Tumori Journal Abstract Book - October 2020 - 37

B - Gastrointestinal (Colorectal) Cancers	
10,9 m 120 mg vs 9,1 m 80 mg, p=0,0325) and 4 (17,7 vs
12,1 m 120 mg vs 14,5 m 80 mg, p=0,0288), and in absence
of adverse events (AE) over the first 4 cycles (22,5 vs 10,2
m, p=0,0018), cycle 1 (14,7 vs 10,7 m, p=0,0410) and 2
(15,6 vs 10,9 m, p=0,0474). OS was longer in absence of
dose/schedule changes overall during the first 4 cycles
(17,7 vs 10 m, p=0,0012), cycle 3 (14,7 vs 9,7 m,
p=0,0031), and 4 (15,4 vs 10,9 m, p=0,0351), for single
site PD (12,9 vs 10,7 m, p=0,0349), non-liver single site
PD (15,6 vs 8,1 m, p=0,0066), no liver PD (13,6 vs 10 m,
p=0,0043). Median PFS was 4.2 m (95%CI 3,43-43,03).
PFS was longer in G2 mCRC (4,5 m vs 2,2 G1 vs 3,3 G3,
p<0,0001), in absence of AE over the first 4 cycles (6,53
vs 3,9 m, p=0,0047), cycle 1 (6,1 vs 3,8 m, p=0,0056) and
2 (6,1 vs 3,9 m, p=0,0244) and of dose/schedule changes
globally during the first 4 cycles (11,3 vs 3,4 m, p=0,0020),
cycle 2 (4,5 vs 3,7 m, p=0,0298), 3 (6,5 vs 3,3 m, p=0,0008)
and 4 (6,5 vs 4,2 m, p=0,0080). PFS was improved for
single site PD (4,5 vs 3,7 m, p=0,0138), non-liver single
site PD (6,5 vs 3 m, p=0,0090), no lung (4,8 vs 3,9 m,
p=0,0338) and no liver PD (6,3 vs 3,3 m, p<0,0001).
Conclusions: In our study G2 mCRC, low LDH, single
site PD, absence of AE, treatment changes and of liver/
lung PD were associated with better outcome in pre-treated
long term mCRC survivors receiving regorafenib.

B15
CLINICAL UTILITY OF PLASMA REAL
TIME PCR FOR RAS/BRAF MUTATIONS
IN METASTATIC COLORECTAL CANCER
(mCRC) PATIENTS. THE IMPORTANCE OF
DISCORDANT CASES
Lucchetti J.1, Doldo E.1, Riondino S.1, Formica V.1, Morelli C.1, Renzi
N.1, Nitti D.1, Palmieri G.1, Orlandi A.1, Roselli M.1
1

Policlinico Tor Vergata, Roma

Background: Tissue (T) mutational analysis is the standard for mCRC however liquid biopsy can better represent
tumor heterogeneity. Highly sensitive methods (as ddPCR)
with a limit of detection (LoD) of <0.01% detects rare
RAS/BRAF mutations with uncertain clinical meaning.
Conversely, real-timePCR (RTPCR) techniques have a
lower LoD (0.5-0.1%) with possible higher clinical utility
Patients and methods: Consecutive mCRC pts candidate
for a firstline chemotherapy with known T-KRAS/NRAS/
BRAF status, were enrolled. Progression free survival
(PFS) was defined according to RECIST 1.1 and considered as primary prognostic endpoint. The total number of
tumor lesions (TNL) and the sum of maximum diameters
of all lesions (SMD) were calculated as measures of tumor
burden. Data on routine biochemical variables and CEA
and CA19.9 were also collected. DNA-binding magnetic
beads (MagCore® Plasma DNA Extraction Kit) and

37
selective detections of exons 2, 3 and 4 of KRAS and
NRAS and exon 15 of BRAF mutations by qualitative
Real-Time PCR (EasyPGX®) were used to assess PL
mutational status. Cox-regression hazard model and
Kaplan Meier method were used for survival analysis.
Logistic regression analysis (LRA) was used to identify
predictors of T vs PL discordant cases.
Results: 45 mCRC pts were enrolled. All BRAF MUT
cases were concordant between PL and T; 10 pts were concordant for RAS mutation in PL and T (RAS MUT concordant); 20 pts were RAS WT in both PL and T (RAS WT
concordant); 9 RAS discordant cases were recorded: 4 WT
in T and MUT in PL (RAS WT-T/MUT-PL) and 5 pts
MUT in T and WT in PL (RAS MUT-T/WT-PL). RAS
plasma mutational assessment was significantly associated
with PFS: RAS WT-T/MUT-PL had similar PFS to RAS
MUT concordant pts and RAS MUT-T/WT-P had similar
PFS to RAS WT concordant pts (table). SMD was found to
be a significant predictor of discordant cases among RAS
MUT-T pts (p=0.02). RAS MUT-T pts with a SMD<140
mm had a 80% chance to be RAS WT in PL vs 10% of pts
with SMD>140 mm (OR 36; 95% CI 1.78- 731.6). TNL
was of borderline significance as predictor of discordant
cases among RAS WT-T pts (p=0.07). RAS WT-T pts with
>10 TNL had a 50% chance of being MUT in PL vs 10%
of pts with TNL<10(OR 9).
Conclusions: PL mutational status assessed by RTPCR
allows a better prognostication than T analysis alone.
Large sample size and further investigations are required
to corroborate these findings.
Mutations

PFS (months)

HR

p value

BRAF MUT
RAS MUT concordant
RAS WT-T/MUT-PL
RAS MUT-T/WT-PL
RAS WT concordant

4.5
7.9
9.6
24.4
23.3

1
0.33
0.22
0.02
0.04

 
0.06
0.04
0.0001
0.0002

B16
Central Nervous System as
Possible Sanctuary of Relapse
in HER2-positive Metastatic
Colorectal Cancer
Tosi F.1, Sartore Bianchi A.2, Rizzato M.D.3, Amatu A.1, Ghezzi S.1,
Martino C.4, Bonazzina E.1, Bencardino K.1, Fenocchio E.4, Patanè
D.1, Ardizzoni A.5, Torri V.6, Valtorta E.1, Bonoldi E.1, Vanzulli A.2,
Regge D.4, Ciardiello F.7, Lonardi S.3, Marsoni S.8, Siena S.2
1
Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda,
Milano; 2Dipartimento di Oncologia ed Emato-Oncologia, Università
degli Studi di Milano, Milano; 3Oncologia Medica 1, Istituto Oncologico
Veneto - IRCCS, Padova; 4Istituto di Candiolo, Fondazione del Piemonte per
l'Oncologia-IRCCS, Candiolo; 5UOC Oncologia Medica, Policlinico S. Orsola,



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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Tumori Journal Abstract Book - October 2020 - Cover3
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