Tumori Journal Abstract Book - October 2020 - 171

S - Management of Cancer Pain	
Survival (OS) was estimated using Kaplan-Meier method.
A Cox regression model was carried out for statistical
analyses.
Results: One hundred eighty-four patients were enrolled,
96 males and 88 females. Median age was 67 years (1990). The median duration of hospitalization was 12 days
(1-64). The most frequent cancer diagnosis was non-small
cell lung cancer (28%) and the majority of patients had a
metastatic disease (86%). 44% of patients were admitted
from the emergency department requesting treatments for
cancer symptoms, such as pain (71%), dyspnoea (39%)
and neurological impairment (38%). A quarter of patients
received active cancer treatment before dying, of which
chemotherapy (54%), radiotherapy (17%) or a combination of both (24%). Clinical parameters that predicted
lower survival were: emergency admission (8 vs 15 days,
p=0.0064, HR 0.64, CI95% 0.47-0.88), reported pain at
admission (9 vs 13 days, p=0.0056, HR 0.59, CI95% 0.410.86), creatinine =1.2 mg/dl (7 vs 14 days, p=0.0002, HR
0.45, CI95% 0.29-0.69), pleural effusion (9 vs 13 days,
p=0.0206, HR 0.65, CI95% 0.46-0.94). Procedures that
correlated with improved survival were radiotherapy (25
vs 11 days, p=0.0011, HR 0.53, CI95% 0.36-0.77), blood
transfusions (18 vs 10 days, p<0.0001, HR 0.50, CI95%
0.37-0.68) and antibiotics (7 vs 15 days, p<0.0001, HR
0.34, CI95% 0.23-0.51). Age, gender, disease stage, chemotherapy, use of terminal sedation, haemoglobin, neutrophil-to-lymphocyte ratio, hyperbilirubinemia, dyspnoea,
neurological impairment, fever, haemorrhage did not significantly affect survival.
Conclusions: Our study identified factors which may be
useful to predict high risk for death during hospitalization
in medical oncology department. It is remarkable that palliative treatments that correlated with better prognosis may
be offered in day hospital/home care setting. Further studies are needed to evaluate if territorial end-of life care
could prevent inappropriate hospital access.

S08
A prospective, observational
study assessing SIADH (syndrome
of inappropriate antidiuretic
hormone secretion) management
and outcome among lung cancer
patients in Italy (ASSERT trial)
Berardi R.1, Garassino M.C.2, Tiseo M.3, Palazzo S.4, Montesarchio
V.5, Tonini G.6, Cavanna L.7, Ferrari D.8, Morabito A.9, Pinotti G.10,
Buosi R.11, Scartozzi M.12, Torniai M.13, De Marino V.5
1
Oncology Clinic, Università Politecnica delle Marche, AOU Ospedali Riuniti
di Ancona, Via Conca 71, 60126 Ancona, Italy, Ancona; 2Fondazione IRCCS
Istituto Nazionale Tumori Via Giacomo Venezian, Milan, Italy, Milan;
3
Azienda Ospedaliero-Universitaria di Parma, Parma, Italy, Parma; 4Ospedale
Annunziata, Cosenza, Italy, Cosenza; 5Azienda Ospedaliera Specialistica
dei Colli "Monaldi - Cotugno - CTO", Naples, Italy, Naples; 6Policlinico

171
Universitario Campus Bio-Medico di Roma, Rome, Italy, Rome; 7AUSL di
Piacenza, Piacenza, Italy, Piacenza; 8Azienda Ospedaliera San Paolo, Milan,
Italy, Milan; 9Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale",
Naples, Italy, Naples; 10Ospedale di Circolo e Fondazione Macchi, Varese,
Italy, Varese; 11ASL Alessandria Santo Spirito Hospital, Casale Monferrato
AL, Italy, Alessandria; 12Policlinico Universitario Duilio Casula, Monserrato,
Italy, Monserrato; 13Oncology Clinic, Università Politecnica delle Marche, AOU
Ospedali Riuniti di Ancona, Ancona

Background: SIADH represents the most common cause
of hyponatremia (serum sodium concentration < 135
mEq/l) in cancer patients, particularly in lung cancer.
Methods: ASSERT trial was a prospective, observational,
non-interventional study conducted 18 Italian oncology
Centers. Cancer patients requiring treatment for hyponatremia secondary to SIADH were enrolled from October
2015 to June 2017. The key objective of the study was to
evaluate pharmacological versus non-pharmacological
treatments for the management of hyponatraemia in
accordance with the local standard of care and guideline
recommendations. The primary endpoint was change in
sodium level from baseline visit to the end of first month
or sixth month of the observational period, or until earlier
discontinuation.
Results: The full analysis set (FAS) included 68 adult
cancer patients and lung cancer was the most common
neoplasm (N = 48, 71%). Regarding lung cancer cohort,
the linear regression analysis showed that tolvaptan dose
intensity significantly correlated with clinical response
(intended as increase of sodium level) after 1 month (p =
0.012) and after 6 months (p = 0.005). Furthermore, the
percentage of patients with serum sodium ⩾ 130 mEq/l
(target event) resulted significantly higher in the group of
patients treated with tolvaptan (Group 1, N = 32) than in
other patients not received this drug (Group 2, N = 16)
during 6 months of follow-up (87.5% vs 62.5% respectively, p = 0.033). Furthermore, in the whole population,
overall survival was significantly higher in patients in
Group 1 vs. Group 2, with a median overall survival (OS)
of 123 vs 56 days and a mean OS of 299 vs 75 days; both
p=0.001. Regarding patient-reported outcomes, no significant between-group differences in in EORTC QLQC30 mean scores were observed at follow-up (Visit 2:
Month 1), except for the nausea and vomiting item [mean
score: 1.17 (Group 1) versus 1.80 (Group 2); p=0.013].
For the EQ-5D, no significant differences in any of the
five items were observed for patients in Group 1 versus
Group 2 at baseline visit and Visit 2 (Month 1). Similarly,
no significant between-group differences in MMSE
scores were noted at baseline and at any time point during follow-up.
Conclusions: Hyponatremia secondary to SIADH represents a potentially modifiable risk factor influencing the
outcome of cancer patients. Acting effective and timely on
the normalization of sodium levels might have a positive
effect on outcome in this setting of patients.



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
Tumori Journal Abstract Book - October 2020 - 1
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Tumori Journal Abstract Book - October 2020 - Cover3
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