Neem (Azadirachta indica) seed kernel extracts were evaluated in cabbage fields in the Philippines for their ability to control the diamondback moth, Plutella xylostella (L.). The extracts were compared to synthetic insecticides and a Bacillus thuringiensis (Berl.) formulation (thuricide hp). The B.t. treatments (1 kg prod./ha) showed low efficacy in controlling P. xylostella. The assumption that this was due to higher UV‐radiation in the trial area could not be confirmed in a corresponding field experiment. Possible development of B.t. resistance in P. xylostella populations is discussed. Zusammenfassung über die geringe Wirksamkeit einer Bacillus thuringiensis (Berl.) Formulierung bei der Bekämpfung von Plutella xylostella auf den Philippinen Extrakte aus Niemsamen (Azadirachta indica) wurden In Kohlfeldern auf den Philippinen im Hinblick auf ihre Eignung zur Bekämpfung der Kohlmotte Plutella xylostella (L.) untersucht. Die Extrakte wurden mit synthetischen Insektiziden und einer Bacillus thuringiensis (Berl.)‐ Formulierung (thuricide hp) verglichen. Die B.t.‐Behandlungen zeigten einen geringen Bekämpfungseffekt bei P. xylostella. Die Annahme, daß dies auf stärkere UV‐Einstrahlung im Versuchsgebiet zurückzuführen sein könnte, ließ sich in einem entsprechend angelegten Feldversuch nicht bestätigen. Die mögliche Resistenzentwicklung gegen B.t. bei P. xylostella wird diskutiert.

Although the benefits remain unproven, a considerable number of cancer patients use unconventional therapy, in many cases without the knowledge of the oncologist. At the oncological out-patient department of the women's clinic of the Justus-Liebig-University Giessen we conducted a survey of the various unconventional methods used. 38.8% (80/206) of the patients used unconventional therapies, mainly mistletoe extracts (50%), trace minerals (46%), megavitamins (39%), and enzymes (22%). The perceived etiology of cancer determined the choice for the various methods (p = 0.00074). Users of unconventional methods suffered significantly more from conventional therapy, had less faith in their doctors, and felt more nervous and emotionally unstable after the diagnosis of "cancer".

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Background: Unconventional therapy has become increasingly popular in cancer patients. Apart from some factors such as age and education there is little known about patients’ conviction and motivation. Patients and Methods: 206 patients having attended the oncologic after-care out-patient department were asked to complete a questionnaire and return it anonymously by mail. Patients’ self-concept and body image were assessed with the help of the ‘Frankfurter Selbstkonzept-skalen’ (FSKN) and ‘Frankfurter Körperkonzeptskalen’ (FKKS), respectively, by Deusinger (1986). Motivation and conviction were assessed with further questions known from the literature. Results: No statistically significant differences with respect to body image and self-concept have been found, although a trend was observed indicating that users have a higher ability to solve problems and to cope with difficulties. Further investigations revealed that users have a different attitude to conventional therapy and generally wish to play a more active part. Conclusion: Open-minded counselling of patients about unconventional therapy considering patients’ needs is necessary to avoid that patients will reject possibly curative or good palliative conventional therapy in cases of recurrences.

279 Background: Several therapies have recently gained regulatory approval in the United States (US) as second-line (2L) treatment options for patients with advanced unresectable or metastatic hepatocellular carcinoma (HCC). Treatment patterns and associated outcomes in a real-world population, especially in the contemporary era, remain understudied. Methods: This retrospective study utilized electronic health record data collected during routine patient care in outpatient oncology practices in the US. Adult patients diagnosed with advanced/ metastatic HCC between April 2017 and January 2020 were identified from the Concerto HealthAI database. Patients who survived at least one month from the end of first-line (1L) systemic therapy but did not initiate 2L therapy were classified as having received supportive care alone (SCA). Demographics, patient and disease characteristics, treatment patterns, and outcomes were described descriptively. Median overall survival (OS) from initiation of 2L therapy or end of 1L therapy for patients receiving SCA until death was estimated by the Kaplan-Meier method. Results: A total of 586 patients with advanced/ metastatic HCC were identified in the database. 330 patients received 1L therapy, and of those patients 63% (N= 207) received systemic 2L therapy (n= 105) or SCA (n= 102). At first diagnosis of advanced/ metastatic HCC, the median age was 64 years, and 86% were male. Of patients with ECOG status available at diagnosis (67%), 45% had ECOG status 0-1. The most common 1L agents prescribed were sorafenib (n= 126, 61%), lenvatinib (n= 28,14%) and sorafenib + nivolumab (n= 13, 6%) The most frequent agents prescribed in 2L were nivolumab (n= 44, 42%), sorafenib (n=18,17%), and lenvatinib (n=9, 9%). The median OS of patients receiving any systemic 2L therapy was 7.7 months (95% confidence interval 5.7-11.1) from time of receiving 2L therapy, whereas the median OS of patients receiving SCA was 5.0 months (95% confidence interval 3.3-7.1) from time of end of 1L therapy. Conclusions: In this contemporary national real-world cohort of patients with advanced/ metastatic HCC, a third of patients who received 1L therapy subsequently received 2L therapy. Next steps include investigating factors associated with non-receipt of 2L therapy, sequencing of therapies when multiple lines of therapies are received, and evaluating outcomes by type of agent received in 2L and beyond.