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Aims & Scope

Tumori Journal covers all aspects of cancer science and clinical practice with a strong focus on prevention, translational medicine and clinically relevant reports. We invite the publication of randomized trials and reports on large, consecutive patient series that investigate the real impact of new techniques, drugs and devices inday-to-day clinical practice.

State-of-the-art reviews that summarize and critically analyze the clinical, economic, and social consequences of cancer are also welcome.

Affiliated with:

Organisation of European Cancer Institutes (OECI) Italian Association of Medical Oncology (AIOM) Italian Association of Radiation Oncology (AIRO) Italian Cancer Society (SIC)

Italian Society of Surgical Oncology (SICO)

Manuscript Submissions Guidelines

To view the manuscript submission guidelines, please click on the Submit Paper tab at journals.sagepub.com/home/tmj Editor in Chief

Ugo Pastorino Editorial Board Section editors

Anesthesia and Intensive Care

Federico Piccioni, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Animal Models

Giacomo Manenti, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Biostatistics

Carlotta Galeone, University of Milan, Milan, Italy Breast Oncology

Serena Di Cosimo, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Stefania Gori, Ospedale Sacro Cuore Don Calabria, Negrar, Italy

Cancer Biology

Luca Roz, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Diagnostic Imaging

Nicola Sverzellati, University of Parma, Parma, Italy Epidemiology and Prevention

Annalisa Trama, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Gastrointestinal Oncology

Giuseppe Aprile, Azienda ULSS8 Berica, Vicenza, Italy

Filippo Pietrantonio, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Carlo Sposito, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Genitourinary Oncology

Sergio Bracarda, Ospedale San Donato, Istituto Toscano Tumori (ITT), Arezzo, Italy Andrea Necchi, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Giuseppe Procopio, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Gynecologic Oncology

Domenica Lorusso, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Fedro Peccatori, Istituto Europeo di Oncologia, Milan, Italy

Hematology-Oncology

Niccolò Bolli, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Hepatology and Pancreatic Oncology

Sherrie Bhoori, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Immunology and Microenviroment

Claudia Chiodoni, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Medical Physics

Mauro Carrara, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Melanoma and Sarcoma

Alessandro Gronchi, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Molecular Oncology

Elena Tamborini, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Neuro-Oncology

Antonio Silvani, Fondazione IRCCS Carlo Besta, Milan, Italy Ophthalmic Oncology

Martina Angi, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Palliative and Supportive Care

Cinzia Brunelli, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Pathology

Angelica Sonzogni, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Paola Collini, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Pediatric Oncology

Andrea Ferrari, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Preclinical Pharmacology

Paola Perego, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Psycho-Oncology

Carlo Alfredo Clerici, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Radiotherapy/Head and Neck

Ester Orlandi, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Thoracic Oncology

Andrea Billè, Guy’s Hospital London, London, UK Massimo Di Maio, University of Turin, Turin, Italy

Marina Garassino, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

International Editorial Board

Stefan Aebi, Kantonsspital Luzern, Luzern, Switzerland Joachim Aerts, Amphia Hospital, Breda, Netherlands Matti S. Aapro, Clinique de Genolier, Genolier, Switzerland

Emiliano Calvo, START Madrid, Centro Integral Oncológico Clara Campal, Madrid, Spain Wanqing Chen, National Cancer Center, Pan-jia-yuan South Lane, China

Joachim Cohen, Vrije Universiteit Brussels (VUB) and Ghent University, Brussels, Belgium Padraig D’Arcy, Linköping University, Linköping, Sweden

Maria De Santis, Cancer Research Unit, University of Warwick, Coventry, UK Simon Ekman, Uppsala University Hospital, Uppsala, Sweden

Alexandre Escargueil, Centre de Recherche Saint-Antoine, Paris, France Rui Henrique, Portuguese Oncology Institute, Porto Portugal

Kenzo Hiroshima, Yachiyo Medical Center, Yachiyo, Japan Natasha Leighl, University of Toronto, Toronto, Canada Herbert Loong, University of Hong Kong, Hong Kong, China Cynthia A. Mapua, St. Luke’s Medical Center, Quezon City, Phillipines Tomohiro Matsuda, National Cancer Registry Center, Tokyo, Japan Mari Mino-Kenudson, Massachusetts General Hospital, Boston, USA Andre L. Moreira, NYU Langone Medical Center, New York, USA Yukio Nakatani, University Graduate School of Medicine, Inohana, Japan Tom Newsom-Davis, Chelsea and Westminster Hospital, London, UK Chang-Mo Oh, National Cancer Center, Ilsandong-gu, South Korea

Christoph Ostgathe, Friedrich-Alexander-Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany

Luis Paz-Arez, Hospital Universitario Doce de Octubre, Universidad Complutense and CNIO, Madrid, Spain

Martin Reck, LungenClinic Grosshansdorf, Grosshansdorf, Germany Satoru Sagae, JR Sapporo Hospital, Sapporo, Japan

Hutcha Sriplung, Prince of Songkla University, Songkhla, Thailand Carmen Jerónimo, Portuguese Oncology Institute of Porto, Porto, Portugal

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Abstracting and indexing

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Printed by Henry Ling

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Abstract Book of the

21th National Congress of Italian Association of Medical Oncology (AIOM) 25-27 October, 2019 - Rome, Italy

Guest Editor Stefania Gori

Director of Oncology Department IRCCS Cancer Care Center “Sacro Cuore - Don Calabria”, Negrar, (VR) President, Italian Association of Medical Oncology (AIOM)

.

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Volume 105, 2019 Issue 6S

21th National Congress of Italian Association of Medical Oncology (AIOM)

25-27 October, 2019 - Rome, Italy

Guest Editor Letter IV

Board of Directors V

Abstracts

Plenary Session 1

Session A: Gastrointestinal (Colorectal) Cancers 3

Session B: Gastrointestinal (non-Colorectal) Cancers 25

Session C: Breast Cancer 47

Session D: Thoracic Cancers 84

Session E: Genitourinary Tumours 117

Session F: Gynaecological Tumours 130

Session G: Sarcomas 135

Session H: Melanoma and Skin Cancers 137

Session L: Head and Neck Tumours 141

Session M: Brain Tumours 145

Session N: Neuroendocrine Tumours 150

Session P: Management of Cancer Pain 154

Session R: Miscellanea 155

Session S: Oncology Nursing 197

Late Breaking Abstracts 210

Author Index 217

Please note that Abstracts marked with an asterisk ‘*’ are Oral Communications.

