Tumori Journal Abstract Book - October 2020 - 196

196	
demonstrating treatment efficacy - has been replaced by a
flat dose (240 mg every 2 weeks), based on population
pharmacokinetic analyses and clinical safety.
In order to optimize our pharmaceutical spending, we conducted an economic assessment to compare the costs of the
2 different schedules, and to estimate the potential economic
savings in clinical practice associated with the adoption of a
"re-shift" from N 240 mg flat dose to BW-based dose.
Methods: An analysis has been conducted on all N administrations of pts treated between January 2019 and April
2020 in Medical Oncology at Mauriziano Hospital, Turin.
For each administration, we calculated the economic gap
between the actually administered flat-dose and an hypothetical BW-based dose, keeping 240 mg as the maximum
dose for pts > 80 kg. For each administration, we also
evaluated the vial residue, assuming no residue for flat
dosage: a sensitivity analysis has been conducted taking
into account the economic value of drug residues.
Results: The analysis included 32 pts, affected by NSCLC
(N= 19), RCC (N=6) and HNSCC (N=7), for a total of 237
administrations. Median BW was 67 kg [range 46-115]. From
the analysis of all the administrations along the examined
period, we calculated that the transition from flat dose to 3mg/
kg schedule "with cap" would have allowed a cost reduction
equal to 13,16% of the total spending. Sensitivity analysis
showed that, even accounting for the drug waste in the calculation, cost savings could be 11,99% of the total spending.
Conclusions: To our knowledge, N 3 mg/kg is the first
schedule to be considered off label in oncology despite its
use in pivotal trials. Of course, drug price has experienced
reductions over the years. However, in a condition of comparable safety and efficacy profile between the 2 different
schedules, the "re-shift" from flat dose to BW-based dose
could allow a significant cost saving, making the novel therapeutic options more sustainable. In a perspective of prescriptive appropriateness and economic sustainability, the
possible waste of drug connected to the use of BW-based
schedule could be reduced by a "drug-day" strategy.

T39
ENDOCRINE TOXICITY OF IMMUNE
CHECKPOINT INHIBITORS (ANTI-PD-1/
PD-L1) IN ADVANCED CANCERS
Dottore A.1, Ruggeri R.M.2, Massafra M.3, Pettineo G.3, Garipoli C.3,
Giuffrida G.2, Maisano C.3, D'Aquino A.3, Santarpia M.3, Altavilla G.3
1

Medical Oncology Unit, Department of Human Pathology "G.Barresi",
University of Messina, Messina; 2Endocrine Unit, Department of Clinical and
Experimental Medicine, University of Messina, Messina; 3Medical Oncology
Unit, Department of Human Pathology "G.Barresi", University of Messina,
Messina

Background: Immune checkpoint inhibitors (ICIs) have
changed the therapeutic scenario in cancer treatment, but
their use is often associated with immune-related adverse

Tumori Journal 106(2S)
events (IRAEs) involving different organs, i.e. skin, liver,
lung, colon and endocrine glands.
We aimed to assess the frequency and management of
endocrine IRAEs in clinical practice, in cancer patients
(pts) treated with anti-PD1/PD-L1 monoclonal antibodies
(mAbs) in a single institution.
Material and Methods: We evaluated a series of pts with
advanced cancers, including NSCLC, melanoma, head and
neck cancer, renal cell and urothelial cancers, treated with
anti-PD1/PD-L1 mAbs in our centre from January 2018 to
April 2020.
No pts had received systemic steroid or immunosuppressive therapy prior to the first dose of treatment. We monitored thyroid function (TSH, free T3 and free T4) and
thyroid antibodies, blood glucose levels, serum creatinine,
liver function, sodium and potassium, cortisol and ACTH,
at baseline and during the course of treatment, every 2
cycles. Toxicity was evaluated according to the CTCAE
version 5.0. Response to immunotherapy was assessed
according to RECIST 1.1 criteria.
