e15756 Background: Preclinical studies have shown that calcium channel blockers (CCB) may potentiate anticancer effect of chemotherapy via intra-cellular drug accumulation. Gemcitabine-based chemotherapy is commonly used in pancreatic cancer (PC) patients. The aim of this study was to determine whether CCB may affect overall survival (OS) in PC patients receiving gemcitabine-based chemotherapy. Methods: The retrospective cohort of PC patients treated with gemcitabine between 2007 and 2016 was identified in the Polish National Health Fund databases. Electronic records of prescriptions were searched to identify in this cohort patients receiving CCB (amlodipine, nitrendipine, felodipine, lacidipine). The primary endpoint was OS and it was determined by Kaplan-Meier methods and compared by the log-rank test. Results: In total 4628 PC patients treated with gemcitabine (median OS 7.7 months; 95% CI: 7.4-7.9) were identified. Among these 380 patients were prescribed any CCB. There was a significant difference (p < 0.001) in median OS between patients prescribed CCB (n = 380; OS 9.3 months; 95% CI: 7.8-11.0) and those who did not (n = 4214; OS 7.6 months; 95% CI: 7.3-7.8) with hazard ratio for death 0.70 (95% CI: 0.62-0.79). Notably, the survival curves tended to flatten in CCB group, with 24% of patients alive at 2 years (95% CI: 20-29%) and 15% alive at 5 years (95% CI: 11-19%), compared with 11% (95% CI: 10-12%) and 4% (95% CI: 4-5%) in controls respectively. Conclusions: The use of CCB in PC patients receiving gemcitabine-based chemotherapy was associated with improved OS. Further validation is needed to evaluate effectiveness of CCB-gemcitabine combinations in the management of PC.
715 Background: Lymphocyte-to-monocyte ratio (LMR) is a strong prognostic factor in many cancers. Recently, in Polish-2 study it was demonstrated to have a predictive value for hypofractionated neoadjuvant radiotherapy in rectal cancer (WCGIC 2017). LMR > 2.6 was associated with significant improvement of overall survival after short-course radiotherapy (5x5 Gy) and consolidating chemotherapy when compared to chemoradiotherapy (HR 0.36). To our knowledge this is the first observation on use of a predictive biomarker for hypofractionated radiotherapy. In this study we assessed the intra-patient variability of pre-treatment LMR in order to evaluate its reproducibility. Methods: Patients with rectal cancer treated in Maria Sklodowska-Curie Memorial Cancer Center, Warsaw, Poland between January 2013 and August 2017 were identified. In order to test reproducibility of the biomarker, only the patients with minimum two peripheral blood morphology tests within 5 weeks prior to any anti-cancer therapy were selected. Other inclusion criteria were locally advanced rectal cancer with no distant metastasis; no prior radiotherapy or chemotherapy. Patients with LMR > 2.6 were identified as “LMR high”. Results: After pre-screening of 719 rectal cancer patients, 50 patients met the inclusion criteria. LMRs calculated at two time-points were correlated with the coefficient of 0.588 (p < 0.05). 40% of assessments were “LMR high”. In 18% of patients the second test has not confirmed initial assignment to LMR class (95% CI 8.6%-31.4%). If LMR at the first time-point was in the range of 2.2-3.0 (+/- 0.4 from cut off), the chance for misclassification rose to 40% (95% CI 12.2%-73.8%), while outside of this range it dropped to 7.5% (95% CI 1.6%-20.4%). Conclusions: In our study LMR demonstrated significant intra-patient variability, espetially in patients with LMR outside of the indicated range (2.2-3.0). Further translational research is needed to identify the exact biological context of this biomarker in order to identify the molecular subtype of rectal cancer responding to hypofractionated radiotherapy.
(1) Background: T-cell lymphoblastic lymphoma (T-LBL) is extremely rare and highly aggressive, with no practical risk model defined yet. The prognostic value of T-LBL immunological subtypes is still a matter of controversy. (2) Methods: We re-evaluated 49 subsequent adult T-LBL patients treated according to the German Multicenter Study Group for Adult Acute Lymphoblastic Leukemia (GMALL) protocols, 05/93 (n = 20) and T-LBL 1/2004 (n = 29), 85.7% of which achieved complete remission (CR). (3) Results: The 5/10-year overall survival (OS) and event-free survival (EFS) were 62%/59% and 48%/43%, respectively. In 96% of patients, flow cytometry analyses defining the WHO 2008 immunophenotypes were available. Cortical, early/pro-T/CD2(−), early/pre-T/CD2(+), and mature subtypes were identified in 59.5%, 19%, 15%, and 6.5% of patients, respectively. Overall, 20% of patients had the early T-cell precursor (ETP)-LBL immunophenotype, as proposed by the WHO 2017 classification. For the early/pro-T/CD2(−) subtype, the five-year OS and EFS were 13% and 13%, while for all the other, non-pro-T subtypes, they were 69% and 67%. By multivariate analysis, only CD2(−) status and age > 35 years emerged as strong, independent factors influencing OS and EFS, while the risk of CR failure was influenced by age only (>35 years). (4) Conclusions: ETP was non-significant for OS, unless an ultra-high-risk pro-T/CD2(−) subtype was concerned.
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