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Stefania Gori Medical Oncology

IRCCS - “Sacro Cuore Don Calabria” Hospital, Negrar (VR) Italy

Dear Colleagues,

On behalf of the Scientific Board, it is a great pleasure for me to introduce the proceedings of the XXI National Con- gress of Italian Association of Medical Oncology (AIOM).

The abstracts are published in a special issue of “Tumori Journal”. The number of submitted abstracts has continuously increased over years suggesting, once again, the presence of a widespread research activity in spite of the shortage of public funds and lack of interest of public authorities. Many and many young oncologists are coauthors of the abstracts and several of them are first authors. This should be an encouragement for all of us: there is a present and also a future for AIOM.

As you can realize by reading this issue, the abstracts cover all topics of medical oncology, including prevention, screening, diagnosis, treatment, follow-up, simultaneous care, always with a multidisciplinary approach. These top- ics will be debated in several educational and scientific sessions co-organized with other scientific societies and also National and regional health agencies. We would like to highlight as the innovations in the field of immunotherapy and targeted therapy and all the results of Italian research are a relevant part of the program of the meeting. As clinicians involved in the care of the patients, we have to keep in mind that research activity improves the care of cancer patients.

The ability to conjugate these two aspects is the only way to improve the chance of cure for our patients.

Finally, I’d like to thank the Scientific Committee and all the reviewers for their invaluable work and I hope that the meeting could be the occasion of sharing knowledge and experiences, in order to enrich our skills. Enjoy the meeting!

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The Board of Directors for the years 2017-2019 includes:

• Stefania Gori (President)

• Giordano D. Beretta ((President-elect)

• Roberto Bordonaro (Secretar)

• Saverio Cinieri (Treasurer)

• Giuseppe Aprile

• Sergio Bracarda

• Lucia Del Mastro

• Daniele Farci

• Nicla La Verde

• Silvia Novello

• Giuseppe Procopio

• Antonio Russo

We are looking forward to seeing you in Rome.

Dott. Stefania Gori (President of the Congress)

This abstracts book will be available on-line and will also be freely available to subscribers to the following website congresso.aiom.it from October 28, 2019

https://doi.org/10.1177/0300891619872589 Tumori Journal

2019, Vol. 105(6S) 1 –216

© Fondazione IRCCS Istituto Nazionale dei Tumori 2019 Article reuse guidelines:

sagepub.com/journals-permissions DOI: 10.1177/0300891619872589 journals.sagepub.com/home/tmj

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Plenary Session 01*

INCIDENCE, REPRODUCTIVE AND DISEASE OUTCOMES OF PREGNANCY AFTER BREAST CANCER IN PATIENTS CARRYING A BRCA MUTATION: RESULTS FROM AN INTERNATIONAL COHORT STUDY

Lambertini M.¹, Ameye L.², Hamy A.³, Zingarello A.⁴, Poorvu P.D.⁵, Carrasco E.⁶, Grinshpun A.⁷, Han S.⁸, Rousset-Jablonski C.⁹, Ferrari A.¹⁰, Paluch-Shimon S.¹¹, Cortesi L.¹², Senechal C.¹³, Miolo G.¹⁴, Pogoda K.¹⁵, Pérez-Fidalgo A.¹⁶, De Marchis L.¹⁷, Del Mastro L.¹, Peccatori F.A.¹⁸, Azim Jr. H.A.¹⁹

1IRCCS Policlinico San Martino - Università di Genova, Genova; ²Institut Jules Bordet, Brussels; ³Institut Curie, Paris; ⁴Institut Gustave Roussy, Paris; ⁵Dana- Farber Cancer Institute, Boston; ⁶Vall Hebron Institute of Oncology, Barcelona;

7Hadassah-Hebrew University Medical Center, Jerusalem; ⁸University Hospi- tals Leuven, Leuven; ⁹Leon Berard Cancer Center, Lyon; ¹⁰Fondazione IRCCS Policlinico San Matteo, Pavia; ¹¹Shaare Zedek Medical Centre, Jerusalem;

12Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena; ¹³Bergo- nie Institute, Bordeaux; ¹⁴Centro di Riferimento Oncologico di Avano (CRO) IRCCS, Aviano; ¹⁵Maria Sklodowska-Curie Institute–Oncology Center, Warsaw;

16INCLIVA University Hospital of Valencia, Valencia; ¹⁷“La Sapienza” University of Rome, Rome; ¹⁸European Institute of Oncology (IEO), Milan; ¹⁹Tecnologico de Monterrey, Monterrey

Background: Very limited data are available on the safety of pregnancy and reproductive outcomes in BRCA-mutated patients with prior breast cancer history. We report the results of the largest study to date addressing these questions.

Material and methods: This international, multicenter, hospital-based, retrospective cohort study included con- secutive patients with invasive early breast cancer (stage I-III) diagnosed between January 2000 and December 2012 at the age of = 40 years and carrying a deleterious germline BRCA mutation. Primary endpoints were preg- nancy rate and disease-free survival (DFS); overall sur- vival (OS) and pregnancy outcomes were secondary endpoints. To account for guarantee-time bias, we per- formed two survival analyses: 1) Case-control approach matching pregnant and non-pregnant (1:3) patients for classic prognostic factors (each non-pregnant control had a disease-free interval =than the time elapsing between breast cancer diagnosis and date of pregnancy of the matched pregnant case); 2) Extended Cox model with

occurrence of pregnancy as time-varying covariate includ- ing all patients.

