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128 Background: A fluoropyrimidine with or without bevacizumab is often used in clinical practice as maintenance therapy after a first-line chemotherapy + bevacizumab induction in mCRC. However, the role of maintenance following an anti-EGFR-based induction and the optimal regimen are not well established. Methods: We searched PubMed and conferences’ proceedings for clinical trials assessing maintenance therapy after first-line treatment for RAS WT mCRC. Two independent reviewers excluded single-arm studies and retrospective reports from trials that were not designed to assess maintenance therapy. We used the method of Guyot et. al. to obtain the individual patient data, followed by a Cox procedure to derive the survival hazard ratios (HR) from studies that did not report that value. Safety analysis included grade 3-4 asthenia, neuropathy, neutropenia, rash, and diarrhea. We performed a random-effects bayesian network metanalysis using the package “GeMTC R Package” to compare all treatment strategies included (anti-EGFR, anti-EGFR + chemotherapy [CT], CT alone, and observation). The risk of bias was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions. Results: The systematic review retrieved 145 studies from which 142 were excluded. Two additional studies were found in the Conferences’ Proceedings review. Consequently, 5 studies were included in this NMA. In terms of Progression-Free Survival (PFS), there was a benefit of anti-EGFR and anti-EGFR+CT versus CT alone (HR 0.63 [95%CrI 0.31-1.30] and 0.72 [95%CrI 0.41-1.30], respectively). The rank probability of anti-EGFR being the best option considering PFS was 61%. In terms of Overall Survival (OS), the benefit of anti-EGFR and anti-EGFR+CT versus CT alone was statistically weak (HR 0.92 [95%CrI 0.54-1.50] and 0.84 [95%CrI 0.57-1.20], respectively). The rank probability of anti-EGFR+CT be the best option in terms of OS was 51%. Comparing anti-EGFR versus anti-EGFR+CT resulted in no statistically significant difference. Anti-EGFR-containing regimens increased the rate of rash and diarrhea compared to CT alone (RR 11.23 and 1.23, respectively). The risk of bias was average low, except for the unclear risk of selection bias linked to unpublished studies. Conclusions: Anti-EGFR±CT maintenance therapy improves PFS and OS compared to CT alone or observation in RAS WT mCRC, with manageable safety profile.

e14144 Background: Complementary and alternative medicine (CAM) use is relatively common among cancer patients. Data regarding CAM use in Brazil is scarce. We sought to define CAM use by cancer patients and investigate factors that might influence it. Methods: We conducted a cross-sectional survey of adults diagnosed with any cancer type who came to appointments at our outpatient clinic in January 2020. Chi-square tests were used to investigate the association between CAM use and age and gender Results: We interviewed 156 patients who consented to the face-to-face interview and all of them completed the questionnaires. Most patients were between 51 and 70 years-old; 56% were female and 55% had their cancer diagnosed in the last 12 months. Most cancer types were breast (17.4%), colorectal (16.7%), and lung (16.1%). More than 90% of the participants were on any active treatment. The prevalence of current CAM use was 29.6%. 58.7% of the patients did not believe CAM has anti-cancer properties, including 32.6% of patients who reported CAM use. Two-thirds of the participants have never discussed about CAM with their oncologists. Only 5.1% of the respondents would abandon conventional cancer treatment in order to use just CAM. Among CAM users, 55% referred multiple therapies use. Of those therapies, spiritual surgery was the most prevalent one. There was a significant higher proportion of females reporting CAM use (p = 0,029) as well as a higher proportion of CAM use among younger patients (p = 0,008). Conclusions: CAM use was common among our study population, especially spiritual surgery. Women and younger patients were more prone to use CAM. Although most patients would not abandon conventional treatment, many of them have never discussed about CAM with their oncologists.

