Background: More than 50% of advanced NSCLC patients are older than 65 years old (y), with a median age at diagnosis of 68 y. This group of patients have been usually underrepresented in clinical trials. The aim of our study is to compare whether clinical characteristics, toxicity, response rate, overall survival (OS), and progression free survival (PFS) are different in p > 70y vs. < 70y, treated with platinum based chemotherapy. Method: We reviewed the database of the Instituto Oncologico Córdoba, Argentina (IONC). Survival curves were made up by Kaplan-Maier method and compared using the log-rank test. Results: Out of 198 p; 103 p (52 %) < 70y, and 95 p (48 %) > 70y We found significant differences in OS (9.4 vs. 7.5 months, p¼0.003) and PFS (6.4 vs. 5.1 months, p¼0.002) Significant differences in OS were also found between the two groups regarding anemia, Performance status (PS) and response rate with no difference on sex and histology. Conclusion: Significant differences in OS and PFS were evident between both groups. We observed increased toxicity in p > 70y, but without greater treatment-related mortality. OS and PFS were superior in patients treated with platinum-based doublets when compared to monotherapy (according to historical records); therefore we should choose the former in elderly patients.

Background. Hereditary predisposition explains 10-15% of Breast cancer (BC), individuals carrying germline BRCA1 andBRCA2 mutations have a 46-87% lifetime risk for BC. According to ACOG, Genetic Cascade Testing (GCT) refers to the performance of genetic counseling (GC) and testing in blood relatives of individuals who have been identified with specific genetic mutations. CGT could offer advantages to relatives in order to adjust surveillance and even offer risk reduction procedures. Even if CGT should be more affordable, its cost is still a burden for most Mexican health care institutions and patients (pts) as well. Herein, we intended to explore the CGT rate, and describe the barriers to CGT in Mexican pts with BC. Methods. Through this retrospective work, we collected clinical, demographic and familial information of BRCA1&2 mutation carriers diagnosed from nov2014-mars2019. Through GC or medical record review, we explored if some of the relatives older than 18 years had GT, and if CGT was complete for their 1st and 2nd degree relatives. Finally, pts available for an interview were asked to list CGT barriers. Also, we asked them whether a GC session was offered to their relatives. Descriptive and parametric tests were used. Results. We identified 27 pts carriers of a pathogenic variant in BRCA1 or BRCA2. 16 pts (59%) were carriers of BRCA1 mutations. Mean age was 44.52y (SD 10.3). (48.1%) 13 pts held bachelor or a higher degree. 6 pts (22.22%) reported some CGT. 2 pts (7.4%) described GT in offspring, and 1 pt (3.4%) in siblings. 2 pts described GT in 2nd or 3rd degree relatives. Nonetheless, only 1 pt (3.7%) had complete GT for 1st degree relatives. 5 pts were not available for interview, 2 deceased before we started collecting these data, and 2 pts were had their result too recently. Thus, we conducted 18 interviews. All patients had a positive attitude toward GT. The barriers described were: in 16 cases (88.8%) lack of coverage; in 12 (66.66%), the cost of GT; in 5 cases (27.7%), the relatives were beneficiaries of other health care institution, or declined the test because they were males and perceived a low risk. In 4 cases (22.22%), the relatives had not access to a genetics department, or indolence was referred too. In 3 cases (16.6%) family issues were reported. In 2 cases (11.11%), the relatives were comfortable having only clinical surveillance or their primary physician counseled it. A GC session in relatives was only performed in 9 families (33.3%). We found no association between CGT and age of diagnosis (p=0.372), education (p=0.301) or year of prescription of GT (p=0.477). Conclusion. Overall, we found a low cascade testing rate among our BRCA positive pts, and only one case was described as complete. Lack of coverage and cost of GT are described as the most important barriers. Only 1 pt disclosed the price of GT ($1000 for every single relative tested), which is not affordable for most of the population. Male gender was associated with lower testing rate, CG is necessary to improve understanding of risks according to gender and inheritance. Better communication between the different health care institutions could be helpful in order to identify relatives at risk. Unfortunately, we didn’t gather information about income, which could have an association with CGT. New modalities of GT are becoming more affordable and probably, more pts should be counseled about these options. Our sample is small, but it could be representative of a large issue along the whole country. Citation Format: Guillermo Pacheco-Cuellar, Karen Campos-Gomez, Juan Jesus Valdes-Andrade, Saul Campos-Gomez. Disparities in cascade screening in BRCA1 or BRCA2 mutation carriers. Exploring rate and barriers in a Mexican population [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P6-08-27.