Results: 1,252 BRCA-mutatedbreast cancer patients (811 BRCA1,430 BRCA2, 11BRCA1&2) were included from 30 centers worldwide, of whom 195 patients had a pregnancy (pregnancy rate = 16% [95% CI 14-18]) after a median 4.5 years (range 3.1-6.7 years) following breast cancer diagno- sis. Pregnant patientswere younger and had more ER-negative tumors (all p<0.01). 16 (8.2%) and 20 (10.3%) patients had an induced and spontaneous abortion, respec- tively. Among the 150 (76.9%) patients who conceived (n = 170 babies), pregnancy complications and congenital anomalies were described in 13 (11.6%) and 2 (1.8%) cases, respectively.Median follow-up was 8.3 years (range 8.1-8.7 years). In the case-control analysis, pregnant patients had better DFS (HR 0.71; 95% CI 0.51-0.99; p = 0.045), with no difference in OS (HR 0.86; 95% CI 0.44-1.67; p = 0.65).

Subgroup analysis suggested that the superior outcome was restricted to BRCA1-mutatedpregnant patients(p-interac- tion<0.01). Similar results were obtained in the second sup- portive analysis.

Conclusions: Pregnancy following breast cancer is safe in BRCA-mutated patients, particularly those with BRCA1- mutations, with no detrimental impact on maternal prog- nosis or fetal outcomes. These findings are of paramount importance for fertility counseling in young BRCA- mutated breast cancer patients.

ClinicalTrials.gov Identifier: NCT03673306

02*

UPDATED RESULTS OF TRIBE2, A PHASE III, RANDOMIZED STRATEGY STUDY BY GONO IN THE FIRST- AND SECOND-LINE TREATMENT OF UNRESECTABLE mCRC Rossini D.¹, Cremolini C.¹, Lonardi S.², Antoniotti C.¹, Pietrantonio F.³, Cordio S.S.⁴, Bergamo F.², Marmorino F.¹, Maiello E.⁵, Passardi A.⁶, Masi G.¹, Tamburini E.⁷, Santini D.⁸, Grande R.⁹, Zaniboni A.¹⁰, Granetto C.¹¹, Murgioni S.², Aprile G.¹², Boni L.¹³, Falcone A.¹

1Department of Translational Research and New Technologies in Medicine and Surgery, Unit of Medical Oncology 2, Azienda Ospedaliera Universitaria Pisana, Pisa; ²Unit of Medical Oncology 1, Department of Clinical and Experimental Oncology, Veneto Institute of Oncology, IOV - IRCCS, Padua; ³Medical Oncology Department, Fondazione IRCSS - Istituto Nazionale dei Tumori, Milan; ⁴Onco- logia Medica, Azienda Ospedaliera ARNAS Garibaldi, Catania; ⁵Oncology Unit, 872589TMJ0010.1177/0300891619872589Tumori JournalAIOM abstracts

research-article2019

AIOM abstracts

Hospital Casa Sollievo della Sofferenza-IRCCS, San Giovanni Rotondo (FG); ⁶ Medical Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola; ⁷Department of Medical Oncology, Infermi Hos- pital, Rimini; ⁸Department of Medical Oncology, Campus Bio-Medico - University of Rome, Rome; ⁹Medical Oncology, Ospedale Fabrizio Spaziani-ASL Frosinone, Frosinone; ¹⁰Medical Oncology Unit, Poliambulanza Foundation, Brescia; ¹¹Oncolo- gia Medica, Azienda Sanitaria Ospedaliera Santa Croce e Carle, Cuneo; ¹²Depart- ment of Oncology, San Bortolo General Hospital, ULSS8 Berica-East District, Vicenza; ¹³Clinical Trial Coordinating Center, AOU Careggi, Florence

Background: In the phase III TRIBE study FOLFOXIRI/

bev significantly improved Response Rate (RR), PFS and OS when compared with FOLFIRI/bev as initial treatment of mCRC. However, the actual advantage by the triplet could be lower when compared with a pre-planned sequen- tial strategy of doublets (FOLFOX, FOLFIRI). TRIBE2 (NCT02339116) is a phase III trial in which unresectable mCRC pts were randomized 1:1 to FOLFOX/bev followed by FOLFIRI/bev after PD (arm A) or FOLFOXIRI/bev followed by the reintroduction of the same regimen after PD (arm B). A pre-planned interim analysis showed a sig- nificant advantage for arm B in terms of PFS2, primary endpoint of the study, defined as the time from randomiza- tion to PD on any treatment given after first PD or death (PD2).

Methods: The study had 80% power to detect a HR for PFS2 of 0.77 in favor of arm B with an overall 2-sided-a error of 0.05 (0.0131 and 0.0455 for the interim and final analyses, planned at 303 and 466 PFS2 events, respec- tively). Secondary endpoints included RR, 1st-PFS, i.e. the time from randomization to the first evidence of PD or death (PD1), 2nd-PFS, i.e. the time from PD1 to PD2, and OS.

Results: From February 2015 to May 2017, 679 pts (arm A/B: 340/339) were enrolled in 58 Italian sites. Main pts’

characteristics were (arm A/B): right side 38%/38%, syn- chronous mets 89%/89%, RAS mutant 65%/63%, BRAF mutant 10%/10%. At a median follow up of 30.6 mos, 514 (arm A/B: 272/242) PD2, 594 (arm A/B: 303/291) PD1 and 408 (arm A/B: 217/191) OS events were collected. A significant advantage by upfront FOLFOXIRI/bev was confirmed in terms of PFS2 (19.1 vs 16.4 mos, HR 0.74, 95%CI 0.62-0.88, p<0.001), RR (62% vs 50%, OR 1.61, 95%CI 1.19-2.18, p = 0.002) and 1st-PFS (12.0 vs 9.8 mos, HR 0.75, 95%CI 0.63-0.88, p<0.001). A significant OS benefit for pts in arm B was also observed (27.6 vs 22.6 mos, HR: 0.81, 95%CI: 0.67-0.98, p = 0.033). Out of 594 pts with a PD1 event, 470 (79%, arm A/B: 251/219) received a treatment after PD. In the per-protocol analysis (N = 323), pts in arm B showed significantly longer 2nd- PFS (6.5 vs 5.8 mos, HR 0.76, 95%CI 0.59-0.97, p = 0.024).

Conclusions: Upfront FOLFOXIRI/bev followed by the pre-planned reintroduction of the same agents after PD provided a statistically significant and clinically relevant PFS2 and OS benefit when compared with the pre-planned sequential administration of FOLFOX/bev and FOLFIRI/

bev in unresectable mCRC patients. A median OS of 27.6 mos was reached despite the high percentage of pts with poor prognostic features.

