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Background: The COVID-19 pandemic deeply threatens the rigorous conduct of clinical trials, notably by delaying site initiation visits, patient enrolment, treatment administration, trial-associated procedures, and data monitoring. Unlike most other medical specialties, clinical trials are an integral part of patient care in oncology. Limiting access to clinical trials therefore results in a loss of chance for patients. Methods: In this retrospective single-center study, we collected clinical trial-specific items (including patient-related or trial management-related items) during the first pandemic wave (March– June 2020) and lockdown (March 17th-May 11th) at Gustave Roussy, and compared them to those of the same period in 2019. Results: In March 2020, 84 phase I (P1) and 210 phase II/III (P2/3) trials were open. During the first pandemic wave, 21 (25%) P1 and 20 (9%) P2/3 trials were temporarily halted, following a unilateral sponsor decision in virtually all cases;all but one were industry-sponsored. Despite this, all important metrics of the P1/2 trial activity remained similar to those of 2019, including the number of patients referred for inclusion (599 vs 620), inclusion consultations (215 vs 247), patients starting treatment (130 vs 130), Internal Review Board (IRB) submissions (14 vs 16), and site initiation visits (11 vs 15), all in 2020 vs 2019, respectively. The impact of the first lock-down was more marked on P2/3, with 152 patient inclusions (vs 346 in 2019), 125 randomizations (vs 278), 43 IRB submissions (vs 50) and 34 site initiation visits (vs 40). However, in parallel, 475 patients were included in three “COVID and cancer” trials. Among the 443 P1 and 2851 P2/3 patients, 198 and 628 COVID-19 PCR were performed internally, and five and 15 (2.5%) were positive, respectively. One patient with a community-based COVID-19 died after transfer in intensive care. Conclusions: Cancer clinical trials can, and must be maintained despite challenges brought by COVID-19. Sharing experiences and retrospectively evaluating the impact on patients’ safety and cancer-related outcomes will be critical to durably improve the clinical trials conduct and to anticipate at best challenges brought by future similar crises. Legal entity responsible for the study: Gustave Roussy. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

Background The comprehensive genomic profile (CGP) by next generation sequencing (NGS) ctDNA can identify a wide spectrum of GA that range from drivers with approved targeted therapies for routine use to other GA with lack of evidence for actionability. We aimed to assess the clinical utility of NGS-ctDNA based on ESCAT in a large cohort of NSCLC patients. Methods Advanced NSCLC patients were prospectively enrolled between 11.2015-05.2019 in the Liquid Biopsy Program in our institution. Plasma ctDNA was collected at diagnosis, under therapy or at progressive disease (PD) and analyzed by InVisionFirstTMLung. We evaluated the detection of driver GA on ctDNA and the clinical utility for accessing targeted therapies approved for routine use (EGFR mutation (m), ALK rearrangement (r), BRAFV600Em, ROS1r), according to ESCAT tiers. Results Preliminary results are available for 308 patients/547 samples (n = 117 untreated; 217 at PD). 58% were females, 42% nonsmokers, with median age of 61 (24-90) and 87% had adenocarcinoma. At diagnosis, ≥1 ctDNA GA was found in 79% (91/115; 2 failed analyses): 29% (26/91) were ESCAT tier I (16 EGFRm ex19/21, 1 ALKr, 1 ROS1r, 8 BRAFV600Em), 2% ESCAT tier II (2 METa ; 1 case co-driver with EGFRm) and 31% tier III (21 KRASm with 8 cases G12C; 5 HER2m, 2EGFRm ex20). ctDNA provided clinically informative results for 33% (38/115). At PD, ≥1 ctDNA GA was found in 75% (163/217); 2 failed analyses): 65% (106/163) in ESCAT tier I (66 EGFRm ex19/21, 7 ALKr, 32 BRAFV600Em, 1 ROS1r), Conclusions ctDNA