Results: We included 61 pts: male/female (84%/16%),
median age 65 years (range, 32-81 y), ECOG 0/1
(44%/56%), affected by NSCLC (n=45), melanoma (n=6),
head and neck cancer (n=4), renal cell carcinoma (n=5)
and urothelial cancer (n=1). They were treated with anti
PD-1 mAbs, Nivolumab (35 pts) or Pembrolizumab (22
pts), and the anti-PD-L1 mAb Atezolizumab (4 pts).
Immunotherapy was administered as first- (24%), second(56%) or third-line (20%) treatment.
Within 12-16 weeks from the first dose, we observed grade
1-2 hypothyroidism in 8 pts, of which 5 grade 2 pts
required thyroid hormone replacement; 4 pts presented
with acute thyrotoxicosis secondary to destructive thyroiditis (immunotherapy was discontinued in 1 for grade 3 toxicity). No one developed autoimmune hyperthyroidism
with increased TSH receptor antibodies (TRAb).
There were no cases of hypophysitis and adrenalitis, while
1 pts developed type 2 diabetes mellitus promptly treated
with oral hypoglycaemic agents. No correlation was
observed between the onset of thyroid side effects and
response to treatment.
Conclusions: Thyroid dysfunction is a common AE in pts
receiving anti-PD1/antiPD-L1 therapy. Its early recognition, appropriate treatment and monitoring allow continuing ICIs therapy with improved clinical outcomes.

T40
Sex imbalance in Phase I clinical
trials. Focus on gastrointestinal
cancer studies
Crivelli F.1, Montagnani F.2, Paris M.2, Perfetti E.2, Bertolin A.2,
Brioschi D.3, Tempia P.3, Leone F.3
1
ASL BI S.C. Oncologia - Fondazione Tempia, Biella; 2ASL BI S.C. Oncologia,
Biella; 3ASL BI S.S. Psicologia Clinica, Biella



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
Tumori Journal Abstract Book - October 2020 - 2
Tumori Journal Abstract Book - October 2020 - 3
Tumori Journal Abstract Book - October 2020 - 4
Tumori Journal Abstract Book - October 2020 - 5
Tumori Journal Abstract Book - October 2020 - 6
Tumori Journal Abstract Book - October 2020 - 7
Tumori Journal Abstract Book - October 2020 - 8
Tumori Journal Abstract Book - October 2020 - 9
Tumori Journal Abstract Book - October 2020 - 10
Tumori Journal Abstract Book - October 2020 - 11
Tumori Journal Abstract Book - October 2020 - 12
Tumori Journal Abstract Book - October 2020 - 13
Tumori Journal Abstract Book - October 2020 - 14
Tumori Journal Abstract Book - October 2020 - 15
Tumori Journal Abstract Book - October 2020 - 16
Tumori Journal Abstract Book - October 2020 - 17
Tumori Journal Abstract Book - October 2020 - 18
Tumori Journal Abstract Book - October 2020 - 19
Tumori Journal Abstract Book - October 2020 - 20
Tumori Journal Abstract Book - October 2020 - 21
Tumori Journal Abstract Book - October 2020 - 22
Tumori Journal Abstract Book - October 2020 - 23
Tumori Journal Abstract Book - October 2020 - 24
Tumori Journal Abstract Book - October 2020 - 25
Tumori Journal Abstract Book - October 2020 - 26
Tumori Journal Abstract Book - October 2020 - 27
Tumori Journal Abstract Book - October 2020 - 28
Tumori Journal Abstract Book - October 2020 - 29
Tumori Journal Abstract Book - October 2020 - 30
Tumori Journal Abstract Book - October 2020 - 31
Tumori Journal Abstract Book - October 2020 - 32
Tumori Journal Abstract Book - October 2020 - 33
Tumori Journal Abstract Book - October 2020 - 34
Tumori Journal Abstract Book - October 2020 - 35