Background: Lung cancer is the most common cancer and remains the main death cause worldwide. The aim of study was to determinate the incidence and survival rate of lung cancer in a population of affiliates in a private institution (ONCOSALUD-AUNA). Method: In a dynamic cohort, the incidence of lung cancer was evaluated in a population of affiliates to ONCOSALUD-AUNA between 2008-2013 (n¼1'096,140). Overall survival (OS) was evaluated in patients treated in ONCOSALUD e AUNA between 2000-2005 (n ¼ 114). The incidence rate was calculated based on new cases/persons-year of observation. The incidence rate standardized by age was calculated having the structure of the world standard population. OS was estimated using the Kaplan-Meier method and comparisons of survival curves were performed using the Log-rank or Breslow test. Results: The median age at affiliation was 33 years (range: <1, 98), 18.9% were under 15 years old, 5.6% were older than 64, and 55.7% were women. A total of 2,611,438.3 persons-year of observation was calculated and 394 affiliates (193 and 201 in women and men, respectively) were diagnosed with lung cancer. The median age at diagnosis was 70 years (range: 35, 98). The standardized incidence rate by age was 7.9 per 100,000 persons-year (6.5 and 10.0 in women and men per 100,000 persons-year, respectively), and 74 years cumulative risk was 1.0% (0.9 and 1.3% in women and men, respectively). For survival assessment, the median age at diagnosis was 69 years, 37.9% were women and 76.3% had advanced disease (CS III: 18.2% and CS IV: 58.1%). With a 10.6-year follow-up, the median survival was 0.62 years (CI95%: 0.46, 0.78). The OS rate at 5 and 10 years were 16.4% and 12.9%, no significant differences in relation to sex (p ¼ 0.118), age (<60 vs. >60 years: p ¼ 0.300) were observed, and it shows significant difference according clinical stage (CS I-II vs. IIIeIV: p < 0.001). Conclusion: The incidence rate of lung cancer in our population is slightly lower than reported by the IARC for the Peruvian population. The survival rate at 5 and 10 years is similar to reported by other series.

No abstract

Background: a previous study found significant clinicopathological differences between young Breast Cancer BrCA patients (pts) from Romania (Ro) and from Mexico (Mx). Here, we provide a molecular and clinical description of pts carrying BRCA mutations of both cohorts. Methods: in this retrospective study, we analyzed 2 cohorts of BRCA1/2 mutations carriers tested in COEI from Mx between 2014-2017 and IOCN from Ro between 2015 to 2016. Ro pts were selected according to NCCN criteria, while Mx pts were selected based on risk evaluation models. NGS analysis and MLPA for BRCA1&2 were performed in all pts. We compared demographic, clinicopathological and molecular data. Results: 65 pts, 21 (32.7%) from Mx and 44(67.7%) from Ro carried a BRCA mutation. 66.7% of Mx pts and 65.9% of Ro pts carried a BRCA1 mutation. We found clinical similarities: Mean age was 44.5y for Mx and 40.59y for Ro pts. IDC was the most frequent type of BrCa in both series (90.5 vs 90.9%). TNBC was seen in 13 Mx vs 27 Ro pts (61.9% vs 61.4%), HR positive was seen in 7 (33.3%) and 12 (27.3%) cases. Grading 3 was more frequently seen in Ro, while grading 2 was mainly noted in MX pts(p=&lt;0.020). BRCA1/2 pathogenic mutations were different between the 2 cohorts and no BRCA 1/2 identical mutation was identified. 15 different mutations in 21 Mx pts, and 16 different mutations in 44 Ro pts were found. Mutations were different between 2 cohorts. Notably for the Ro cohort, 4 founder mutations (c.181T&gt;G, c.3607C&gt;T, c.5266dupC in BRCA1,and c.9928A&gt;G[GPC1] in BRCA2) were found in 31/44 pts, while the Mx cohort, c.5123C&gt;A and del 9-12del ex in BRCA1 were found in 6/21 mutations. Three Large rearrangements (LR) were exclusively seen in the Mx pts (5/21). Conclusions Both cohorts didn't share any mutation, but the clinical features are similar. BRCA1 del 9-12del is a Mexican founder mutation, we found it in 14% of Mx pts, LR have been described more frequently in Latin American Populations, we found it in 30% of the MX cohort, while for Ro cohort four recurrent mutations qualify as founder mutations. Citation Format: Campos-Gomez S, Antone N, Pacheco-Cuéllar G, Pop L, Campos Gomez K, Stoian A, Eniu R, Valdes-Andrade J, Dronca E, Matei R, Ligtenberg M, Ouchene H, Onisim A, Rotaru O, Eniu AE. Prevalence and type of BRCA mutations in young breast cancer patients undergoing genetic cancer risk assessment in two developing countries: Analysis of two cohorts from Romania and Mexico [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-09-14.