Tumori Journal Abstract Book - October 2020 - 108

108	
ctDNA through droplet digital PCR (ddPCR). ctDNA%
was defined as the proportion of the different lengths of
ACTB DNA fragments: 136 bp (ACTB_short) more likely
to be related to ctDNA over 420 bp and 2000 bp (ACTB_
medium and ACTB_long) the genomic portion mainly
derived from cytolysis. The overall DNA yield was measured through Qubit. Blood samples were collected before
treatment start (BL) and after 3 months concomitantly with
CT scan restaging (E1). Matched pairs variations were
tested through Wilcoxon test, the prognostic impact of
ctDNA% and DNA yield was tested in terms of PFS
though uni-and multivariate Cox regression analyses.
Results: The main treatment regimen was ET+CDK4/6
inhibitors (92%), only 6% of pts received ET as a single
agent. While DNA yield categorized at the 75th percentile
failed to show a prognostic impact, pts with a ctDNA%
>75th percentile were burdened by a significantly worse
outcome (Median PFS: 7.8 months, P=0.0290). When compared with E1, a significant decrease in ACTB_short (71%
P=0.0162), ACTB_medium (66% P=0.0011) and ACTB_
long (78% P=0.0001) was observed. As expected, a significant drop in neutrophils count was also observed during
treatment with CDK4/6 inhibitors (decrease in 94% of cases
P<0.0001). The prognostic impact of a drop higher than
10% was then investigated for the different fragments of
ACTB in terms of PFS. While a significant impact was
observed for ACTB_short (HR: 5.98, 95%CI1.61 - 22.24, P
= 0.008), no significance was observed for ACTB_medium
and ACTB_long (respectively HR: 3.08, 95%CI 0.8 - 10.79,
P=0.079 and HR: 2.27, 95%CI 0.47 - 10.92, P=0.305). The
prognostic impact of ACTB_short was also retained after
correction for ACTB_medium and ACTB_long in multivariate analysis (HR: 4.88, 95%CI 1.07 -22.17, P=0.040).
Conclusions: The study proofed the concept of a feasible
mutation-agnostic workflow for a more granular disease
monitoring and prognostication in MBC. Although prospectively generated, these results need to be confirmed on
a larger population.

E17
Development of a Clinicopathological Nomogram
for Predicting Pathological
Complete Response (pCR) in Luminal
Breast Cancer (LBC) patients
(pts) undergoing neoadjuvant
chemotherapy (NACT)
Garufi G.1, Carbognin L.1, Orlandi A.1, Paris I.1, Palazzo A.1, Fiorio E.2,
Miglietta F.3, Dieci M.V.3, Pasqualoni M.1, Pannunzio S.1, Cannizzaro
M.C.1, Pontolillo L.1, Cutigni C.1, Indellicati G.1, Sperduti I.4, Milella
M.2, Scambia G.1, Tortora G.1, Bria E.1
1

Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma; 2Azienda
Ospedaliera Universitaria Integrata, Verona; 3Istituto Oncologico Veneto
IRCCS, Padova; 4Regina Elena National Cancer Institute IRCCS, Roma

Tumori Journal 106(2S)
Background: Given the low chance of response to NACT
in locally advanced LBC pts, the identification of predictive clinico-pathological factors of pCR represents a challenge for daily clinical practice. With this purpose, a
multicenter retrospective analysis was performed in order
to develop a predictive nomogram for pCR, on the basis of
pre-treatment clinico-pathological features.
Methods: Clinical and pathological data of stage I-III
LBC pts undergone NACT and surgery at 3 Italian
Institutions were collected. Descriptive statistics were
adopted. For continuous variables, the Receiver Operating
Characteristic (ROC) analysis was applied. A multivariate
model was used to identify independent predictors of pCR.
The obtained log-Odds Ratios (OR) were adopted to derive
weighting factors of the predictive nomogram, aimed to
recognize differential risks of pCR. The ROC analysis was
also applied to determine the nomogram accuracy.
Results: Data from 446 pts were gathered (median age 49
years [yrs], range 28-79 yrs). Many pts were pre-menopausal (60%) and presented a Luminal-B immunophenotype
(74%) and a ductal histology (70%). Overall pCR rate was
12.1%, 95% Confidence Interval (CI) 8.9-14.9% (Luminal-A
5.3%, 95% CI 1.1-13.2% and Luminal-B 14.2%, 95% CI
13.5-23.8%). The optimal Ki67 cut-off obtained from the
ROC analysis to predict pCR was 48% (AUC 0.70; SE
0.05). At the multivariate analysis, clinical stage I-II (OR
3.01, 95% CI 1.43-6.33, p=0.004), Ki67 >48% (OR 3.59,
95% CI 1.82-7.07, p<0.0001) and the progesterone receptor (PgR) <1% (OR 2.97, 95% CI 1.30-6.77, p=0.01) independently predicted pCR. According to the resulting
nomogram, the probability of pCR ranged from 7.1% for pts
with clinical stage III, PgR >1% and Ki67 <48% to 63.8%
for pts with a clinical stage I-II, PgR <1% and Ki67 >48%.
At the ROC analysis a differential probability of pCR was
found among pts with a continuous score >1 and <1 with a
predictive accuracy of 77% (AUC 0.77; SE 0.04; p<0.0001).
Conclusions: The combination of commonly available
clinico-pathological pre-NACT factors allows to develop a
nomogram which appears to reliably predict pCR in LBC
pts. Given the retrospective nature of the study, an external
validation of the nomogram is currently ongoing.

E18
Updated subgroup tumor response
of abemaciclib plus aromatase
inhibitor (AI) for hormone
receptor positive (HR+), HER2
negative advanced breast cancer
(MONARCH 3)
O'Shaughnessy J.1, Johnston S.2, Martin M.3, Huober J.4, Toi M.5,
Andre V.A.M.6, Martin H.R.7, Hardebeck M.C.7, Di Leo A.8, Goetz
M.P.9, Biganzoli L.P.10
1

Texas Oncology-Baylor Charles A. Sammons Cancer Center, Dallas;
Breast Unit, The Royal Marsden NHS Foundation Trust, London;

2



Tumori Journal Abstract Book - October 2020

Table of Contents for the Digital Edition of Tumori Journal Abstract Book - October 2020

Contents
Tumori Journal Abstract Book - October 2020 - Cover1
Tumori Journal Abstract Book - October 2020 - Cover2
Tumori Journal Abstract Book - October 2020 - I
Tumori Journal Abstract Book - October 2020 - II
Tumori Journal Abstract Book - October 2020 - Contents
Tumori Journal Abstract Book - October 2020 - IV
Tumori Journal Abstract Book - October 2020 - V
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