Tumori Journal Abstract Book - October 2020 - 36
Tumori Journal Abstract Book - October 2020 - 37
Tumori Journal Abstract Book - October 2020 - 38
Tumori Journal Abstract Book - October 2020 - 39
Tumori Journal Abstract Book - October 2020 - 40
Tumori Journal Abstract Book - October 2020 - 41
Tumori Journal Abstract Book - October 2020 - 42
Tumori Journal Abstract Book - October 2020 - 43
Tumori Journal Abstract Book - October 2020 - 44
Tumori Journal Abstract Book - October 2020 - 45
Tumori Journal Abstract Book - October 2020 - 46
Tumori Journal Abstract Book - October 2020 - 47
Tumori Journal Abstract Book - October 2020 - 48
Tumori Journal Abstract Book - October 2020 - 49
Tumori Journal Abstract Book - October 2020 - 50
Tumori Journal Abstract Book - October 2020 - 51
Tumori Journal Abstract Book - October 2020 - 52
Tumori Journal Abstract Book - October 2020 - 53
Tumori Journal Abstract Book - October 2020 - 54
Tumori Journal Abstract Book - October 2020 - 55
Tumori Journal Abstract Book - October 2020 - 56
Tumori Journal Abstract Book - October 2020 - 57
Tumori Journal Abstract Book - October 2020 - 58
Tumori Journal Abstract Book - October 2020 - 59
Tumori Journal Abstract Book - October 2020 - 60
Tumori Journal Abstract Book - October 2020 - 61
Tumori Journal Abstract Book - October 2020 - 62
Tumori Journal Abstract Book - October 2020 - 63
Tumori Journal Abstract Book - October 2020 - 64
Tumori Journal Abstract Book - October 2020 - 65
Tumori Journal Abstract Book - October 2020 - 66
Tumori Journal Abstract Book - October 2020 - 67
Tumori Journal Abstract Book - October 2020 - 68
Tumori Journal Abstract Book - October 2020 - 69
Tumori Journal Abstract Book - October 2020 - 70
Tumori Journal Abstract Book - October 2020 - 71
Tumori Journal Abstract Book - October 2020 - 72
Tumori Journal Abstract Book - October 2020 - 73
Tumori Journal Abstract Book - October 2020 - 74
Tumori Journal Abstract Book - October 2020 - 75
Tumori Journal Abstract Book - October 2020 - 76
Tumori Journal Abstract Book - October 2020 - 77
Tumori Journal Abstract Book - October 2020 - 78
Tumori Journal Abstract Book - October 2020 - 79
Tumori Journal Abstract Book - October 2020 - 80
Tumori Journal Abstract Book - October 2020 - 81
Tumori Journal Abstract Book - October 2020 - 82
Tumori Journal Abstract Book - October 2020 - 83
Tumori Journal Abstract Book - October 2020 - 84
Tumori Journal Abstract Book - October 2020 - 85
Tumori Journal Abstract Book - October 2020 - 86
Tumori Journal Abstract Book - October 2020 - 87
Tumori Journal Abstract Book - October 2020 - 88
Tumori Journal Abstract Book - October 2020 - 89
Tumori Journal Abstract Book - October 2020 - 90
Tumori Journal Abstract Book - October 2020 - 91
Tumori Journal Abstract Book - October 2020 - 92
Tumori Journal Abstract Book - October 2020 - 93
Tumori Journal Abstract Book - October 2020 - 94
Tumori Journal Abstract Book - October 2020 - 95
Tumori Journal Abstract Book - October 2020 - 96
Tumori Journal Abstract Book - October 2020 - 97
Tumori Journal Abstract Book - October 2020 - 98
Tumori Journal Abstract Book - October 2020 - 99
Tumori Journal Abstract Book - October 2020 - 100
Tumori Journal Abstract Book - October 2020 - 101
Tumori Journal Abstract Book - October 2020 - 102
Tumori Journal Abstract Book - October 2020 - 103
Tumori Journal Abstract Book - October 2020 - 104
