchangefrombaselineinGHS/QoLwas3.00inptswithoutskin reactions compared with -1.09 and -0.51 in those with grade I and grade II-IV early skin reactions, respectively. Social functioning score worsened in pts with no skin reactions (mean -6.41) compared with a slight improvement in those with grade I (mean 1.64) and grade II-IV (mean 1.48) early skin reactions, respectively. Tumor response was higher (58% vs 40%, p = 0.0002) and survival longer (hazard ratio 1.68, p < 0.0001) in asymptomatic versus symptomatic pts at baseline. FOLFIRI plus cetuximab increased tumor response in symptomatic (65% vs 52%, p = 0.0388) and asymptomatic pts at baseline (52% vs 31%, p = 0.0034), and in pts whose tumors had responded, maximum symptom relief from baseline occurred earlier (8 vs 16 weeks) compared with FOLFIRI alone. Conclusions: Adding cetuximab to FOLFIRI improved clinical outcome without negatively impacting on QoL, improving response despite baseline symptoms and leading to earlier symptom relief in pts whose tumors had responded. Symptom status at baseline was demonstrated to be a useful prognostic factor in mCRC. Disclosure: C. Köhne: The author reports honoraria from Pfizer and Merck KGaA. G. Folprecht: The author reports consultant/advisory roles for Merck KGaA, Roche and BMS, honoraria from Merck KGaA, Pfizer, Roche and Novartis and research funding from Merck KGaA. P. Rougier: The author reports, in relation to the topic concerned, honoraria for three years from Merck KGaA for participation at scientific boards and symposia. D. Curran: The author acted as a consultant (on statistical and QoL analysis) for Merck KGaA. U. Sartorius: The author is an employee of Merck KGaA. I. Griebsch: At the time of this research, the author was an employee of Merck KGaA. E. Van Cutsem: The author has received research funding from Merck KGaA. All other authors have declared no conflicts of interest. 562P BEVACIZUMAB BEYOND PROGRESSION: HOW TO MONITOR TREATMENT EFFICACY? RESULTS OF A FUNCTIONAL IMAGING STUDY IN MURINE COLORECTAL CANCER L. Heijmen 1 , E.E.G.W. Ter Voert 2 , C.J.A. Punt 3 , L. De Geus-Oei 4 , A. Heerschap 2 , J. Bussink 5 , V. Zerbi 2 , W.J.G. Oyen 6 , O. Boerman 4 , H.W.M. van Laarhoven 3 1 Medical Oncology, Radboud University Medical Centre, Nijmegen, NETHERLANDS, 2 Radiology, Radboud University Medical Centre, Nijmegen, NETHERLANDS, 3 Department of Medical Oncology, Academic Medical Center, Amsterdam, NETHERLANDS, 4 Nuclear Medicine, Radboud University Medical Centre, Nijmegen, NETHERLANDS, 5 Radiation Oncology, Radboud University Medical Centre, Nijmegen, NETHERLANDS, 6 Department of Nuclear Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, NETHERLANDS Introduction: The BRiTE study suggested that bevacizumab beyond progression to first line therapy is beneficial for survival in advanced stage colorectal cancer. However, since response to bevacizumab cannot always be predicted by tumor size measurements, we studied utility of several functional imaging modalities to assess efficacy of bevacizumab beyond progression (BBP). Methods: 26 BALB/c nude mice with s.c. LS174T xenografts (diameter >0.4 cm) were treated with daily capecitabine (200 mg/kg), weekly oxaliplatin (3mg/kg) and 2x/weekly bevacizumab (5 mg/kg). Tumor volume was assessed using caliper measurements. Tumors were considered progressive on the treatment regimen when volume was ≥1.5 times initial volume at 2 succeeding measurements. In 13 mice bevacizumab treatment was continued (BBP group), while the control group received saline injections. Within 3 days after progression, imaging was performed: FDG-PET, diffusion weighted imaging (DWI), T2*, dynamic contrast enhanced MRI (DCE-MRI). Measurements were repeated 7 and 10 days after the first measurements. Linear mixed models were used to assess differences between the 2 groups over time. After the last measurement, tumors were snap-frozen and immunohistochemically examined for 9F1 (vasculature), glucose transporter 1 (GLUT-1), carbonic anhydrase IX (CAIX) and Ki67 (proliferation) expression. Results: Tumor growth after progression was more pronounced in the control group (p < 0.01). FDG-PET showed a trend towards higher FDG uptake in the control group (p = 0.08). DWI, T2* and DCE-MRI parameters were not significantly different in the 2 groups. Immunohistochemical analyses showed a trend towards lower Ki67 expression (fraction 0.027 vs 0.041 p = 0.05) and higher CAIX fraction (0.21 vs. 0.10 p < 0.01) in the BBP group. The relative vascular area was lower in the BBP group (0.029 vs. 0.042 p = 0.03). Vascular density (104 vs. 127 vessels/mm 2 p= 0.16) and GLUT-1 expression (0.08 vs 0.11 p = 0.48) did not significantly differ. Conclusion: Bevacizumab after progression had significant effects on tumor microenvironment. FDG-PET may be a sensitive functional imaging technique to assess the effects of bevacizumab. Disclosure: All authors have declared no conflicts of interest. Annals of Oncology 563P SKIN RASH AND OUTCOME IN COLORECTAL CANCER (CRC) PATIENTS TREATED WITH ANTI-EGFR MONOCLONAL ANTIBODIES F. Petrelli 1 , K.F. Borgonovo 2 , M. Cabiddu 3 , M. Ghilardi 4 , M. Cremonesi 3 , F. Maspero 3 , S. Barni 3 1 UO Oncologia, Azienda Ospedaliera Treviglio-Caravaggio, Treviglio, ITALY, 2 Medical Oncology Division, A.O. Treviglio-Caravaggio, Treviglio, ITALY, 3 Medical Oncology Division, Azienda Ospedaliera Treviglio-Caravaggio, Treviglio, ITALY, 4 Medical Oncology Division, A.O. Trevilgio-Caravaggio, Treviglio, ITALY Introduction: The most common toxicity associated with anti-EGFR monoclonal antibodies (MoAbs) is an acneiform rash, that occurs in nearly all patients. One of the more interesting and useful clinical observations regarding EGFR-targeted therapy has been the association of clinical benefit with development of skin rash. We have performed a systematic review and a pooled analysis of the predictive value of skin rash for patients with advanced CRC treated with cetuximab (C) and panitumumab (P) in prospective clinical trials or in retrospective case series. Materials and methods: We searched PubMed and ASCO Meetings for publications reporting the correlation of skin rash with survival and/or response rate. The lower limit date for the search was February 11,2012 with no upper limit. The primary outcome was overall survival as a function of severity of cutaneous toxicity in patients treated with C or P (OS). Secondary endpoints