proved clinically informative results for 33% in untreated patients, most of them ESCAT tier I GA (22%) directing targeted therapies in routine. At time of TKI failure, ctDNA was clinically informative assessing resistance in 50% of EGFR/ALK patients. Legal entity responsible for the study Gustave Roussy. Funding Has not received any funding. Disclosure L. Mezquita: Advisory / Consultancy: Roche Diagnostics; Honoraria (self): Bristol-Myers Squibb; Honoraria (self): Tecnofarma; Honoraria (self): Roche; Honoraria (self): AstraZeneca; Travel / Accommodation / Expenses: Chugai. D. Planchard: Advisory / Consultancy: Eli Lilly, Merck, Novartis, Pfizer, prIME Oncology, Peer CME, Roche; Honoraria (self): AstraZeneca, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Eli Lilly, Merck, Novartis, Pfizer, prIME Oncology, Peer CME, Roche; Research grant / Funding (institution): AstraZeneca, Bristol-Myers Squibb, Boehringer Ingelheim, Eli Lilly, Merck, Novartis, Pfizer, Roche, Medimmun, Sanofi-Aventis, Taiho Pharma, Novocure, Daiichi Sankyo; Travel / Accommodation / Expenses: AstraZeneca, Roche, Novartis, prIME Oncology, Pfizer; Advisory / Consultancy: AstraZeneca, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Daiichi Sankyo, Eli Lilly, Merck, Novartis, Pfizer, prIME Oncology, Peer CME, Roche. F. de Kievit: Shareholder / Stockholder / Stock options: INIVATA Ltd. L. Lacroix: Advisory / Consultancy: Abbott, Astrazeneca, Boehringer Ingelheim, Bristol Myers Squibb, Ca Bayer Healthcarer, Illumina, Genomic Health, Myriad, Novartis, Pfizer, Roche, Siemens, Thermofisher, VelaDx. J. Remon Masip: Advisory / Consultancy: Pfizer, MSD, BMS, Astrazeneca, Boehringer Ingelheim; Travel / Accommodation / Expenses: OSE Immunotherapeutics, BMS, Astrazeneca, Roche; Honoraria (self): OSE Immunotherapeutics. P. Lavaud: Travel / Accommodation / Expenses: Astellas-Pharma, AstraZeneca, Ipsen, Janssen Oncology, Mundi Pharma. A. Gazzah: Travel / Accommodation / Expenses: Boehringer Ingelheim, Novartis, Pfizer, Roche; Advisory / Consultancy: Novartis; Research grant / Funding (institution), Clinical trials at Gustave Roussy: Aduro Biotech, Agios Pharmaceuticals, Amgen, Argen-X Bvba, Arno Therapeutics, Astex Pharmaceuticals, AstraZeneca, Aveo, Bayer Healthcare Ag, Bbb Technologies Bv, Beigene, Bioalliance Pharma, Biontech Ag, Blueprint Medicines, Boehringer Ingelheim, Bristol; Research grant / Funding (institution): AstraZeneca, BMS, Boehringer Ingelheim, Janssen Cilag, Merck, Novartis, Pfizer, Roche, Sanofi; Non-remunerated activity/ies, Drug supply: Astrazeneca, Bayer, BMS, Boringher Ingelheim, Johnson & Johnson, Lilly, Medimmune, Merck, NH TherAGuiX, Pfizer, Roche. C. Morris: Shareholder / Stockholder / Stock options: INIVATA Ltd. K. Howarth: Shareholder / Stockholder / Stock options: INIVATA Ltd. E. Green: Shareholder / Stockholder / Stock options: INIVATA Ltd. C. Massard: Advisory / Consultancy: Amgen, Astellas, AstraZeneca, Bayer, BeiGene, BMS, Celgene, Debiopharm, Genentech, Ipsen, Janssen, Lilly, MedImmune, MSD, Novartis, Pfizer, Roche, Sanofi, Orion; Research grant / Funding (institution), Clinical Trials at Gustave Roussy: AbbVie, Aduro, Agios, Amgen, Argen-x, Astex, AstraZeneca, Aveopharmaceuticals, Bayer, Beigene, Blueprint, BMS, Boehringer Ingelheim, Celgene, Chugai, Clovis, Daiichi Sankyo, Debiopharm, Eisai, Eos, Exelixis, Forma, Gamamabs, Genentech, Gortec, GSK, H3 biomed. B. Besse: Research grant / Funding (institution): AbbVie, Amgen, AstraZeneca, Biogen, Blueprint Medicines, BMS, Celgene, Eli Lilly, GSK, Ignyta, IPSEN, Merck KGaA, MSD, Nektar, Onxeo, Pfizer, Pharma Mar, Sanofi, Spectrum Pharmaceuticals, Takeda, Tiziana Pharma; Research grant / Funding (institution), Clinical Trials at Gustave Roussy: Nerviano, GSK, Pfizer, Roche-Genentech, Lilly, OSE Pharma, MSD, Celgene, Stemcentrx, Ignyta, AbbVie, Loxo Oncology, AstraZeneca, Blueprint Medicines. All other authors have declared no conflicts of interest.

