e16104 Background: Portugal has the highest gastric cancer incidence in western Europe. In our institution, FOLFIRI/XELIRI is the standard second line (2L) chemotherapy (CT) in advanced gastroesophageal adenocarcinoma (aGEA). Other treatment option is paclitaxel/ramucirumab combination. There is no prospective trial comparing these regimens. Our global aim was to investigate efficacy and safety of FOLFIRI/XELIRI after failure of a fluoropyrimidine/platinum (FP) regimen in patients with aGEA. Methods: Single center, retrospective cohort study of all patients with aGEA who failed FP regimen and received > 1 cycle of FOLFIRI/XELIRI between 2015-2020. Failure of a FP regimen defined as: 1) progression after first line (1L) palliative CT; 2) progression < 6 months after a curative intent strategy. Kaplan-Meier method was used to estimate median overall (mOS) / progression free survival (mPFS) and multivariate Cox regression analysis to assess PFS predictors. Results: Thirty-three patients analyzed. FOLFIRI/XELIRI regimen was used as 1L palliative CT (after failure of curative intent CT) in 48.5% of patients and as 2L palliative CT in 51.5%. Median age was 63 years (IQR 54–68.5), 72.7% were men. ECOG performance status (ECOG-PS) was 0-1 in 84.8%. Primary tumor site was stomach (87.9%), gastroesophageal junction (9.1%), esophagus (3.0%). All but one patient had metastatic disease (57.6% ≥2 metastatic sites; 42.4% peritoneal disease). Histology subtypes identified were diffuse and intestinal (14 patients each). Signet ring cell features were present in 12,1% of cases. 6 had HER2 positive tumors and in 1 there was microsatellite instability. 30,3% of patients had surgery of the primary tumor. Median number of cycles was 12 (IQR 5–17.5). Tumor response was accessed in 27 patients. Disease control rate was 74,1% (1 complete response, 8 partial responses, 11 stable disease). With a median follow-up of 9.4 months, mPFS was 5.1 months (95%CI 4.3-5.9) and the mOS 9.8 months (95%CI 6.6-13.0). 6-month overall survival was 69.7%. In multivariate analysis ECOG-PS (HR 6.20, p = 0.002), age (HR 0.94, p = 0.011), pre-treatment level CEA (HR 1.01, p = 0.011) and FOLFIRI/XELIRI as 1L palliative CT (HR 0.25 p = 0.004) were predictors of PFS. Treatment was discontinued in 31 patients (20 disease progression, 10 worsening of ECOG-PS). The main treatment-related grade 3 or 4 adverse events were neutropenia (12.1%), mucositis (9.1%) and anemia (6.6%). No treatment-related deaths occurred. Fifteen patients initiated a subsequent treatment line (7 taxane, 2 ramucirumab, 5 taxane/ramucirumab, 1 Tas102). Conclusions: FOLFIRI is an active and well tolerated regimen after failure of a FP regimen in patients with aGEA. Population with poor prognostic features was well represented. Efficacy outcomes were similar to the ones reported for the paclitaxel/ramucirumab combination RAINBOW trial.

RESUMOAs sobreviventes de cancro da mama têm originado um conjunto de questões da maior relevância sob o ponto de vista clínico e cientí-fico. De facto, o cancro da mama é a neoplasia mais prevalente em mulheres em idade reprodutiva. O efeito da gravidez na sobrevida global e na recorrência após tratamento de cancro da mama, bem como as questões relacionadas com a hereditariedade continuam a ser matéria da maior atualidade e do mais elevado interesse científico. Os estudos mais recentes são consensuais em admitir que a gravidez após o cancro da mama é potencialmente segura para a doente e sua descendência, embora a questão permaneça complexa. A hereditariedade e a genética parecem desempenhar um papel importante nesta temática mas, também aqui, as conclusões carecem de absoluta e inequívoca consistência. Verifica-se a necessidade de meta-análises, estudos coorte e caso-controlo, translacionais e prospetivos, alargados e prolongados no tempo, no sentido de obter uma maior segurança no estabelecimento de estratégias e linhas de orientação para os clínicos e informação adequada e objetiva para as jovens doentes com cancro da mama. Palavras-chave: Complicações Neoplásicas na Gravidez; Gravidez; Neoplasias da Mama ABSTRACTBreast cancer survivors have given rise to several issues of major relevance from a clinical and scientific point of view. In fact, breast cancer is the most prevalent malignancy in women of reproductive age. The effect of pregnancy on overall survival and in the recurrence after treatment of breast cancer, as well as the questions related to heredity continue to be matter of the highest timeliness and scientific interest. Most recent studies seem to agree in admitting that pregnancy after breast cancer appears to be potentially safe to both the women and her offspring, although this issue remains complex. Heredity and genetics seem to play an important role in this subject, but the conclusions lack absolute and unequivocal consistency. There is a need for meta-analysis, cohort and case-control studies, translational and prospective studies extended in time, in order to obtain greater safety in the establishment of strategies and guidelines for clinicians and adequate objective information for young breast cancer patients. Keywords: Breast Neoplasms; Pregnancy; Pregnancy Complications, Neoplastic INTRODUÇÃOO cancro da mama em mulheres jovens representa um cenário particularmente complexo; na verdade, apesar de mais prevalente na mulher pós-menopausa, o cancro da mama constitui a neoplasia mais comum na mulher em idade reprodutiva, correspondendo a cerca de 40% de todos os cancros em mulheres com idades inferiores a 40 anos. 1-3Dada a presente tendência em adiar a maternidade, muitas mulheres são diagnosticadas com cancro da mama antes de engravidar, sendo mais comum a intenção de engravidar após a doença. 4O diagnóstico desta neoplasia em idade reprodutiva poderá ter grande impacto no projeto familiar destas mulheres, dada a necessidade consequente de adiar a maternidade. 1,5,6 As sobreviventes de c...

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This is a retrospective study of patients diagnosed with gastric cancer aged 45 years and under, treated in the Department of Medical Oncology in Blida between January 2014 and December 2017. We were interested in the clinico-epidemiological characteristics of this population.Results: During this period, 56 patients with gastric cancer aged 45 years and under were seen, which is about 25.3% of all patients with gastric cancer (total, 221 patients); 38 were male (67.8 %) and 18 were female (32.1%), the median age at diagnosis was 36 years (range, 21 to 45 years). Body mass index (BMI) was higher than 25 in 15 patients (26.7%); smoking was found in 18 patients (32.1%); consumption of salted and preserved products was observed in 23 patients (41%); a diet high in meat and fat was observed in 25 patients (44.6%); oil of cade intake was noted in some patients; family history of gastric cancer was seen in 3 patient; and a family history of other cancer was seen in 10 patients. The most common symptom was epigastralgia; diagnosis delay was >3 months in 64% of cases; the gastric antrum was the most frequent seat; the histological type was adenocarcinoma in 91%; helicobacter pylori infection was determined in 29 biopsies; locally advanced (III) and metastatic stages (IV) were identified in 35.7% and 48% of cases, respectively. Conclusion:There was a high incidence of gastric cancer in young people in our series. The main risk factors in young people are smoking, HP+, low socioeconomic status, intake of salty and smoked food, oil of cade, a diet rich in meat and fat and low in vegetables and fruits, physical inactivity, excess weight, and unknown behavioral factors. Eating habits and lifestyle factors of our young population must be analyzed carefully. Gastric cancer remains a serious health problem in Algeria; therefore, other prospective studies designed to identify other risk factors are highly recommended.

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