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Annals of Oncology suggested that cancer stem cells may influence the biological behaviour of many solid tumours including colorectal cancer. We tested a panel of genetic markers of stemness in resected Dukes stage B and C colorectal cancer and their impact on prognosis. We performed k-means unsupervised clustering (K = 2) using the mRNA expression data of 66 genes. The algorithm divided the patients into two groups (A and B) and most of the patients clustered in a manner consistent with relapse free survival, defined as the time between primary surgery and first radiological sign of metastatic involvement or patients death, whichever came first. A total of 62 patients were analysed (46, 74% stage II and 16, 26% stage III), 36 (58%) patients relapsed during the follow-up period (range 1.63-86.5 months). Respectively 12 (19%) and 50 (81%) patients were allocated into group A and B. A significantly different median relapse-free survival was observed between the 2 groups (22.18 vs 42.85 months, p = 0.0296). Interestingly enough, even if group A had a worse outcome in terms of risk of relapse, an higher percentage of stage II patients could be found in this group (83%) when compared with the group B (52%). Among of all genes tested, those with the higher “weight” in determining allocation into one of the two groups were CD44, ALCAM, DTX2, HSPA9, CCNA2, PDX1, MYST1, COL1A1 and ABCG2. This analysis supports the idea that, other than (or maybe more than) stage, biological variables, such as expression levels of colon cancer stem cell genes, may be relevant in determining an increased risk of relapse in resected colorectal cancer patients. Disclosure: All authors have declared no conflicts of interest. 216P GENE EXPRESSION PROFILING IN ESTOROGEN RECEPTOR POSITIVE BREAST CANCER WITH CANCER STEM-LIKE CELLS Y. Tsunoda 1 , M. Sakamoto 1 , E. Fukma 1 ,T.Sawada 2 , A. Sasaki 3 , G. Yamamoto 3 , T. Tachikawa 3 1 Breast Center, Kameda Medical Center, Kamogawa City, JAPAN, 2 Breast Surgery, Showa University School of Medicine, Tokyo, JAPAN, 3 Dental Pathology, Showa University School of Medicine, Tokyo, JAPAN Objective: Breast cancer cells with CD44 + CD24-/low gene expression signature have been suggested to have stem cell-like tumor-initiating properties. The purpose of this study is to clarify the gene expression profiling of cells with CD44 + CD24-/low gene expression signature in the estrogen receptor (ER) positive tumors. Methods: Laser-captured microdissection was used to select the isolation of cancer cells in 32 frozen tissues of breast cancer, and RNA extracted from these cells was examined by real-time RT-PCR to quantify CD44 and CD24 expressions. Human stem cell RT 2 Profiler PCR Array was used for gene expression analysis in the groups of CD44 + CD24-/low and CD44 + CD24+ gene expression signature. Results: Thirty-two tumors were divided into 2 groups. Group A was composed of the CD44 + CD24-/low type, in which the ratio of CD44/CD24 was >10.0. Group B was composed of the CD44 + CD24+ type, in which the ratio was >0.1 and ≦ 10.0. The number of tumors in group A and B were 4 and28, respectively. Regarding the correlation of CD44/CD24 status with tumor characteristics, the tumors of group A were significantly associated with axillary lymph node metastasis compared with those of group B (P = 0.009). There were no significant differences in tumor size, nuclear grade between the two groups. HER2 status in the tumors of group B was significantly higher than group A (P = 0.028). According to signaling pathways, the number of expression genes for the Notch pathway in group A was significantly greater than in group B (P = 0.028). Overexpressed genes for ALDH1 (P = 0.021) and SOX2 (P = 0.018) were noted in group A compared to group B. Conclusion: This study suggests that the Notch pathway may be an important signaling pathway in luminal subtype with CD44 + CD24-/low gene expression signature. In addition, either ALDH1or SOX2 may be a candidate marker for cancer stem cells in the ER positive breast cancer. Disclosure: All authors have declared no conflicts of interest. 217P CARBON NANOTUBE DEVICES FOR THE DETECTION OF CIRCULATING TUMOR CELLS G. Kloecker 1 , B. King 2 , B. Panchapakesan 2 1 Department of Medical Oncology & Hematology, Brown Cancer Center University of Louisville, Louisville, KY, UNITED STATES OF AMERICA, 2 Department of Mechanical Engineering, University of Louisville, Louisville, KY, UNITED STATES OF AMERICA Introduction: Combining clinical and imaging tools with the presence and level of circulating cancer cells (CTC) has great potential. Carbon nanotube electrical devices are a promising technique to detect CTCs in small samples of blood. This study tests, if free energy change for specific interactions is higher than for non-specific interactions. Cell surface receptors found on breast cancer cells are targeted by functionalizing the carbon nanotube electronic devices with cancer-specific antibodies. The study also tested, if the concentration of CTCs correlates with the change in the electronic properties of the nanotube device. Methods: Antibodies, specific for IGF1R, EPCAM, Her2, and a nonspecific antibody (EMD Biosciences, San Diego CA) in PBS are adsorbed on to the individual nanodevices. One ml drops of fresh human donor blood is mixed with 1 micro-liter of cancer cells (1000 cells). This mixture is applied to the device using a micro-pipette and the change in conductivity is measured. Negative control cell lines that do not overexpress IGF1R, EPCAM, or Her2, such as human Jurkat