03*

BENEFIT FROM LETROZOLE AS

EXTENDED ADJUVANT THERAPY AFTER SEQUENTIAL ENDOCRINE THERAPY:

A RANDOMIZED, PHASE III STUDY OF GRUPPO ITALIANO MAMMELLA (GIM)

Del Mastro L.¹, Mansutti M.², Bisagni G.³, Ponzone R.⁴, Durando A.⁵, Amaducci L.⁶, Fabi A.⁷, Frassoldati A.⁸, Michelotti A.⁹, Pazzola A.¹⁰, Valle E.¹¹, Sanna G.¹², Gori S.¹³, De Placido S.¹⁴, Garrone O.¹⁵, Donadio M.¹⁶, Bruzzi P.¹⁷, Bighin C.¹⁸, Lambertini M.¹⁹, Poggio F.¹⁸

1Department of Medical Oncology, UO Oncologia Medica 2, Policlinico San Martino-IST - Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genova, Genova; ²Department of Oncology-ASUI Udine University Hospital, Udine; ³Oncologia Medica Azienda USL/IRCCS di Reggio Emilia, Reggio Emilia; ⁴Gynecologic Oncology, Candiolo Cancer Institute Turin, Torino; ⁵Breast Unit, Città della Salute e della Scienza, ASO S. Anna Torino, Torino; ⁶Ospedale Faenza, Dipartimento Oncologico Area Vasta Romagna Faenza, Faenza; ⁷Division of Medical Oncology, “Regina Elena”

National Cancer Institute Rome, Roma; ⁸Division of Oncology, Ferrara Univer- sity Hospital, Ferrara; ⁹Medical Oncology, AOU Pisana, Ospedale S. Chiara, ITT Pisa, Pisa; ¹⁰Medical Oncology - Ospedale Civile SS. Annunziata, Sassari; ¹¹Onco- logia Medica, Ospedale Oncologico “A. Businco”-AO Brotzu, Cagliari; ¹²Azienda Ospedaliera Universitaria di Sassari, Sassari; ¹³Oncology Unit, Ospedale Sacro Cuore-don Calabria, Negrar; ¹⁴Oncology Unit, Department of Clinical Medicine and Surgery, University Federico II of Naples, Napoli; ¹⁵Breast Unit Medical Oncology S. Croce and Carle Hospital, Cuneo; ¹⁶Oncology Department Aou Città Della Salute e Della Scienza, Torino; ¹⁷IRCCS Ospedale Policlinico San Martino, Genova; ¹⁸Department of Medical Oncology, UO Oncologia Medica 2, Policlinico San Martino-IST, Genova; ¹⁹Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino

& Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova

Background: The effect of extended adjuvant endocrine therapy (ET) with aromatase inhibitors (AI) after sequen- tial ET with tamoxifen followed by AI for 5 years is still controversial. We conduct a clinical trial to assess different durations of ET with letrozole after tamoxifen.

Methods: The GIM4 LEAD (Gruppo Italiano Mammella 4- Letrozole adjuvant therapy duration study, ClinicalTrials.

gov:NCT01064635) was a prospective, randomized, phase III, Italian multicentric trial. Post-menopausal patients (pts) with hormone receptor positive early breast cancer free of recurrence after 2-3 years of adjuvant tamoxifen, were randomized in a 1:1 ratio to receive 3-2 years (short arm, S) or 5 years (long arm, L) of letrozole. The primary study end point was disease-free survival (DFS) in both arms. Results: Between August 2005 and May 2010, 2056 pts were randomly assigned to receive 3-2 years (n = 1030) or 5 years (n = 1026) of letrozole. Main patients character- istics in the S and L arms were, respectively: median age 60 vs 61 years, node negative 56 vs 56%, (neo)adjuvant chemotherapy 53.4 vs 54.1%. The median follow-up was

A - Gastrointestinal (Colorectal) Cancers 3 10.4 years (IQR range: 8.8-11.4). In the intention to treat

(ITT) population the 8-year DFS was 82.2% (95% CI:79.5- 84.9.) and 86.8% (95% CI:84.4-89.1) in the S and L arm, respectively. In a land-mark univariate Cox analysis, in which events occurred while patients in the 2 arms received the same therapy (i.e. 2/3 years after randomization) were excluded, the Hazard Ratio (HR) for DFS was 0.81 (95%

CI 0.65-1.00; p = 0.051). This effect did not change in a multivariate Cox model that included nodal status, tumor size, grading, age and previous chemotherapy (HR 0.81;

95% CI 0.66-1.01; p = 0.06). Among 1960 pts evaluable for toxicity, osteoporosis was diagnosed in 47 (4.8%) in the S arm and 81 (8.3%) pts in the L arm (chi-square = 9.88;

p = 0.002). Bone fractures occurred in 5 (0.5%) and 9 (0.9%) pts in S and L arm, respectively (p = 0.29, Fisher exact test).

Conclusions: After 2-3 years of adjuvant tamoxifen, extended treatment with 5 years of letrozole improved DFS compared to the standard duration of 2-3 years of letrozole.

A - Gastrointestinal (Colorectal) Cancers

A01*

CLINICAL RELEVANCE OF MUCINOUS AND POORLY DIFFERENTIATED

COLON ADENOCARCINOMAS ON THE OUTCOME OF PATIENTS WITH STAGE II:

A TOSCA SUBGROUP ANALYSIS

Rosati G.¹, Galli F.², Cantore M.³, Lonardi S.⁴, Banzi M.⁵, Zampino M.G.⁶, Pelliccioni S.⁷, Pella N.⁸, Ronzoni M.⁹, Antista M.¹⁰, Tamberi S.¹¹, Marchetti P.¹², Bozzarelli S.¹³, Marsico V.A.¹⁴, Bochicchio A.M.¹⁵, Artioli F.¹⁶, Labianca R.¹⁷, Galli F.², Bilancia D.¹, Bregni G.¹⁸

