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BackgroundIn elderly patients affected by metastatic castration-resistant prostate cancer (mCRPC) chemotherapic treatment may be the choice if one considers not only the chronological age, but also the clinical status, the functional reserve, and the vulnerability of patients. Several studies have confirmed the survival benefit of docetaxel and vinorelbine among every class of age. Most CRP elderly patients are defined as frail, maybe due to comorbidities: these patients, who are unable to be candidates for a standard treatment, should be candidates for a more tolerable treatment.MethodsTwenty-six elderly, frail patients were evaluated. The patients were affected by mCRPC and were receiving chemotherapy with intravenous weekly docetaxel (12 patients) or oral metronomic vinorelbine (14 patients). Safety and efficacy were investigated evaluating clinical and objective response and tolerability. The level of patient satisfaction with treatment was assessed through a questionnaire.ResultsNo significant difference was found between groups in terms of 6-month progression-free survival: 57.1% for patients treated with oral metronomic vinorelbine versus 58.3% for patients treated with docetaxel. Median progression free survival was 8.6 months (95% confidence interval: 7.1–9.4 months), and 8.2 months (95% confidence interval: 6.9–9.3 months) for patients treated with oral metronomic vinorelbine and socetaxel, respectively. Oral metronomic vinorelbine was associated with increased patient satisfaction with respect to docetaxel administration. The most frequent side effect associated with oral metronomic vinorelbine was anemia and vomiting, with similar frequency compared to patients treated with docetaxel.ConclusionWeekly docetaxel and oral metronomic vinorelbine are equally effective and well tolerated in elderly unfit and frail patients affected by mCRPC. Metronomic vinorelbine treatment is associated with higher patient compliance and satisfaction.

259 Background: Oncologist and Primary Care Provider are both involved in cancer patients follow-up. Patient's preference is an important issue. Aims This observational study was made to investigate: a) if and how long after the diagnosis the patient prefers to be followed by PCPs, Oncologist or both; b) if they prefer to be followed in the same institute where they received acute phase care; c) if it's important to receive recommendations about their lifestyle. Methods: 150 patients were recruited between May and June 2015 in the transient phase. They were affected by different tumors (breast, colon, prostate, melanoma, gynecological cancers and lymphoma disease) 53 pts under 3 years, 38 pts 5 years, 59 pts 7 years since the diagnosis. A questionnaire investigating the aims of the study was administered. Results: Among the pts on 3 years follow-up, only one preferred to be followed by the PCPs for logistical reasons; 24/53 patients after 5 years follow-up preferred PCPs and 18/53 preferred to be followed only by the oncologist because of more competence. In the 5 and 7 years follow-up 80/97 pts preferred to be exclusively followed by the oncologist for these reasons: A) poor PCPs involvement during the acute phase. B) oncologist expertise in acute phase, follow-up and possible relapse; c) lack of interest shown by the PCPs for survivorship care plan. All pts (150) gave positive response on receiving advices about their lifestyle (diet, sport activities, etc...). For 63% of the patients a unique structure would be suitable for receiving follow-up too. Conclusions: The preferences of patients, followed in the transient phase, suggest that fear of relapse guides patient's choice and the relationship with the oncologist offers security.

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