were the predictive role of skin rash for progression free survival/time to progression and response rate (ORR). Results: Fourteen publications (for a total of 3,833 patients) were included in this meta-analysis. All included studies enrolled patients with advanced disease. For the primary endpoint (OS) 11 trials had available data; the occurrence of skin rash was significantly associated with reduced risk of death in patients treated with C or P (HR 0.51, P < 0.00001). For the association of risk of progression with skin rash (data available from 5 trials) the HR was significant too (HR 0.58, P < 0.00001). According to response rate analysis (15 trials available) skin rash was a significant predictor of activity with a RR of 2.23 (P < 0.00001) for patients with toxicity compared to patients with no or low-grade toxicity. ORR was 35% compared with 13% for high-grade compared to low-grade skin toxicity arms. The results appear similar for C and P trials for all the endpoints. Conclusion: Skin rash represents an early predictive biomarker of response, however the prognostic value of this event is presently unknown. Disclosure: All authors have declared no conflicts of interest. 564P QUALITY-ADJUSTED SURVIVAL IN PATIENTS WITH WILD-TYPE (WT) KRAS METASTATIC COLORECTAL CANCER (MCRC) RECEIVING FIRST-LINE THERAPY WITH PANITUMUMAB PLUS FOLFOX VERSUS FOLFOX ALONE J. Wang 1 , Z. Zhao 2 , B. Barber 2 , J. Zhang 1 , B. Sherrill 3 , S. Braun 4 , R. Sidhu 5 , M. Gallagher 2 , J. Douillard 6 1 Biostatistics, RTI Health Solutions, Research Triangle Park, NC, UNITED STATES OF AMERICA, 2 Global Health Economics, Amgen Inc., Thousand Oaks, CA, UNITED STATES OF AMERICA, 3 Biometrics, RTI Health Solutions, Research Triangle Park, NC, UNITED STATES OF AMERICA, 4 Amgen (Europe) GmbH, Zug, SWITZERLAND, 5 Department of Clinical Research, Amgen Inc., Thousand Oaks, CA, UNITED STATES OF AMERICA, 6 Medical Oncology, Centre René Gauducheau (ICO) Institut de Cancerologie de l’Ouest, St Herblain, FRANCE Background: Panitumumab plus FOLFOX significantly improved progression-free survival (PFS) in patients with WT KRAS mCRC. The objective of this analysis was to use the quality-adjusted time without symptoms of disease or toxicity of treatment (Q-TWiST) method to compare quality-adjusted survival between the treatment arms. Methods: Patients with mCRC were randomized to panitumumab plus FOLFOX or FOLFOX alone in a phase III clinical trial. For each treatment arm, the area under the survival curve, which was estimated using the Weibull distribution, was partitioned into health states: toxicity (TOX), time without symptoms of disease progression or toxicity (TWiST, i.e., PFS minus TOX), and relapse period (REL, i.e., overall survival (OS) minus PFS); and adjusted using utility weights derived from patient-reported EuroQoL 5-dimensions measures. The null hypothesis of no difference between treatment groups was tested based on the normal approximation with standard errors calculated by the bootstrap method. Sensitivity analyses were performed using the standard Q-TWiST approach with means restricted to median OS. Results: Of 1,183 patients who were randomly assigned, 1,096 patients (93%) had available tumor KRAS status, of which 656 patients (60%) had WT KRAS tumors (panitumumab plus FOLFOX, n = 325; FOLFOX alone, n = 331) and were included in this analysis. Compared to patients treated with FOLFOX alone, the panitumumab plus FOLFOX group had significantly longer quality-adjusted PFS (8.5 versus 7.2 months, respectively; 1.3 additional quality-adjusted months; p = 0.02) and quality-adjusted OS (22.4 versus 18.6 months; 3.8 additional quality-adjusted ix192 | Abstracts Volume 23 | Supplement 9 | September 2012
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Annals of Oncology www.annonc.oxfor
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subscriptions A subscription to Ann
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Annals of Oncology Official Journal
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The European Society for Medical On
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Audit Committee Chair: Fortunato Ci
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Familial cancer Judith Balmaña, Ba
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ESMO 2012 Congress Travel Grants 47
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Exhibitors The following companies
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ESMO Fellowships, 1989-2011 The Eur
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Ondrej Gojis, Czech Republic 2008-2
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abstracts hpv biology and implicati
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abstracts the characterization of l
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abstracts description of intra-tumo
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prevent cell death. It is anticipat
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22IN TARGETING THE HOST IN TNBC G.
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abstracts a paradigm shift in early
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abstracts how can medical oncologis
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feasibility), but by how high the c
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abstracts re-inventing the medical
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abstracts emerging diagnostic and t
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abstracts biologically based treatm
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abstracts molecular targets in mali
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abstracts melanoma therapy: from fr
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diagnosis and can also be used for
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analysis at 11 months median follow
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mouse model of Kras mutant NSCLC. I
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abstracts subtyping soft tissue sar
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abstracts key topics in supportive
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ESMO-CSCO Joint Symposium: Building
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ESMO-EANM-ESR Joint Symposium: Imag