cells, human nontumorigenic MCF10A cells, and nontumorigenic R- mouse embryonic fibroblast cells with targeted disruption of the IGF1R gene are used as negative controls to test the device efficacy. Results: Functionalized nanotubes with specific antibodies elicited significant changes in conductivity (10 times change per 100 cells, r∧2 0.95) while non-specific interaction caused negligible conductivity changes. Larger conductivity drops were seen in blood containing cancer cells than blood alone or isolated white blood cells (change in resistance from 2-6 kW for 200 cells in blood, r∧2 0.95). Changes in conductance were linear with an increasing number of cells in the range of 10-300 cells/5 ml. (5 kW per 100 cells, 20 kW per 200 cells and 30 kW per 300 cells, r∧20.95). Conclusion: The specific and proportional changes in conductivity suggest that this approach could be useful in sensing cancer cells in a small volume of blood. Monitors based on nano-technology may be of clinical utility in the detection of a wide variety of cancer types. This non-invasive test would give clinicians immediate results (similar to a glucometer), which can improve screening, response assessment and surveillance. Disclosure: All authors have declared no conflicts of interest. 218P CIRCULATING TUMOR CELLS AS A PROGNOSTIC MARKER IN ADVANCE COLORECTAL CANCER PATIENTS TREATED WITH CETUXIMAB-CONTAINING SALVAGE CHEMOTHERAPY S. Matsusaka 1 , Y. Kuboki 1 , M. Suenaga 1 , E. Shinozaki 1 , N. Mizunuma 1 , K. Hatake 2 1 Gastroenterology, Cancer Institute Hospital, Tokyo, JAPAN, 2 Medical Oncology, Cancer Institute Hospital of JFCR, Tokyo, JAPAN Background: Circulating tumor cells (CTC) can be a predictive, or a prognosis marker in advance colorectal cancer (ACC) patients treated with chemotherapy plus targeted agents as front-line therapy. We assessed assessed the prognostic and predictive role of CTC in ACC patients treated with cetuximab (with or without irinotecan) who had been previously treated with a fluoropyrimidine, irinotecan, and oxaliplatin. Material and methods: Between October 2008 and March 2011, 63 patients with KRAS wild-type ACC were treated with cetuximab as a third-line therapy at the Cancer Institute Hospital, providing written informed consent for CTC collection. We used CellSearch system for detection and EGFR expression for CTC. Patients were stratified into low (less than three CTC per 7.5ml of blood) or high (three or more CTC per 7.5ml of blood). Results: A total of 63 patients were assessable for CTC analysis. Of the 63 patients with evaluable baseline CTC results, 19 patients (30%) had high CTC. The median number of CTC was one (range 0- 220, mean 7.28) at baseline. Patients with high CTCs had a shorter median overall survival (8.9 months) than those with low CTCs (15.3 months) [P < 0.005; HR 2.2 (95% CI 1.2–3.9)]. There was no significant difference in PFS between the two groups (PFS; HR 1.2). Of the 33 patients with positive CTC, 7 patients (21%) had EGFR-positive CTC, and 26 patients (79%) had EGFR-negative CTC. The concordance rate for EGFR between tumor and CTC was 30.5%. Conclusion: High CTC count at baseline is a poor prognostic factor for OS in ACC patients treated with cetuximab-containing chemotherapy as salvage. Disclosure: All authors have declared no conflicts of interest. 219P ASSESSMENT OF CIRCULATING FREE DNA (CFDNA) AND CIRCULATING MELANOMA CELLS (CMCS) AS PROGNOSTIC BIOMARKERS IN METASTATIC CUTANEOUS MELANOMA K. Aung 1 , L.T. Khoja 1 , C. Zhou 1 , M. Lancashire 1 , R. Sloane 1 , G. Brady 1 , G. Clack 2 , A. Hughes 2 , P. Lorigan 3 , C. Dive 1 1 Clinical and Experimental Pharmacology, The Paterson Institute for Cancer Research, Manchester, UNITED KINGDOM, 2 Early Phase Oncology, AstraZeneca Pharmaceuticals, Macclesfield, UNITED KINGDOM, 3 Medical Oncology, The Christie NHS Foundation Trust, Manchester, UNITED KINGDOM Background: cfDNA is detectable in patients with metastatic cutaneous melanoma and its plasma concentration could potentially predict their clinical outcomes. We assessed the correlation between cfDNA concentration and patients’ overall survival and clinical characteristics including known poor prognostic factors in melanoma. Prognostic value of CMCs number and its association with cfDNA level was also explored. Methods: Pre-treatment blood samples from 50 patients with metastatic cutaneous melanoma were collected prospectively. cfDNA was extracted from 1 ml of plasma using QIAamp Circulating Nucleic Acids Kit (Qiagen, Hilden, Germany) and quantified by RNase P qPCR (ABI Life Technologies, Foster City, NJ, USA). CMC enumeration per 7.5 ml whole blood was performed within 96 hours of sample collection using the CellSearch Melanoma Kit (Veridex, NJ, USA). Correlation between cfDNA concentration and clinical characteristics and CMC number was performed using χ 2 -test and Fisher’s exact test where appropriate. Survival curves were produced and compared by the Kaplan-Meier method and log-rank test respectively. Volume 23 | Supplement 9 | September 2012 doi:10.1093/annonc/mds391 | ix87
Results: The median concentration of cfDNA was 6.8 ng/ml (range 0-205.8) and median CMC number was 0/7.5ml (range 0-16). Patients with cfDNA concentration of >75% percentile had significantly shorter overall survival compared to those with cfDNA level
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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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Results: We evaluated 76 pts with M
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more than 6 cycles of capecitabine.
