Tumori Journal Abstract Book - October 2020 - 162

162	
limited disease or with local invasion, tissue destruction,
and lymph node metastases. Distant metastases are rarely
found at presentation. In the western world tobacco smoking and alcohol use are the main risk factors for OCSCC.
Poor oral hygiene, periodontal disease, radiation, sun exposure, betel nut quid chewing and immune deficiency have
also a significant role. While infection with oncogenic
human papillomavirus (HPV), is associated with the rising
incidence of tonsil and base of tongue cancer, the association between OCSCC and HPV infection is less evident.
Males are affected about twice as much as females.
Material (patients) and methods: we retrospectively
reviewed the record of the patients undergoing surgery for
early or locally advanced OCSCC from January 2012 to
December 2019. Excluding those patients coming from
distant regions, we identified 186 patients operated, treated
with adjuvant radiotherapy or chemoradiotherapy (CRT)
as needed, and followed at our center.
Results: Of 186 patients, 96 (52%) were males. We found
67 smokers and 119 never-smokers (64%). Median age
was 68 years (28-88) with only 8 patients (3.8%) < 40
years old. The main sites involved were the tongue (37%),
the floor of the mouth (36%) and buccal mucosa (24%).
Ninety-three patients (50%) had pathological stage I-II, 25
(13%) stage III and 68 (37%) stage IVa-b disease. Sixtynine patients were pT3-4 (38%; pT3 8% and pT4 30%),
nodal involvement was present in 60 cases (32%). HPV+
8%. Positive or "close" margins were present in 23 cases
(12%) and extranodal extension (ENE) in 31 (17%).
Radiotherapy or CRT were offered to 25 and 23 patients,
respectively. With a median follow-up of 42 months, at the
end of December 2019 the 5-y disease-free survival and
overall survival rate was 88% and 96%, respectively. Two
treatment-related deaths were observed in the group (17
patients) undergoing adjuvant CRT.
Conclusions: With the limits of a retrospective and monocentric study, we believe a multimodality approach supporting the patients in all their needs can lead to optimal
results. Our series is characterized by an unusual high
prevalence of females and non-smokers. Together with
high-quality surgery and accurate management of adjuvant
therapies, this can represent an explanation for the long
survivals we observed.

P - Brain Tumours
P01
Pembrolizumab activity in
recurrent high-grade gliomas
with immunohistochemical loss
of mismatch repair proteins: A
monocentric, observational and
prospective pilot study

Tumori Journal 106(2S)
Lombardi G.1, Barresi V.2, Indraccolo S.3, Simbolo M.2, Fassan M.4,
Mandruzzato S.5, Simonelli M.6, Caccese M.1, Pizzi M.4, Fassina A.3,
Padovan M.1, Masetto E.3, Gardiman M.P.4, Bonavina M.G.7, Caffo
M.8, Chioffi F.9, D'Avella D.10, Dei Tos A.P.4, Scarpa A.2, Zagonel V.1
1

Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV
- IRCCS, Padova; 2Department of Diagnostics and Public Health, Section
of Pathology, University of Verona, Verona; 3Immunology and Molecular
Oncology Unit, Veneto Institute of Oncology - IRCCS, Padova; 4Department
of Medicine (DIMED), Surgical Pathology and Cytopathology Unit, Padova;
5
Department of Surgery, Oncology and Gastroenterology, University of
Padova and IOV - IRCCS, Padova; 6Humanitas University, Department of
Biomedical Sciences, Milano; 7Medical Direction Unit, Veneto Institute of
Oncology, IOV - IRCCS, Padova; 8Department of Biomedical and Dental
Sciences and Morphofunctional Imaging, Unit of Neurosurgery, University
of Messina, Messina; 9Neurosurgery Unit, Azienda Ospedaliera di Padova,
Padova; 10Academic Neurosurgery, Department of Neurosciences, University
of Padua, Padova

Backgroung: Pembrolizumab demonstrated promising
results in DNA mismatch repair (MMR) deficient tumors
of diverse origin, but its activity in HGG patients with
MMR deficiency is unknown.
Material and methods: This was a monocentric, observational and prospective study. The objective is to evaluate
the efficacy and safety of pembrolizumab in previously
treated HGGs with immunohistochemical loss of at least 1
MMR protein. Post hoc exploratory analyses were undertaken to describe the genetic and molecular tumor features.
Data were collected from May 2017 to May 2019. The
median follow up was 20.6 months. Consecutive eligible
patients with recurrent HGG and loss of MMR proteins at
immunohistochemistry received pembrolizumab 200 mg
once every 3 weeks until disease progression or unacceptable toxic effects. The primary end point was disease control
rate (DCR). Secondary end points included progressionfree survival (PFS), overall survival (OS), and safety. In 12
of the 13 cases, post hoc exploratory analyses were performed. These included next-generation sequencing to
assess tumor mutational burden (TMB) and the mutational
and copy number status of 409 cancer genes, and immunostaining for CD8+ cytotoxic T-cells and CD68+ immunosuppressive macrophages.
Results: Among 310 HGG patients screened, 13 cases
with MMR loss were enrolled: 8 with glioblastoma, 4 anaplastic astrocytoma, and 1 anaplastic oligodendroglioma.
Median age was 43 years and median prior chemotherapy
lines was 2. Six HGGs had concurrent loss of MSH2 and
MSH6, 2 had concurrent loss of MLH1 and PMS2, 3 of
MSH2 alone, and 2 of MSH6 alone. The DCR was 31%: 4
patients had stable disease and no patient had complete or
partial response. Median PFS and OS were 2.2 (95%CI
1.6-2.8) and 5.6 (95%CI 0.1-11.9) months, respectively.
TMB was obtained in 12 cases and ranged between 6.8 and
23.4 mutations/megabase, and 8 cases were hypermutated
(>9 muts/Mb.). Neither TMB nor gene mutations, nor
CD8+ T-cell and CD68+ macrophage content were associated with pembrolizumab activity.



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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