1Ospedale San Carlo, Potenza; ²Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano; ³Azienda USL 1 di Massa e Carrara, Carrara; ⁴IRCCS Istituto Oncologico Veneto, Padova; ⁵Azienda USL-IRCCS, Reggio Emilia; ⁶IRCCS Istituto Europeo di Oncologia, Milano; ⁷Azienda Ospedaliera Marche Nord, Pesaro/Fano; ⁸Azienda Ospedaliera Universitaria S. Maria della Misericordia, Udine; ⁹Ospedale San Raffaele, Milano; ¹⁰Fondazione IRCCS INT, Milano;

11Ospedale degli Infermi, Faenza; ¹²Ospedale Sant’Andrea, Università Sapi- enza e IRCCS Istituto Dermopatico dell’Immacolata, Roma; ¹³Istituto Clinico Humanitas IRCCS, Rozzano; ¹⁴Ospedale S. Giovanni Calibita Fatebenefratelli, Roma; ¹⁵Ospedale Oncologico Regionale CROB, Rionero in Vulture; ¹⁶Ospedale B. Ramazzini, Carpi; ¹⁷Cancer Center ASST Papa Giovanni XXIII, Bergamo;

18IRCCS San Martino-IST, Genova

Background: Although it has been proven for many years that adjuvant chemotherapy is the standard of care for stage III colon cancer (CC) after resection, there is no suf- ficient evidence that its role on stage II patients get the same benefit. ASCO and ESMO guidelines have identified inadequate sampling of lymph nodes, pT4 primary tumors, obstruction or perforation, lymphovascular and perineural

invasion, and poorly differentiated tumors as negative prognostic factors supporting the clinicians in treating this subgroup of patients. However, the influence of histologi- cal subtypes on the risk of death or disease recurrence remains controversial.

Patients and methods: The phase III, multicenter, rand- omized TOSCA trial compared 3 versus 6 months of fluo- ropyrimidine-oxaliplatin adjuvant chemotherapy in 3,759 patients with high-risk stage II or stage III CC. Objective of this sub-study was to investigate the role of the histo- logical subtype [(mucinous adenocarcinoma (MUC) or non-mucinous adenocarcinoma (NMUC)] on the impact of the treatment duration in terms of relapse-free survival (RFS) and overall survival (OS) in the subgroup of patients with high-risk stage II and grade 3 CC.

Results: Out of 3,614 patients from 130 centres enrolled in the per-protocol population defined in the TOSCA trial, 85 MUC and 389 NMUC patients were included in this analysis. No statistical differences were found between 3 versus 6 months groups in both histological subgroups in terms of baseline characteristics, except for tumor side.

After a median follow-up of 62 months, 60 progression/

deaths and 38 deaths were observed. A significant interac- tion between treatment duration and histology was observed on both RFS (p = 0.027) and OS (p = 0.017). In the subgroup of patients with MUC, worse RFS (adjusted hazard ratio [HR], 3.95; 95% confidence interval [CI], 1.03–15.17; p = 0.045) and OS (HR, 9.56; 95% CI, 1.14–

79.98; p = 0.037) were detected for patients treated in the 3 months arm. No statistically significant differences were detected in the subgroup of patients with NMUC.

Conclusions: Both MUC and poorly differentiated sub- types identify unfavorable clinical characteristics. Patients with MUC, grade 3, stage II CC require special attention and may need 6 months of oxaliplatin-based chemother- apy. Larger studies are required to clarify the possible negative effect of the histological subtype to improve the prognosis of these patients.

A02*

BEVACIZUMAB (BV) MAINTENANCE (M) AFTER FIRST-LINE CHEMOTHERAPY (CT) PLUS BV FOR METASTATIC COLORECTAL CANCER (mCRC)

PATIENTS (pts): A META-ANALYSIS OF INDIVIDUAL PTS DATA (IPD) FROM 3 PHASE III STUDIES

Salvatore L.¹, Bria E.¹, Sperduti I.², Bensi M.¹, Hinke A.³, Hegewisch- Becker S.⁴, Aparicio T.⁵, Le Malicot K.⁶, Boige V.⁷, Koeberle D.⁸, Baertschi D.⁹, Dietrich D.⁹, Tortora G.¹, Arnold D.¹⁰

1UOC Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; ²Biostatistics, Regina Elena National Cancer Institute IRCCS, Roma, Italy; ³CCRC, Düsseldorf, Germany; ⁴HOPE -Hämatologisch-Onkologis- che Praxis Eppendorf, Hamburg, Germany; ⁵Department of Gastroenterology,

Saint Louis Hospital, Paris, France; ⁶FFCD and INSERM U1231, Dijon, France;

7Digestive Oncology, Gustave Roussy, Villejuif, France; ⁸Claraspital, Basel, Switzer- land; ⁹Swiss Group for Clinical Cancer Research, Bern, Switzerland; ¹⁰Asklepios Tumorzentrum Hamburg AK Altona, Hamburg, Germany

Background: Although CAIRO3 and AIO KRK 0207 trials have demonstrated the benefit of BV and fluoropyrimidine as M regimen after induction CT plus BV, the role of BV alone is not clear. Indeed, SAKK 41/06 and PRODIGE 9 trials failed to demonstrate the superiority of BV alone in compari- son to no M, while AIO KRK 0207 showed the non-inferior- ity of BV alone vs combo M. Thus, in order to evaluate the magnitude of the eventual benefit of M with BV alone in comparison to no M, an IPD meta-analysis of randomized tri- als prospectively investigating such issue was performed Patients and methods: Trials whereas mCRC pts were pro- spectively randomized to receive BV M or not were consid- ered eligible. Primary end-points were Progression-Free and Overall Survival (PFS/OS), both from the start of induction and M. Univariate and multivariate analyses for PFS and OS were performed, with the following variables: baseline ECOG PS; age (> vs = 65 years); RAS and BRAF status;

LDH and CEA baseline level; RR (PR or CR vs SD) during induction; induction CT (oxa- vs iri-based); resected primary tumor; primary tumor side; synchronous vs metachronous;

adjuvant treatment; number of metastatic sites.

Results: IPD of 1,064 pts enrolled in the PRODIGE 9, AIO KRK 0207 and SAKK 41/06 trials were collected.