Background Bromodomain and extra-terminal (BET) proteins are epigenetic readers that regulate the expression of genes involved in cell growth and oncogenesis. CC-90010 is a potent, reversible oral BET inhibitor that reduces tumor growth in xenograft models. Methods CC-90010-ST-001 (NCT03220347; 2015-004371-79) is a phase I, first-in-human study of CC-90010 in patients (pts) with advanced solid tumors and R/R NHL. Four dosing schedules and 11 dose levels were evaluated (Table). Primary objectives were to determine maximum-tolerated dose, safety, and/or recommended phase II dose (RP2D). A Bayesian logistic regression model guided the dose escalation. Secondary objectives were to identify early activity signals, pharmacokinetics, and pharmacodynamics (PD). Results As of 4 Mar 2019, 69 pts were enrolled, 67 with solid tumors, including 10 with glioblastoma and 2 with R/R NHL. Median age was 57 y (range, 21–80), 38 (55%) were men, and median number of prior systemic anticancer regimens was 3 (range, 1–9). Two RP2Ds were identified (dose cohorts 3A and 4B); 4B was selected for expansion. Dose-limiting toxicities (n = 6) occurred in dose cohorts 3A, 3C, and 4B. Grade 3/4 treatment-related adverse events (TRAEs) occurred in 21 pts (30%), most commonly (>2 pts) thrombocytopenia (16%), asthenia/fatigue (4%), and anemia (4%). Seven pts died, all from progressive disease.Eleven pts remained on treatment >6 mo with clinical benefit. Two pts (endometrial carcinoma and astrocytoma) had a partial response, and 6 had prolonged stable disease ≥9 mo. Plasma exposures and PD marker regulation increased with each dose level; terminal half-life was ∼73 h. Conclusions Most TRAEs were mild or moderate in severity and manageable with dose modifications. CC-90010 had a long terminal half-life that enabled less frequent dosing and promising anticancer activity. Dose escalation is complete, and expansion in select advanced malignancies is ongoing. Table: 1075P . Dose Level: 1 (n = 7) 2 (n = 7) 3A (n = 4) 3B (n = 6) 3C (n = 6) 4A (n = 7) 4B (n = 7) 4C (n = 7) 5A (n = 6) 5B (n = 6) 5C (n = 6) Dose, mg 15 15 25 30 15 40 45 25 30 55 35 Schedule, days on/off 3/4 3/11 3/11 4/24 2/5 3/11 4/24 2/5 3/11 4/24 2/5 Clinical trial identification NCT03220347; 2015-004371-79. Editorial acknowledgement Tisheeka Graham-Steed, PhD BioConnections, LLC. Legal entity responsible for the study Celgene Corporation. Funding Celgene Corporation. Disclosure V. Moreno: Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: BMS; Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Regeneron; Speaker Bureau / Expert testimony: Bayer/Loxo. I. Brana: Research grant / Funding (self): Celgene. J.M. Sepulveda Sanchez: Advisory / Consultancy, Research grant / Funding (self): Pfizer; Advisory / Consultancy, Travel / Accommodation / Expenses: AbbVie; Advisory / Consultancy: Celgene; Advisory / Consultancy: GW Pharma; Speaker Bureau / Expert testimony: Astellas; Travel / Accommodation / Expenses: Ipsen. M. Vieito Villar: Travel / Accommodation / Expenses: Roche. O. Saavedra: Travel / Accommodation / Expenses: Mundipharma; Travel / Accommodation / Expenses: Teva; Travel / Accommodation / Expenses: MSD; Travel / Accommodation / Expenses: Grunenthal; Travel / Accommodation / Expenses: Kyowakirin; Travel / Accommodation / Expenses: Boehringer-Ingelheim; Travel / Accommodation / Expenses: Debiopharm. G. Musuraca: Advisory / Consultancy: Servier. P.A. Asierto: Advisory / Consultancy: Pierre Fabre; Advisory / Consultancy: Incyte; Advisory / Consultancy: Newlinks Genetics; Advisory / Consultancy: Genmab; Advisory / Consultancy: Medimmune; Advisory / Consultancy: Sindax; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Sun Pharma; Advisory / Consultancy: Sanofi; Research grant / Funding (institution): BMS; Research grant / Funding (institution): ROCHE Genentech; Research grant / Funding (institution): Array; Travel / Accommodation / Expenses: MSD. C. Carlo-Stella: Honoraria (self): BMS; Honoraria (self): MSD; Honoraria (self), Advisory / Consultancy: Servier; Honoraria (self), Advisory / Consultancy: Amgen; Honoraria (self), Advisory / Consultancy, Travel / Accommodation / Expenses: Janssen; Advisory / Consultancy, Research grant / Funding (institution): Sanofi; Advisory / Consultancy, Research grant / Funding (institution), Travel / Accommodation / Expenses: ADC Therapeutics; Advisory / Consultancy, Research grant / Funding (institution): Novartis; Research grant / Funding (institution): Rhizen Pharma; Research grant / Funding (institution), Travel / Accommodation / Expenses: Roche; Travel / Accommodation / Expenses: Takeda. R. Sarmiento: Travel / Accommodation / Expenses, Shareholder / Stockholder / Stock options, Full / Part-time employment: Celgene. J. Di Martino: Leadership role, Shareholder / Stockholder / Stock options, Licensing / Royalties, Full / Part-time employment: Celgene Corp. M. Zuraek: Travel / Accommodation / Expenses, Shareholder / Stockholder / Stock options, Full / Part-time employment: Celgene Corp. T. Sanchez Perez: Full / Part-time employment: Celgene Corp. E. Filvaroff: Travel / Accommodation / Expenses, Shareholder / Stockholder / Stock options, Licensing / Royalties, Full / Part-time employment: Celgene Corp.; Shareholder / Stockholder / Stock options: Amgen; Shareholder / Stockholder / Stock options: Gilead; Shareholder / Stockholder / Stock options: Genentech/Roche. B. Hanna: Research grant / Funding (self), Shareholder / Stockholder / Stock options, Full / Part-time employment: Celgene Corp. Z. Nikolova: Travel / Accommodation / Expenses, Shareholder / Stockholder / Stock options, Full / Part-time employment: Celgene Corp. All other authors have declared no conflicts of interest.