12060 Background: Complementary and alternative medicine (CAM) use is relatively common among cancer patients. Data regarding CAM use in Brazil is scarce. We sought to define CAM use among cancer patients and investigate factors that might influence it. Methods: We conducted a cross-sectional survey of adults diagnosed with any cancer type who came to appointments at two cancer centers in Brazil from January 2020 to January 2021. Unadjusted and adjusted analyses were conducted by using Logistic Regression models to determine the association of covariates with binary outcome. Statistical analyses were performed with SAS 9.4 (SAS Institute Inc, Cary, NC). All tests were 2-sided, and P < 0.05 was considered significant. Results: In total, 319 patients who consented to the face-to-face interview were included and all of them completed the questionnaires. Most patients (52.4%) were between 51 and 70 years-old, 59,6% were female, 85,2% were from the private service and 67% had college graduate/baccalaureate. Most cancer types were from gastrointestinal tract (31,4%), breast (20.4%), lung (12.3%) and genitourinary type. More than 85% of the participants were on any active cancer treatment. The prevalence of current CAM use was 34.2% and 50.2% of the patients did not believe CAM has anti-cancer properties. Two-thirds of the participants have never discussed about CAM with their oncologists. Only 4.1% of the respondents would abandon conventional cancer treatment in order to use just CAM. Among CAM users, 55% referred multiple therapies use. Of those therapies, spiritual surgery was the most prevalent one. There was a significant higher proportion of females reporting CAM use (p = 0,008) as well as a higher proportion of CAM use among private patients (p = 0,008). Conclusions: CAM use was common among our study population, especially spiritual surgery. Women and private patients were more prone to use CAM. Although most patients would not abandon conventional treatment, many of them have never discussed about CAM with their oncologists.

Introduction: Next Generation Sequencing (NGS) is a key tool since it unreveals genetic alterations (GA) with potential for targeted-therapy, frequently, not detected for conventional methods done previously. Nevertheless, avaiability of these drugs is a major concern and, additionally, oncologists are challenged to deal with such a huge amount of findings whose clinical significance and sensibility to those drugs are, many times, uncertain. Is broadly unknown, except for isolated initiatives, the correlated clinical outcomes of targeted-therapy guided by NGS. Methods: In this retrospective study, we describe clinical outcomes of 34 pts with advanced solid tumors (tu) treated in a single Cancer Center in Brazil according to therapies guided by NGS. All tests were performed using Illumina HiSeqs of Foundation Medicine (FM). The f/u was obtained from our electronic charts. Results: From apr/14 to oct/17, 34 pts were identified, 13M/21F, mean 58y/o. Histologies were: 7 NSCLC, 10 mCRC, 3 pancreatic, 3 breast and 11 varied. In 26 / 34 pts (76%), druggable GA were identified and 17 (50%) were treated with NGS-guided therapies - 14 with TKi and 3 with immunotherapy (imm). Importantly, 8/ 17 pts (47%) experienced clinical benefit (DE, PR, CR) by RECIST 1.1 (1 melanoma, 1 colon, 6 lung adeno). Seven (41%) had PD in the first control in 4-8w (mCRC treated with cobimetinib because of TP53 G12D; mCRC-trastuzumab-HER2 R678Q; breast-olaparibe-BRCA-2 T431fs*20; breast-EVE-PIK3CA E545K; endometrium-EVE-PIK3CA C604R/PIK3CA E81K and PTEN R233*/PTEN S229; mCRC-trastuzumab+lapatinib-HER2 amplification V777L; HCC-EVE-IKBKE amplification and PTEN loss exon 2-9), 1 had just started the therapy (BRCA-2 mutated pancreatic adeno with olaparib) and 1 died before restaging (HER2-mut mCRC treated with chemo+trastuzumab). The DoR was better in those with anti-ALK (3 pts, 18 mo) and anti-EGFR (1 pt, 6 mo ongoing response) and in those with TMB-I/high treated with imm (1 melanoma with TMB27 and 2 lung adeno with TMB 18 and 8). Amongst the 10 pts with evaluable TMB values, 6 were TMB-I/high and, in those, was found a high frequency of mutations: mean of 7). Curiously, 1 pt with mCRC with Kras G12V mutation treated with Trametinib, according to FM recommendations, experienced SD for 12 mo. Finally, 7 pts had samples tested by local companies using other methods (IHC, FISH, PCR) and in 5 (14% of all 34) it did not identified the GA observed by NGS. Conclusion: NGS identified a significant amount of GA otherwise not detected by conventional tools, changed management and resulted in improved clinical benefit, especially for those with lung adeno treated by anti-ALK/EGFR and those with TMB-I/high treated by imm. Addionally, this study suggests that tu with higher amount of GA in NGS are prone to harbor TMB-I/high and also confirms the low responsiveness of solid tumors to EVE even with driver-mutations in the PI3K-Akt-mTor pathway. Citation Format: Marcos Andre Costa, Marcelo Santos, Roberto Abramoff, Renata D'alpino, Carlos Teixeira, Ariel Kann, Jacques Tabacof, Riad Younes. Clinical outcomes of pts with advanced solid tumors treated according to NGS guided-therapy in a Brazilian cancer center [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 2601.