Considering the different timing of randomization in PRODIGE 9 (at the start of induction) vs AIO KRK 0207 and SAKK 41/06 (at the start of M), IPD of pts not pro- gressed during induction and starting M phase entered the analysis. 909 pts were included, 457 (50%) received BV M. Median PFS from induction start was 9.6 and 8.9 months in BV group vs no M group, respectively (HR 0.78; 95%CI: 0.68-0.89; p<0.0001). At the multivariate PFS analysis, BV M, resected primary tumor and number of m sites were significant. No difference in terms of OS between the two groups was observed.

Conclusions: This is the first IPD meta-analysis investi- gating the role of BV alone M vs no M after first-line induction CT plus BV in mCRC pts. Despite results dem- onstrated a significant PFS improvement in favor of BV M, the absolute benefit appears limited, and without a clear clinical relevance. Based on these findings, we can’t conclude that BV alone can be a M therapy option for the overall population, but we need to identify pts most likely to benefit from BV alone.

A03

EFFICACY OF RETREATMENT WITH ANTI-EGFRS IN mCRC IS NOT

PREDICTABLE BY CLINICAL FACTORS RELATED TO PRIOR LINES OF THERAPY:

A MULTI-INSTITUTIONAL ANALYSIS

Zucchelli G.¹, Pagani F.², Pellino A.³, Dell’Aquila E.⁴, Liscia N.⁵, Bensi M.⁶, Germani M.M.⁷, Masi G.⁷, Moretto R.⁷, Santini D.⁴, Salvatore L.⁶, Scartozzi M.⁵, Lonardi S.⁸, Rossini D.⁷, Ongaro E.⁷, Vannini F.⁷, Colombo C.⁷, Falcone A.⁷, Pietrantonio F.⁹, Cremolini C.⁷

1Department of Translational Research and New Technologies in Medicine and Surgery, Unit of Medical Oncology 2, Azienda Ospedaliera Universitaria Pisana, PISA; ²Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; ³Unit of Medical Oncology 1, Department of Clinical and Experimental Oncology, Veneto Institute of Oncology, IOV - IRCCS, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy;

4Department of Medical Oncology, Campus Bio-Medico - University of Rome, Rome, Italy; ⁵Medical Oncology Department, University Hospital, University of Cagliari, Cagliari, Italy; ⁶Fondazione Policlinico Universitario A. Gemelli-IRCCS- UOC Oncologia Medica, Rome, Italy; ⁷Department of Translational Research and New Technologies in Medicine and Surgery, Unit of Medical Oncology 2, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy; ⁸Unit of Medical Oncol- ogy 1, Department of Clinical and Experimental Oncology, Veneto Institute of Oncology, IOV - IRCCS, Padua, Italy; ⁹Medical Oncology Department, Fondazi- one IRCSS - Istituto Nazionale dei Tumori, Milan, Italy

Background: Retrospective analyses and phase 2 studies suggest that administering an anti-EGFR in advanced lines may be effective in mCRC pts who achieved benefit from a 1st-line anti-EGFR containing regimen. The identifica- tion of clinical features associated with benefit from anti- EGFR re-treatment (re-tx) in pts experiencing PD during 1st-line anti-EGFR (rechallenge) or after its interruption (reintroduction), is a major clinical need.

Methods: A real-life data-base including a total of 5530 pts treated at 6 insitutions from December 2010 to October 2018 was queried. Pts retreated with anti- EGFRs, with RAS/BRAF wild-type status on tissue sam- ples, who had received a 1st-line anti-EGFR-based tx with at least SD as best response, and at least one further line of therapy before anti-EGFR re-tx, were included.

The association with RECIST response (RR), PFS and OS was investigated for the following variables: RR (PR or CR vs SD) and PFS during 1st-line; time from the last anti-EGFR administration to 1st-line PD (i.e. re- introduction vs rechallenge); reason for anti-EGFR dis- continuation in 1st-line (PD vs. other); number of anti-EGFR-free lines of therapy before re-tx; anti-EGFR free interval (time between the last anti-EGFR adminis- tration in 1st-line and the time of re-tx); primary tumor side; time from the diagnosis of metastatic disease to re-tx (=vs. < 18 mos).

Results: Data from 86 patients were retrieved, 56 (65%) and 30 (35%) received anti-EGFR rechallenge or reintro- duction, respectively. Median anti-EGFR free interval was 15.1 mos. The RR during re-tx was 19.8%, with a DCR of 46.5%. Median PFS and OS were 3.8 and 10.2 mos, respectively. No significant association of investigated features with RR and PFS was observed. No differences in RR or PFS were observed among patients receiving anti- EGFR re-tx as rechallenge or reintroduction (20.4% vs 23.1%, p = 0.99; median PFS: 3.5 vs 5.0 mos, p = 0.61).

Patients with left-sided tumors had longer OS (HR: 0.50, 95%CI: 0.26-0.93, p = 0.005).

A - Gastrointestinal (Colorectal) Cancers 5 Conclusions: Clinical factors that are generally believed

to affect the efficacy of anti-EGFR re-tx are not confirmed in our series. Therefore, clinicians should not rely on those characteristics in their decision-making on anti-EGFR re-tx, and adequate studies for implementing liquid biopsy in clinical practice are urgently needed.

A04

TREATMENTS (TX) AFTER PROGRESSION TO FIRST-LINE FOLFOXIRI +

BEVACIZUMAB (BEV) IN METASTATIC COLORECTAL CANCER (mCRC) PATIENTS (pts): A POOLED ANALYSIS OF TRIBE AND TRIBE-2 STUDIES BY GONO

Marmorino F.¹, Rossini D.¹, Lonardi S.², Santini D.³, Tomasello G.⁴, Aprile G.⁵, Moretto R.¹, Prete A.², Granetto C.⁶, Urbano F.⁷, Borelli B.¹, Zaniboni A.⁸, Randon G.⁹, Buonadonna A.¹⁰, Ritorto G.¹¹, Barbara C.¹², Latiano T.¹³, Bordonaro R.¹⁴, Antoniotti C.¹, Falcone A.¹, Cremolini C.¹

1Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa; ²Unit of Medical Oncology 1, Department of Clinical and Experimental Oncology, Veneto Institute of Oncology, IOV - IRCSS, Padova, Italy, Padova; ³Department of Medical Oncology, Campus Bio-Medico - University of Rome, Rome, Italy, Roma; ⁴Oncology Unit, Oncology Department, ASST of Cremona, Cremona, Italy, Cremona; ⁵Medical Oncology Unit, ULSS8 Berica - East District, Vicenza, Italy, Vicenza; ⁶Oncologia Medica, Azienda Sani- taria Ospedaliera Santa Croce e Carle, Cuneo, Italy, Cuneo; ⁷Department of Radiological Science, Oncology and Patology, Policlinico Umberto I, “Sapienza”

University of Rome, Rome, Italy, Roma; ⁸Medical Oncology Unit, Poliambulanza Foundation, Brescia, Italy, Brescia; ⁹Medical Oncology Department, Fondazione IRCSS - Istituto Nazionale dei Tumori, Milan, Italy, Milano; ¹⁰Department of Clinical Oncology, Centro di Riferimento Oncologico (CRO) IRCCS, Aviano, Italy, Aviano; ¹¹SSD ColoRectal Cancer Unit Dipartimento di Oncologia, AOU Città della Salute e della Scienza di Torino, Torino, Italy, Torino; ¹²UOC di Oncologia Medica, Ospedale di Livorno - Azienda USL Toscana Nord Ovest, Livorno, Italy, Livorno; ¹³Oncology Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy, San Giovanni Rotondo; ¹⁴Oncologia Medica, Azienda Ospedaliera ARNAS Garibaldi, Catania, Italy, Catania

Background: FOLFOXIRI + bev is regarded as a valu- able option in the first-line tx of mCRC pts. A possible concern for the adoption is the feasibility and efficacy of tx after progression, and especially the reintroduction of the same agents used upfront. The aim of the study was to evaluate the efficacy of tx after progression among pts treated with first-line FOLFOXIRI + bev in the phase III TRIBE (NCT00719797) and TRIBE2 (NCT02339116) studies. The impact of the oxaliplatin and irinotecan free interval (OIFI), defined as the time from the last admin- istration of oxaliplatin and irinotecan to disease progres- sion, on the efficacy of tx after progression was also investigated.

Methods: Data about tx received after progression includ- ing 2^ndPFS (i.e. the time from 2^nd line tx start to disease progression or death) were collected. The efficacy of tx

after progression according to the duration of the OIFI was explored. A cut-off value of 4 months was adopted Results: Out of 586 pts treated with upfront FOLFOXIRI + bev, 520 progressed. Among 409 (79%) pts who received a tx after progression, 168 (41%) received FOLFOXIRI ± bev (Group A) and 241 (59%) received other tx (Group B), including FOLFOX or FOLFIRI ± bev or other agents not used in first line in 124 and 117 cases, respectively. Anti-EGFR moAbs were administered in 68 cases. Pts in Group A experienced significantly longer 2^nd PFS than pts in Group B (median 2^nd PFS: 6.1 vs 4.2, HR 0.76, 95%CI 0.62-0.94; p = 0.012). Pts with an OIFI ⩾ 4 mos (n = 279) had longer 2^nd PFS than those with an OIFI < 4 mos (n = 130) independently of the second- line tx (6.1 vs 3.7 mos: HR 0.54, 95% CI 0.42-0.69;

p<0.001). In the subgroup of pts with an OIFI ⩾ 4 mos FOLFOXIRI ± bev (n = 125) was associated with longer 2^nd PFS compared to other tx (n = 154) (7.2 vs 5.5 mos; HR 0.75, 95% CI 0.58-0.97; p = 0.029). Conversely, in pts with an OIFI < 4 mos no significant difference was shown between Group A (n = 43) and B (n = 87) (4.4 vs 3.2; HR 0.94, 95% CI 0.65-1.36; p = 0.75).

Conclusions: Tx after progression to first-line FOLFOXIRI + bev were feasible. Pts with longer OIFI showed better 2^nd PFS and seemed to derive more benefit from the rein- troduction of the triplet.

A05

HOW TO DEAL WITH SECOND LINE DILEMMA IN METASTATIC COLORECTAL CANCER? A SYSTEMATIC REVIEW AND META-ANALYSIS

Galvano A.¹, Incorvaia L.¹, Badalamenti G.¹, Rizzo S.¹, Guarini A.¹, Cusenza S.¹, Castellana L.¹, Insalaco L.¹, Iacono F.¹, Gristina V.¹, Barraco N.¹, Calò V.¹, Cutaia S.¹, Castiglia M.¹, Fanale D.¹, Beretta G.², Marchiafava E.¹, Fulfaro F.¹, Bazan V.³, Russo A.¹

1Medical Oncology, Department of Surgical, Oncological and Stomatological Sciences, A.O.U.P. “P. Giaccone” University Hospital, Palermo, Palermo; ²Humani- tas Gavazzeni Research Hospital, Bergamo, Bergamo; ³Department of Biomed- icine, Neuroscience and Advanced Diagnostics - BIND, University of Palermo, Palermo, Italy, Palermo

Background: Monoclonal antibodies targeting epidermal growth factor receptor (EGFR) or vascular endothelial growth factor (VEGF) have demonstrated efficacy in com- bination with chemotherapy as second line for metastatic colorectal cancer (mCRC). However, there is still a pau- city of evidence or guidelines suggesting the right sequen- tial treatment in all RAS (KRAS/NRAS) wild type(wt) mCRC. Therefore, we aimed to evaluate the impact of these targeted therapies by reviewing literature data.

Methods: We used Cochrane, EMBASE and Medline data- bases to select phase III clinical trials containing efficacy and safety data about chemotherapy (CT) or CT + targeted

agents combination (Anti-VEGF and Anti-EGFR) in sec- ond line mCRC setting. We performed direct comparisons to obtain pooled data for anti-VEGF + CT versus CT and anti-EGFR + CT versus CT comparisons. Then we per- formed indirect comparisons between anti-EGFR and Anti- VEGF. Outcomes were disease control rate (DCR), response rate (RR), progression-free survival (PFS), over- all survival (OS) and most common G3-G5 toxicities.