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ESMO-ESTRO Joint Symposium: Innovat
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ESMO-MASCC Joint Symposium: Integra
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ESO Society Symposium: Celebrating
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Results: TIMP-1 expression was incr
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will benefit from this targeted the
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cytomegalovirus (CMV). Analysis of
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functional consequences of Endoglin
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elationship between the ROR score,
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183P EPIDERMAL GROWTH FACTOR RECEPT
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Plasma adiponectin level on the pre
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Table: 198P PFS OS Median, mo HR Me
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204P EVALUATION OF PTEN AND PIK3CA
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Material and methods: We searched P
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Results: The median concentration o
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Table: 226P Methods: Pts were rando
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However, additional analysis sugges
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number of biomarkers have been trie
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Table: 248O 249PD PROTEOMIC PREDICT
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Conclusions: BW and serum Ctrough o
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261P BREAST CANCER SUBTYPES AND OUT
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90 mg/m2-cyclophophamide 600 mg/m2
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to 9 weeks after dosing. Trastuzuma
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Patients and methods: We reviewed d
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sector patients. The aim of this st
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Linear Logistic Model with Relaxed
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Results: The median CTC fold change
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312: Table: Chemotherapy uptake wit
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abstracts breast cancer, locally ad
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Results: 8 trials (2092 pts) with 1
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absolute difference of median value
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Novartis, Genentech, and sanofi-ave
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Results: Three RCTs with 1023 patie
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collected from all patients for det
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355P FIRST REPORT OF LONG-TERM RESP
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361P A RETROSPECTIVE ANALYSIS OF PL
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publications and aggregated in a me
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Thus the primary aim to target BCSC
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383 WHY DO WOMEN WITH BREAST CANCER
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Results: We evaluated 76 pts with M
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Page 149 and 150: Conclusions: As in other cancer typ
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after Gem-based therapy. The additi
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735P RADIOGRAPHIC PARAMETERS IN PRE
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validate the revised AJCC 7th stagi
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Results: Among 862 MM we identified
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Results: Frequently reported advers
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gastric cancer patients with CNS me
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discriminate the prognosis of HCC p
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prospective, non-interventional stu
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abstracts genitourinary tumors, non
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787O EXTERNAL VALIDATION OF THE ASS
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patient preference for P over S, an
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798PD OPEN-LABEL PHASE II TRIAL OF
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Hb, PS and LM. Median PFS for patie
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may have led to reduced dose and sh
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Results: 1,622 patients were identi
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RCC) was designed to address an unm
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Patients and methods: This is a sin
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treatment at week 4, and week 12 by
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effective in second or further line
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Conclusions: In pts with RCC treate
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using Drug inCode ® pharmacogeneti
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Table: 857P standard, but is not av
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efused HDCT. Of 23 patients, 20 com
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we identified 49 and 220 patients w
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879 TREATMENT OF PATIENTS WITH META
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Median overall survival (OS) was 26
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abstracts Genitourinary tumors, pro
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and week 13 BPI-SF Q3 scores), 28%
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Working Group (PCWG)-2 guidelines r
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atio HR 0.39; CI 0.18, 0.83, p = 0.
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We observed tumor responses and pro
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Here we report emerging data from t
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928P LHRH AGONIST-INDUCED SUPPRESSI
