6th ICHNO Abstract Book

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page 20 6th ICHNO
6 th ICHNO Conference
International Conference on innovative approaches in Head and Neck Oncology
16 – 18 March 2017
Barcelona, Spain
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ADCC activity and the total number of circulating NK cells,
and the interaction between iNKT and ADCC.
Material and Methods
In a multi-step proof of concept project we investigate the
impact of individual ADCC activity in pts treated with
cetuximab and radiotherapy (BRT) on the following
outcome by itself or in function of EGFR expression.
Additional analyses are also considered. A population of
pts treated with chemo-radiotherapy (CRT) is considered
as no formal control.
ADCC was measured in vitro by LDH release, using purified
NK cells from fresh peripheral blood of pts.
The following analyses were performed:
ADCC basal value and during treatment.
EGFR status by IHC NK count in
peripheral blood iNKT count in peripheral blood
CD3+ count in peripheral blood
Results
A total of 58 pts treated with cetuximab + RT (43) or with
CDDP + RT are evaluated.
In a previous paper we reported that complete responses
did not correlate with either ADCC or EGFR expression.
However, using a mixed score considering both ADCC and
EGFR expression, they correlate with CR (p=0.04) in BRT
treated pts. Additionally, pts showing both high basal
ADCC and EGFR+++ achieved a 4-year OS of 100% compared
with the others (p=0.02). No differences were observed in
CRT treated patients.
Additional analyses here reported show that changes of
ADCC induced by treatment do not correlate with outcome
and basal ADCC remains the only prognosticator in
patients treated with BRT.
We also observed that the basal value of ADCC is more
important than the basal number of NK. This observation,
made at baseline, suggests the presence of an impaired
NK cell population in HNC pts, and that impairment is not
treatment related.
We evaluate the combined role of iNKT and high basal
ADCC activity since we observed a significant impact on
outcome in colon cancer pts harbouring both high iNKT and
high ADCC compared to other (p=0.0075). Analysis is under
progress and results will be presented at the conference.
Conclusion
Our data show that ADCC plays an important role in
cetuximab activity and, if confirmed in prospectic
analysis, suggest that patients with high basal ADCC and
EGFR+++ should be treated with cetuximab and RT
PD-034 Subsite-dependent prognostic impact of age in
patients with nasopharyngeal and oropharyngeal cancer
E. Orlandi 1, G. Infante2, R. Granata3, N. Iacovelli 1, R.
Miceli2, A. Cavallo4, S. Alfieri3, C.
Bergamini 3, C. Resteghini3, D. Galbiati3, L. Locati 3, S.
Tana1, S. Naimo1, C. Fallai1, L. Licitra3, P. Bossi 3
1Fondazione IRCCS Istituto Nazionale dei Tumori,
Radiation Oncology Department, Milan, Italy
2Fondazione IRCCS Istituto Nazionale dei Tumori, Unit of
Medical Statistics- Biometry and Bioinformatics- Unit of
Clinical Epidemiology and Trial Organization, Milan,
Italy
3Fondazione IRCCS Istituto Nazionale dei Tumori, Head
and Neck Medical Oncology Department, Milan, Italy
4Fondazione IRCCS Istituto Nazionale dei Tumori, Medical
Physics Unit, Milan, Italy
Purpose or Objective
Outcome results in elderly head and neck cancer (HNC)
patients (pts) treated with concurrent chemoradiation are
controversial. Comparative effectiveness analyses showed
a lack of benefit in multimodal treatment; however,
retrospective highly selected series reported older
patients to have similar outcome compared to younger
ones albeit with high burden of toxicities. No subsite-
related differences were specifically investigated ever.
Material and Methods
Consecutive locally advanced oropharyngeal (OPC) and
nasopharyngeal cancer (NPC) pts treated at our institution
with concurrent platinum based chemotherapy (CHT) and
intensity modulated radiation therapy (IMRT) techniques
from 2004 to 2015 were retrospectively evaluated. Overall
survival (OS) and Relapse Free Survival (RFS) Kaplan-Meier
curves were estimated and compared with the log-rank
test; acute toxicity rate > G3 according to Common
Toxicity Criteria Adverse Event v4.0 was also analyzed,
distinguishing between patients >65 years old (elderly)
and ≤65 old. HPV status was recorded in all OPC patients.
Results
Globally, 375 pts received IMRT-CHT, 215 in OPC and 160
in NPC cohort. Elderly pts represented 26% and 11% of OPC
and NPC pts, respectively. OPC HPV positive cases were
similarly represented in older (73% of the cases) and
younger pts (66%); HPV positivity maintained a significant
prognostic role independently of age and also across
different age group. On the contrary, age did not
significantly impact on survival in OPC. Five-years RFS was
68% in older versus 76% in younger patients (p=0.391); the
corresponding figures for OS were 93% versus 87%
(p=0.541). There was no significant difference in
cumulative acute toxicity rate ≥ G3 (39% in elderly vs 36%
in younger, Fisher test p =0.778). When analyzed
separately, no difference was shown for what concerns
dysphagia and mucositis. NPC pts showed a different
outcome according to age both in terms of RFS (5-years
probabilities 41% in elderly vs 80% in younger pts, p
<0.001) and OS (48% vs 90%, p <0.001), which turned out
to be a negative prognostic factor in this disease. Also for
NPC pts, the two age subgroups did not significantly differ
in acute toxicity rate ≥ G3 (56% vs 61%, p = 0.800).
Conclusion
We observed a subsite-specific impact of age on treatment
outcome: older NPC pts showed markedly worse survival
than the younger counterparts, while in OPC pts such an
effect was inconsistent. HPV status was confirmed to be a
positive prognostic factor independently of age.
Symposium: New developments in systemic treatment
SP-035 Is there still a role for targeted signaling agents
in head and neck cancer?
C. Le Tourneau 1
1Institut Curie, Medical Oncology, Paris, France
Abstract text
Head and neck cancers are essentially being treated with
conventional treatments including surgery, radiotherapy
and chemotherapy. EGFR is the only target that
underwent clinical translation with the use of cetuximab,
a monoclonal antibody targeting EGFR, either in
combination with radiotherapy in the locally advanced
setting or in combination with chemotherapy in first-line
metastatic and/or recurrent setting. More recently,
immune check point inhibitors targeting PD1 have been
demonstrated to improve survival in second line
metastatic and/or recurrent setting with a more favorable
safety profile. Many clinical trials are now ongoing with
these agents in first-line metastatic and/or recurrent
setting and in the locally advanced setting. The question
is whether there is still a role for targeted thérapies in
head and neck cancer treatments beyond EGFR.
Several targets have been identified in head and neck
cancers. We aim to to review in this talk the results of the
trials that have evaluated these targeted thérapies, as