Tumori Journal Abstract Book - October 2020 - 105
Tumori Journal Abstract Book - October 2020 - 106
Tumori Journal Abstract Book - October 2020 - 107
Tumori Journal Abstract Book - October 2020 - 108
Tumori Journal Abstract Book - October 2020 - 109
Tumori Journal Abstract Book - October 2020 - 110
Tumori Journal Abstract Book - October 2020 - 111
Tumori Journal Abstract Book - October 2020 - 112
Tumori Journal Abstract Book - October 2020 - 113
Tumori Journal Abstract Book - October 2020 - 114
Tumori Journal Abstract Book - October 2020 - 115
Tumori Journal Abstract Book - October 2020 - 116
Tumori Journal Abstract Book - October 2020 - 117
Tumori Journal Abstract Book - October 2020 - 118
Tumori Journal Abstract Book - October 2020 - 119
Tumori Journal Abstract Book - October 2020 - 120
Tumori Journal Abstract Book - October 2020 - 121
Tumori Journal Abstract Book - October 2020 - 122
Tumori Journal Abstract Book - October 2020 - 123
Tumori Journal Abstract Book - October 2020 - 124
Tumori Journal Abstract Book - October 2020 - 125
Tumori Journal Abstract Book - October 2020 - 126
Tumori Journal Abstract Book - October 2020 - 127
Tumori Journal Abstract Book - October 2020 - 128
Tumori Journal Abstract Book - October 2020 - 129
Tumori Journal Abstract Book - October 2020 - 130
Tumori Journal Abstract Book - October 2020 - 131
Tumori Journal Abstract Book - October 2020 - 132
Tumori Journal Abstract Book - October 2020 - 133
Tumori Journal Abstract Book - October 2020 - 134
Tumori Journal Abstract Book - October 2020 - 135
Tumori Journal Abstract Book - October 2020 - 136
Tumori Journal Abstract Book - October 2020 - 137
Tumori Journal Abstract Book - October 2020 - 138
Tumori Journal Abstract Book - October 2020 - 139
Tumori Journal Abstract Book - October 2020 - 140
Tumori Journal Abstract Book - October 2020 - 141
Tumori Journal Abstract Book - October 2020 - 142
Tumori Journal Abstract Book - October 2020 - 143
Tumori Journal Abstract Book - October 2020 - 144
Tumori Journal Abstract Book - October 2020 - 145
Tumori Journal Abstract Book - October 2020 - 146
Tumori Journal Abstract Book - October 2020 - 147
Tumori Journal Abstract Book - October 2020 - 148
Tumori Journal Abstract Book - October 2020 - 149
Tumori Journal Abstract Book - October 2020 - 150
Tumori Journal Abstract Book - October 2020 - 151
Tumori Journal Abstract Book - October 2020 - 152
Tumori Journal Abstract Book - October 2020 - 153
Tumori Journal Abstract Book - October 2020 - 154
Tumori Journal Abstract Book - October 2020 - 155
Tumori Journal Abstract Book - October 2020 - 156
Tumori Journal Abstract Book - October 2020 - 157
Tumori Journal Abstract Book - October 2020 - 158
Tumori Journal Abstract Book - October 2020 - 159
Tumori Journal Abstract Book - October 2020 - 160
Tumori Journal Abstract Book - October 2020 - 161
Tumori Journal Abstract Book - October 2020 - 162
Tumori Journal Abstract Book - October 2020 - 163
Tumori Journal Abstract Book - October 2020 - 164
Tumori Journal Abstract Book - October 2020 - 165
Tumori Journal Abstract Book - October 2020 - 166
Tumori Journal Abstract Book - October 2020 - 167
Tumori Journal Abstract Book - October 2020 - 168
Tumori Journal Abstract Book - October 2020 - 169
Tumori Journal Abstract Book - October 2020 - 170
Tumori Journal Abstract Book - October 2020 - 171