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Disclosure: S. Oudard: Has acted as
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939P NEOADJUVANT SIPULEUCEL-T IN LO
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945 BONE TURNOVER MARKERS AND POTEN
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952 SEQUENTIAL ANDROGEN DEPRIVATION
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managed in a multidisciplinary (MD)
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or hypercalcemia at screening; prio
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meeting. The prevalence of LGSC is
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Table: 975PD Continued AMG 386 + pa
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physicians in the U.S. and Europe.
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989P PHASE II STUDY OF COMBINATION
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elated with stage, nodal involvemen
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1004P CASE CONTROL STUDY ON TWO DIF
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eight patients who had infertility
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abstracts head and neck cancer 1016
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same CT/RT; Arm B2: 3 cycles of ind
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induction chemotherapy in the treat
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patients. We have developed a rando
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evaluated by the screening instrume
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morbidities that radiation would le
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Conclusions: Through adequate selec
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abstracts hematological malignancie
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anthracyclines in vitro. A favorabl
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1076P RITUXIMAB PLUS SUBCUTANEOUS C
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than the standard target of ≥2.5
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Patients: From November 2002 to May
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lymphadenopathy and multiple cutane
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prospective non-interventional stud
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Funding: GSK Biologicals Disclosure
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survival rates of 13-25% (Prieto et
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high response rates and prolonged p
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GlaxoSmithKline, Merck Sharp & Dohm
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advisor for Merck Sharp & Dohme, an
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or cutaneous melanoma. A survival u
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systemic therapy or were intolerant
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abstracts neuroendocrine tumors and
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morbidity, with G3 tumors behaving
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pts. Poorly differentiated endocrin
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Adenocarcinoma was present in 25 pa
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Method: Endobronchial ultrasound gu
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widely used by single agent or plat
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disease after surgery were treated
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stage IIIA NSCLC, EML4-ALK fusion-p
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1200P CONCOMITANT CHEMORADIATION GI
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Patients and methods: The study was
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months (95% CI:13-25). The PFS and
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maintenance therapy had favourable
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abstracts non-small cell lung cance
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Ingelheim, GSK Biologicals (compens
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1234PD RANDOMIZED PHASE III TRIAL O
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GlaxoSmithKline (myself, compensate
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1243P IDENTIFICATION OF MICRORNA (M
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N-arm n=34 P-arm n=32 All n=66 Male
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1255P POPULATION BASED EVALUATION O
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1262P DISTINCT SPREAD OF EGFR MUTAT
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1268P VISUAL DISTURBANCES IN PATIEN
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MERCK SERONO: Advisor, speaker in s
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Conclusions: These data from SAiL a
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NSCLC diagnosis and time of BM diag
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1291P PHASE I/II DOSE-FINDING STUDY
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Network utilization of WBCGF in the
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1303P COST EFFECTIVENESS OF PEMETRE
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Results: The patients’ characteri
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EGFR mut at exons 18, 19, 21, and K
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Methods: EML4-ALK fusion was screen
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Results: The median survival time (
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enefit from sustained EGFR blockade
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epresented by 19 pts (32%) female,
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and at least one prior course of ch
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Methods: NSCLC patients with radiog
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1367TiP LONG-TERM ERLOTINIB THERAPY
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Austria, Czech Republic, Finland, G
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were every 6 weeks (wk) (S1), every
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Advantage enrollees (83% vs. 25%) [