Results: Eight eligible RCTs (6793 pts) were included: 5 studies compared anti-VEGF + CT and 3 anti-EGFR + CT combinations to CT. After direct comparisons, pooled indirect results showed significantly improved OS (HR 0.83, 95% CI 0.72 – 0.94) and DCR (HR 1.27, 95% CI 1.04 – 1.54) favouring anti-VEGF combinations in overall population; however, no statistically significant differ- ences in all RAS wt patients was observed (HR 0.87, 95%

CI 0.70 – 1.09). Additionally, anti-EGFR combinations significantly increased ORR in all patients (RR 0.54, 95%

CI 0.31 – 0.96), showing a trend in all RAS wt patients (RR 0.63, 95% CI 0.48 – 0.83) too. Furthermore, no sig- nificant difference in PFS and DCR all RAS was regis- tered. Anti-VEGF combination significantly increased the risk of asthenia difference (RR 1.34, 95% CI 1.03 – 1.75).

Conclusions: At our knowledge, our indirect comparisons between anti-VEGF and anti-EGFR combinations showed for the first time better OS and DCR for anti-VEGF com- binations, whereas better RR is observed for anti-EGFR combinatory regimens, defining a role of both targeted agents in second line mCRC setting, according to muta- tional status, clinical conditions and toxicities.

A06

RARE BRAF MUTATIONS (MTs) IN METASTATIC COLORECTAL CANCER (mCRC): A BI-INSTITUTIONAL

RETROSPECTIVE ANALYSIS (REBUS STUDY)

Di Stefano B.¹, Calegari M.A.², Basso M.², Orlandi A.², Boccaccino A.², Lombardo F.³, Zurlo I.V.¹, Bensi M.¹, Camarda F.¹, Vivolo R.¹, Ribelli M.¹, Cocomazzi A.⁴, Martini M.⁴, Auriemma A.³, Pozzo C.², Bria E.², Salvatore L.², Tortora G.²

1Università Cattolica del Sacro Cuore, Roma; ²Fondazione Policlinico Universi- tario A. Gemelli-IRCCS-UOC Oncologia Medica, Roma; ³Azienda Ospedaliera Universitaria Integrata, Verona; ⁴Fondazione Policlinico Universitario A. Gemelli- IRCCS-Istituto di Anatomia Patologica, Roma

Background: Recently, 3 classes of BRAF MTs have been described. BRAF V600 MTs, which identify mCRC with poor prognosis and not benefitting from anti-EGFR drugs, belong to class 1. Class 2 and 3 include BRAF non-V600 MTs, which occur in about 1-2% mCRC and are associated to favourable prognosis and specific clinicopathologic fea- tures. Class 2 and 3 differ in kinase activity and sensitivity to anti-EGFR: class 2 are activated and RAS-independent

MTs; class 3 are kinase-dead and sensitive to inhibition of activated RAS. This study aims to retrospectively evaluate features and prognostic role of rare BRAF non-V600 com- pared to BRAF V600E MTs in mCRC pts treated at 2 Italian Institutions.

Methods: mCRC pts harboring BRAF MTs, assessed by means of NGS, pyrosequencing or RT-PCR, treated between Jan-13 and Dec-18 at 2 Italian Institutions, were retrospectively analyzed. Clinico-pathological and treat- ment characteristics and survival data were collected.

Results: 55 pts bearing BRAF MTs were identified. Of those, 46 (84%) harbored a V600E and 9 (16%) a non- V600 MT. Within the non-V600 group, 3 MTs (K601E, G469A, G469R) belonged to class 2, while 5 MTs (G466E, G466A, 2 D594G, D594N), belonged to class 3.

One pt harboured a T599I MT, whose kinase activity is unknown. Compared to BRAF V600E mCRC, BRAF non-V600 mCRC were more frequently left-sided (p.017) and displayed a lower grade (p.045). In addition, non- V600 mCRC pts had a lower tumor burden (involving one metastatic site) (p.026) and underwent more frequently to resection of metastases with radical intent (77.7 vs 18%;

p.000175). mOS was significantly longer in the non-V600 compared to the V600E group (61.3 vs 20.4 m; HR 0.41, 95%CI 0.18-0.93; p.05). No difference in activity and efficacy of anti-EGFR agents was observed between class 2 and 3.

Conclusions: Despite the small size of our retrospective analysis, the results were consistent with previous evi- dences. BRAF non-V600 MTs identified a subgroup of mCRC, differing both in terms of clinicopathologic char- acteristics and prognosis from BRAF V600 mCRC.

Interestingly, the better prognostic features allowed more frequently radical resection of metastases, positively impacting on survival.

A07

UPDATED RESULTS OF THE PHASE 2 TRUST TRIAL OF TOTAL NEOADJUVANT APPROACH IN LOCALLY ADVANCED RECTAL CANCER (LARC)

Masi G.¹, Vivaldi C.¹, Fornaro L.², Bergamo F.³, Marcucci L.⁴, Laliscia C.⁵, Pasqualetti F.⁵, Martignetti A.⁶, Castagna M.⁷, Alberti G.⁸, Boccaccino A.¹, Manfredi B.⁵, Balestri R.⁹, Musettini G.⁴, Cremolini C.¹, Daniel F.⁸, Puccini M.⁹, Galuppo S.¹⁰, Buccianti P.⁹, Falcone A.¹

1Università di Pisa, Dipartimento di Ricerca Traslazionale e delle Nuove Tecnolo- gie in Medicina e Chirurgia, Pisa; ²Azienda Ospedaliera-Universitaria Pisana, UO Oncologia Medica 2, Pisa; ³Oncologia Medica 1, IOV - IRCCS, Padova;

4Azienda Toscana Nord Ovest, Oncologia Medica, Pontedera; ⁵Azienda Ospe- daliera-Universitaria Pisana, UO Radioterapia, Pisa; ⁶Azienda Toscana Sud Est, Oncologia Medica, Poggibonsi; ⁷Università di Pisa, Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell’Area Critica, Pisa; ⁸Oncologia Medica 1, IOV - IRCCS; Dipartimento di Scienze Chirurgiche, Oncologiche e Gastroen- terologiche, Università di Padova, Padova; ⁹Azienda Ospedaliera-Universitaria Pisana, UO Chirurgia Generale, Pisa; ¹⁰Radioterapia, IOV - IRCCS, Padova