Tumori Journal Abstract Book - October 2020 - 172
Tumori Journal Abstract Book - October 2020 - 173
Tumori Journal Abstract Book - October 2020 - 174
Tumori Journal Abstract Book - October 2020 - 175
Tumori Journal Abstract Book - October 2020 - 176
Tumori Journal Abstract Book - October 2020 - 177
Tumori Journal Abstract Book - October 2020 - 178
Tumori Journal Abstract Book - October 2020 - 179
Tumori Journal Abstract Book - October 2020 - 180
Tumori Journal Abstract Book - October 2020 - 181
Tumori Journal Abstract Book - October 2020 - 182
Tumori Journal Abstract Book - October 2020 - 183
Tumori Journal Abstract Book - October 2020 - 184
Tumori Journal Abstract Book - October 2020 - 185
Tumori Journal Abstract Book - October 2020 - 186
Tumori Journal Abstract Book - October 2020 - 187
Tumori Journal Abstract Book - October 2020 - 188
Tumori Journal Abstract Book - October 2020 - 189
Tumori Journal Abstract Book - October 2020 - 190
Tumori Journal Abstract Book - October 2020 - 191
Tumori Journal Abstract Book - October 2020 - 192
Tumori Journal Abstract Book - October 2020 - 193
Tumori Journal Abstract Book - October 2020 - 194
Tumori Journal Abstract Book - October 2020 - 195
Tumori Journal Abstract Book - October 2020 - 196
Tumori Journal Abstract Book - October 2020 - 197
Tumori Journal Abstract Book - October 2020 - 198
Tumori Journal Abstract Book - October 2020 - 199
Tumori Journal Abstract Book - October 2020 - 200
Tumori Journal Abstract Book - October 2020 - 201
Tumori Journal Abstract Book - October 2020 - 202
Tumori Journal Abstract Book - October 2020 - 203
Tumori Journal Abstract Book - October 2020 - 204
Tumori Journal Abstract Book - October 2020 - 205
Tumori Journal Abstract Book - October 2020 - 206
Tumori Journal Abstract Book - October 2020 - 207
Tumori Journal Abstract Book - October 2020 - 208
Tumori Journal Abstract Book - October 2020 - 209
Tumori Journal Abstract Book - October 2020 - 210
Tumori Journal Abstract Book - October 2020 - 211
Tumori Journal Abstract Book - October 2020 - 212
Tumori Journal Abstract Book - October 2020 - 213
Tumori Journal Abstract Book - October 2020 - 214
Tumori Journal Abstract Book - October 2020 - 215
Tumori Journal Abstract Book - October 2020 - 216
Tumori Journal Abstract Book - October 2020 - 217
Tumori Journal Abstract Book - October 2020 - 218
Tumori Journal Abstract Book - October 2020 - 219
Tumori Journal Abstract Book - October 2020 - 220
Tumori Journal Abstract Book - October 2020 - 221
Tumori Journal Abstract Book - October 2020 - 222
Tumori Journal Abstract Book - October 2020 - 223
Tumori Journal Abstract Book - October 2020 - 224
Tumori Journal Abstract Book - October 2020 - 225
Tumori Journal Abstract Book - October 2020 - 226
Tumori Journal Abstract Book - October 2020 - 227
Tumori Journal Abstract Book - October 2020 - 228
Tumori Journal Abstract Book - October 2020 - 229
Tumori Journal Abstract Book - October 2020 - 230
Tumori Journal Abstract Book - October 2020 - 231
Tumori Journal Abstract Book - October 2020 - 232
Tumori Journal Abstract Book - October 2020 - 233
Tumori Journal Abstract Book - October 2020 - 234
Tumori Journal Abstract Book - October 2020 - 235
Tumori Journal Abstract Book - October 2020 - Cover3
Tumori Journal Abstract Book - October 2020 - Cover4
https://www.nxtbookmedia.com