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Results: Based on 10,000 simulation
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cancer tumors 12%, Germ cell tumor
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Material and methods: 50 lung cance
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1414TiP IMPLEMENTATION OF CANCER RE
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abstracts palliative care 1422O EFF
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Method and results: A total of 317
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1436P SURVEY ON MODELS OF INTEGRATI
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care unit (PCU) at the National Can
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Characteristic No. % Total 63 1 st
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hysterectomised-9.10% and cervix ca
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abstracts psycho-oncology 1462PD IN
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events, tumour response, and surviv
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abstracts sarcoma 1477O ADHESION TO
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1481PD A PHASE II STUDY OF DOVITINI
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1488P ORGANISATION OF SARCOMA PATIE
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Patients and methods: From August 2
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chemotherapy respectively. At a med
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of this group Those with relapsed d
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1515 PREDICTORS OF SURVIVAL IN ADOL
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abstracts small cell lung cancer an
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emaining receiving either CAV or to
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1533P EXPRESSION OF WILM⍰TUMOUR G
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more than 3 months after first line
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lower recurrence rate of NE. Pegfil
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egimens (HR = 2.5, p < 0.001). Phys
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1561P PREDICTIVE DIAGNOSTICS FOR RE
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Methods: A prospective multicentre
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Table: 1574P Pharmacokinetic parame
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Novartis and unrestricted research
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studies have shown that chemotherap
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(Grade 1) and moderate to severe (G
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declined to relatively lower level
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1609P PHYSICAL ACTIVITY (PA) AND PH
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patients were admitted to the oncol
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Dicarbamin 100 mg/day on day 5 befo
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Results: Anemia was detected in 83.
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important to carry out randomized s
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abstracts translational research 16
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expression. Then, we analyzed PB sa
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Table: 1657P TH BV + TH HR (95% CI)
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BRAF mutations. Circulating free DN
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1671P PHASE I CLINICAL TRIAL OF CAN
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1678P PREDICTIVE VALUE OF TWO PHENO
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theorized that the PI3K/AKT pathway
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Material and methods: 101 patients
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overexpressing and 232 had triple n
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author index author index A Aamdal
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author index Badran A. ix288 (874)
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author index Bösmüller H. ix209 (
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author index Chen A. ix319 (966O) C
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author index De Droogh E. ix452 (13
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author index Esposito G. ix209 (618
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author index Geiges G. ix306 (930P)
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author index Hartono S. ix70 (155P)
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author index Iwasaki H. ix542 (1694
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author index Kodaira M. ix90 (228P)
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author index Lichtensztejn D. ix350
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author index Martinez A. ix496 (153
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author index Morishita N. ix432 (13
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author index Okamoto N. ix432 (1320
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author index Piau S. ix456 (1401P)
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author index Rodríguez Rodríguez
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author index Scoggins C.R. ix371 (1
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author index Stern L. ix272 (823P)
Page 583 and 584:
author index Trypaki M. ix429 (1308
Page 585 and 586:
author index Whitmore J.B. ix310 (9
Page 587 and 588:
subject index subject index A AAV-H
Page 589 and 590:
subject index ix115 (316TiP), ix116
Page 591 and 592:
subject index diffuse large B-cell
Page 593 and 594:
subject index (1033P), ix340 (1036P
Page 595 and 596:
subject index medical information,
Page 597 and 598:
subject index (612P), ix214 (633),
Page 599 and 600:
subject index RCC, ix274 (830P) re-
Page 601 and 602:
subject index TR-FRET, ix84 (206P)
Page 603 and 604:
drug index drug index 1248P, 1250P,
Page 605 and 606:
translational research index transl
Page 607 and 608:
Page 609:
show all

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