Type 1 diabetes mellitus (T1DM) patients occasionally develop disordered eating behaviors, leading to insulin manipulation without medical consultation, targeting to achieve weight control. In clinical practice, the Diabetes Eating Problem Survey-Revised Version (DEPS-R) questionnaire has been used to evaluate eating disorders in T1DM patients. This study was conducted to validate the factor structure of the Greek version of DEPS-R using Confirmatory Factor Analysis (CFA), to investigate its reliability and convergent validity in Greek T1DM adults and to compare a single factor DEPS-R model with multiple factor models. Participants were 103 T1DM adults receiving insulin, who responded to DEPS-R. Their anthropometric, biochemical and clinical history data were evaluated. The sample presented good glycemic control and 30.1% scored above the established DEPS-R cut-off score for disturbed eating behavior. CFA results revealed that the data fit well to the factor models. The DEPS-R scale had good reliability and was positively linked to BMI, HbA1c, total daily dose and time in range. Model comparison supported the superiority of the 1-factor model, implying that Greek clinicians and practitioners might not have to consider individualized treatment based on various scores across different subscales but they can adopt a single DEPS-R score for an easy and efficient screening for disordered eating.

Uterine cervix carcinoids are distinct neuroendocrine cervical tumors, representing a comparatively small percentage of them. These well-differentiated neoplasms are far less prevalent than small- and large-cell carcinomas, characterized by a more favorable biological course. We report a case of a 43-year-old woman with a nonmetastatic cervical carcinoid, managed with radical hysterectomy. She still remains free of disease. Scant reports in the literature prohibit any reliable prediction of cervical carcinoid prognosis. Thus, prompt identification of the disease and subsequent therapeutic intervention could alter the final outcome.

The potential use of plasma-derived small extracellular vesicles (sEV) as predictors of response to therapy and clinical outcome in chemotherapy-naïve patients with non-small-cell lung cancer (NSCLC) was explored. sEV were isolated by size-exclusion chromatography from the plasma of 79 chemotherapy-naïve NSCLC patients and 12 healthy donors (HD). sEV were characterized with regard to protein content, particle size, counts by qNano, morphology by transmission electron microscopy, and molecular profiles by Western blots. PD-1 and PD-L1 expression on circulating immune cells was analysed by flow cytometry. Pre-treatment levels of total sEV protein (TEP) were correlated with overall (OS) and progression-free survival (PFS). The sEV numbers and protein levels were significantly elevated in the plasma of NSCLC patients compared to HD (p = 0.009 and 0.0001, respectively). Baseline TEP levels were higher in patients who developed progressive disease compared to patients with stable disease (p = 0.007 and 0.001, stage III and IV, respectively). Patient-derived sEV were enriched in immunosuppressive proteins as compared to proteins carried by sEV from HD. TEP levels were positively correlated with CD8+PD-1+ and CD8+PD-L1+ circulating T cell percentages and were independently associated with poorer PFS (p < 0.00001) and OS (p < 0.00001). Pre-therapy sEV could be useful as non-invasive biomarkers of response to therapy and clinical outcome in NSCLC.

Background: Bones, lungs and liver are the most common sites of primary breast tumors. Metastases to the pituitary gland are rare and usually indicate widespread malignant disease. The more frequent manifestations of pituitary gland involvement are diabetes insipidus and visual disturbances.Case Report: This is a 45-year-old woman who was presented with headache, visual disorders, polyuria, polydipsia, significant hypernatremia and dyspnea. The clinical examination revealed a palpable mass in the right breast, while the imaging evaluation showed extensive lung, liver, brain and bone metastases and a metastatic lesion in the pituitary gland, which was compatible with the symptoms of the patient. She received desmopressin for diabetes insipidus control, and underwent whole brain -orbital irradiation and chemotherapy, with resolution of her symptoms and partial remission of the disease. This case shows that diabetes insipidus may be the first manifestation of metastatic breast cancer and early detection and treatment, can improve the associated symptoms.

e20504 Background: Pre-existing Tumor Antigen specific T-cells describe the endogenous adaptive immunity before any treatment that may represent a valuable novel predictive biomarker for ICI treatment. We investigate the potential value of pre-existing cancer-antigen specific CD8+ T-cells as a circulating predictive biomarker. Additionally, we analyze the major differences of known immune-cell phenotypes between Pre-existing positive (PreI+) and Pre-existing negative immunity (PreI-) NSCLC patients. Here, we present the preliminary results of this study. Methods: Blood was collected from 24 patients with NSCLC, stage III PD-L1+, after completion of radical chemoradiation, before initiation of maintenance durvalumab. PBMCs were isolated with Ficoll density gradient centrifugation from patients and 10 healthy donors (HD). PreI was calculated by detecting endogenous IFNg expressing cells with FACS after in-vivo co-cultures of PBMCs with mixes of hTERT, MAGEA1, NY-ESO-1 και Survivin cancer-associated antigens. Immunophenotyping was performed by multi-color flow cytometry using antibodies against CD3, CD4, CD8, CD45RA, CD45RO, CCR7, PD-1, PD-L1 for T-cells. Results: From 24 patients receiving Durvalumab, 10/24 (41.6%) had peptide specific T-cells (PreI + patients), 60% (6/10) had detectable peptide specific T cells for all (4/4) antigens tested. Survival analysis revealed better PFS in PreI+ than PreI – patients (Log-rank = 0.06, median 333.5 and 185 days ) and better OS (p = 0.032, median not reached and 254 days). The levels of CD3CD4PD-1 were higher in patients compared to HD (p = 0.019) but there was not a difference between PreI+ and PreI- patients (p = 0.25). PreI+ patients had significantly higher numbers of CD3CD8PD-1 cells compared to PreI- (p = 0.024) but not CD3CD8PD-L1. Prei+ patients had high numbers of Teff (CD3+CD8+CD45RA+CD45RO-CCR7) compared to both HD (p = 0.0039) and PreI- (p = 0.032). Conclusions: Pre-existing tumor antigen specific immunity before initiation of ICI in NSCLC patients could serve as a good predictive factor of response. The study is ongoing.