Tumori Journal Abstract Book - October 2020 - 39

B - Gastrointestinal (Colorectal) Cancers	
Response to preoperative chemoradiotherapy was assessed
according to tumor regression grade (TRG sec. Ryan
-AJCC Eight ed.)
Results: The expression level of CD3+, CD20+, FoxP3+
and PD-1+ cells were not significantly different after therapy. The TILs and RILs immunosuppressive cells were
higher in better responder (TRG0), although we did not find
any statistical significance given the small sample size.
Decreasing CD4/CD8 ratio on postoperative samples was
significantly associate with TRG 0 (p <0.01). The increase
of lymphocyte CD8+ was related to a good pathological
response after chemoradiotherapy.
Conclusions: Our data suggest that chemoradiotherapy
may induce an enrichment of lymphocytes T CD8+ in
good responders. The new frontier of best treatment could
be the use of specific immune cells (T lymphocytes) to
activate the system's response immune against disease.

B18
Circulating tumour DNA analysis
for monitoring RAS/BRAF status
under EGFR blockade as a guide
for rechallenge strategy in
metastatic colorectal cancer
patients in clinical practice
Mariani S.1, Liscia N.2, Puzzoni M.1, Lai E.1, Ziranu P.1, Pretta A.2,
Impera V.2, Musio F.1, Persano M.1, Migliari M.1, Dubois M.1, Tolu
S.2, Donisi C.1, Pireddu A.2, Camera S.2, Demurtas L.1, Pusceddu V.1,
Palomba G.3, Pisano M.3, Palmieri G.3, Scartozzi M.1
1

Medical Oncology Unit, University Hospital and University of Cagliari,
Cagliari, Italy, Cagliari; 2Medical Oncology Unit, Sapienza University of RomeUniversity Hospital and University of Cagliari, Cagliari, Italy, Cagliari; 3Istituto
di Ricerca Genetica e Biomedica (IRGB), Consiglio Nazionale delle Ricerche
(CNR), Sassari, Italy, Sassari

Background: The dynamic nature of tumour biology and
the genetic heterogeneity of colorectal cancer (CRC) has
long been known. Liquid biopsy and circulating tumour
DNA (ct-DNA) extraction allow us to follow the trend of
RAS mutational status, which is crucial in EGFR-blockade
acquired resistance. In parallel, data from several studies
suggest the option of rechallenge with EGFR-inhibitors in
pre-treated RAS wild type (WT) metastatic CRC (mCRC)
patients (pts).
Material (patients) and methods: Our study aim was to
retrospectively evaluate the pulsatile behaviour of RAS
clones under EGFR-blockade along with the anti-EGFR
rechallenge effectiveness in clinical practice. ct-DNA from
RAS/BRAF WT mCRC pts was analysed for RAS/BRAF
mutations. The analysis was performed with Pyrosequencing assay (PyroMark Q24 MDx Workstation) and
Sanger-based automated sequencing approach (ABI3130
Genetic Analyzer). Real-time PCR was performed to confirm RAS/BRAF mutations. CEA and CA 19.9 behaviour

39
under rechallenge with anti-EGFR was analysed as surrogate endpoint biomarker.
Results: Globally, seventeen pts treated with anti-EGFR
containing therapy were included in the study, 13 males
and 4 females. Thirteen (76%) pts received anti-EGFR
containing therapy as first-line treatment, whereas 4 (23%)
as third-line treatment. All pts were tested for RAS/BRAF
mutations in ct-DNA; fourteen pts (82%) had a RAS/
BRAF WT molecular profile whereas three pts (18%) had
a KRAS-G12V mutation. Among RAS/BRAF WT ctDNA pts, 8 (57%) underwent rechallenge with anti-EGFR:
7 pts received irinotecan+ cetuximab, and 1 underwent
single agent panitumumab; six (75%) were eligible for
response evaluation at the date of the present analysis. Two
(33%) pts had a partial response whereas 4 (66%) pts had
disease progression according to RECIST criteria. The
Ca19.9 and the CEA level under rechallenge treatment
decreased after 1 month in 5 (62%) patients and 7 (87%)
patients, with a median percentage of reduction of 76,8%
(95% IC:69.6-79.6) and 53.15% (95% IC :43.0-68.1%),
respectively. No grade 3 toxicities occurred.
Conclusions: Despite the small sample size and the retrospective nature, our study suggests that liquid biopsy
might be a useful tool to follow the trend of RAS mutational status and consequently for the decision making in
this setting. Rechallenge with anti-EGFR was feasible and
well tolerated in the study population. Results from prospective trials are awaited to better understand this exciting perspective.

B19
Novel epigenetic 12-gene signature
predictive of poor prognosis
and MSI-like phenotype in
human metastatic colorectal
carcinomas
Condelli V.1, Calice G.2, Cassano A.3, Basso M.3, Rodriquenz M.G.2,
Zupa A.2, Maddalena F.2, Crispo F.2, Pietrafesa M.2, Aieta M.2,
Sgambato A.2, Tortota G.3, Zoppoli P.2, Landriscina M.4
1
Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture,
Potenza; 2Centro di Riferimento Oncologico della Basilicata, Rionero in
Vulture; 3Policlinico Universitario Agostino Gemelli, Roma; 4Università di
Foggia, Foggia

Background: Epigenetic remodeling is responsible for
tumor progression and drug resistance in human colorectal
carcinoma (CRC). This study addressed the hypothesis
that DNA methylation profiling may identify metastatic
CRC (mCRC) subtypes with different clinical behavior.
Material and methods: Global methylation profile was
comparatively analyzed between 24 first-line primaryresistant and 12 drug-sensitive mCRCs, two subgroups with
significantly different outcome. Gene expression and methylation data from the COAD TCGA mCRCs cohort were



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
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