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406TiP PHASE II TRIAL OF PRIMARY SY
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abstracts CNS tumors 410O CONDITION
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Conclusions: Our data suggested tha
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Conclusions: As in other cancer typ
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432 GAMMA KNIFE RADIOSURGERY AS A M
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abstracts developmental therapeutic
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1PR), but no responses were seen in
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RO and Cd, as well as PD data for c
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and vulvar Ca), and 11 SDs were obs
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knowing HLA-A status double-blindly
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Acquired-resistance to EGFR inhibit
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474P PHASE 1 STUDY OF THE SELECTIVE
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TST is active in breast and gastric
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Treatment-induced shedding of circu
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Methods: Either co-cultures of peri
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501 PRECLINICAL DATA INVESTIGATING
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509TiP LUX-LUNG 8: A RANDOMIZED, OP
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(P = 0.64). Synchronous BBC was sig
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abstracts gastrointestinal tumors,
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Disclosure: M. Lee: I am an employe
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plus intravenous Bev(7.5mg/kg q 21d
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anti-EGFR treatment. The present st
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patients harboring a T/T genotype t
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551P ADJUVANT CHEMOTHERAPY (AC) USE
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experienced significantly more ≥
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functioning scales. Exploratory ana
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oxaliplatin (100 mg/m 2 )/raltitrex
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572P PANERB STUDY: WHICH CATEGORY O
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Results: 92/114 patients were preop
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585P CHANGES IN THE INTESTINAL ENVI
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592P PHASE II TRIAL OF COMBINED CHE
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minutes. In a previous study, 30-mi
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Patients and methods: Chemotherapy-
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612P ARE PATIENTS WITH RESECTABLE R
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Conclusions: AMPK and ACC activatio
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of surgical monotherapy in patients
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Table: 632 633 AFLIBERCEPT/FOLFIRI
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factors play the determining role i
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Abstract withdrawn in exceptional c
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were respectively 10.6 vs 8.5 vs 3.
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Results: 20 gastrointestinal cancer
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abstracts gastrointestinal tumors,
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Day 8. A second identical course wa
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proven in stage I GC. The aim of th
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Conclusions: Longer OS to FOLFOX wa
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692P PRELIMINARY SAFETY DATA FROM A
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subgroup. Taking into consideration
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Results: Three years of adjuvant im
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considered sufficient to give an 80
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721P FIRST-LINE TREATMENT WITH FOLF
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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)
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author index Trypaki M. ix429 (1308
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author index Whitmore J.B. ix310 (9
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subject index subject index A AAV-H
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subject index ix115 (316TiP), ix116
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subject index diffuse large B-cell
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subject index (1033P), ix340 (1036P
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subject index medical information,
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subject index (612P), ix214 (633),
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subject index RCC, ix274 (830P) re-
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subject index TR-FRET, ix84 (206P)
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drug index drug index 1248P, 1250P,
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translational research index transl
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