Aim: The optimal strategy for patients with LAPC remain a therapeutic challenge. A growing evidence suggests that both, pts with borderline resectable and unresectable tumors may benefit from a multimodal approach aimed at improving resectability and survival times. In the present work our experience after a long-term follow-up period is reported. Methods: From December 2005 to July 2011, 67 histologically confirmed LAPC, endoscopic ultrasound (EUS) staged T3-4 and/or N+ were retrospectively analysed. They received induction gemcitabine/oxaliplatin- based chemotherapy followed, in case of radiological response or stable disease, by chemo-radiotherapy (50.4 Gy concurrently with daily capecitabine and weekly oxaliplatin). Salvage surgery was performed when technically feasible. We have applied a nonlinear mixed effects (NLME) modeling to evaluate the impact of dynamic changes in tumor size, Ca- 19.9, neutrophil-lymphocyte ratio and platelet-lymphocyte ratio on the clinical outcome of these patients. Results: The median age was 63 years (range 35-85). Male to female 36/31. Thirty eight pts (57%) completed the whole program (group A), whereas 27 (40%) received chemo and radioterapy but were not elegible for surgery (Group B). Two pts (3%) progressed after induction chemotherapy (Group C). EUS staged T4 or N+ was found in 20 (30%) and 24 (36%) respectively. Toxicity profile was mild, with no grade 4 toxicity being documented. On an intent to treat basis, R0 resection rate was 57%; ypT0ypN0 were observed in 11 (29%) of patients. Among resected patients, local and distant failure rates were 5% and 55%, respectively. The liver was the most frequent site of relapse 21(43%) pts. After a median follow up of 23 months (range 4 to 102), median PFS was 21, 10 and 1 month in groups A, B and C respectively (p = Conclusions: Our date suggest that this three-step strategy is feasible and active in LAPC patients. The NMLE population modeling will be presented at the meeting Disclosure: All authors have declared no conflicts of interest.

Background The first-line treatment of metastatic castration-resistant prostate cancer (mCRPC) consists of docetaxel-based chemotherapy. The median time to progression (TTP) from chemotherapy initiation is 6-8 months (mo). Ketoconazole is a nonspecific cytochrome-P 17 inhibitor (CYP17i) that blocks adrenal androgen synthesis. Low-dose ketoconazole (LDK), (200 mg, t.d.s) has shown interesting activity in mCRPC after progression to androgen deprivation. The role of a CYP17i in the maintenance setting after response/stabilization to docetaxel has never been studied. Methods Thirty-eight mCRPC patients showing progression to luteinizing-hormone releasing hormone agonists (LHRHa), maintained LHRHa and received a median of 7 cycles of front-line three-weekly docetaxel (75 mg/m2) plus daily prednisone (10 mg). Twenty out of the thirty-eight patients showing no progression to docetaxel were enrolled. After docetaxel, ten patients were assigned to LDK maintenance treatment plus prednisone (10 mg/day) and LHRHa, and ten patients received LHRHa alone. TTP was the primary endpoint. Results After 33 months follow-up, a median TTP from docetaxel initiation was 11.5 months (IC95%: 6.3-16.6) for maintenance therapy and 9.2 months (IC95%: 8.5-9.9) for the control arm p = 0.047). Maintenance treatment was well tolerated with only one patient experiencing a grade 4 adverse event (non-symptomatic pulmonary embolism). Grade 1 and 2 asthenia and hot flashes worsening were the most common toxicities (table). Conclusions This is the first study testing a CYP17i for maintenance therapy after response/stabilization to docetaxel. A more than 2 months significant benefit in TTP with a favorable toxicity profile is observed. A further prospective analysis in a larger series using a CYP17i is warranted. Toxicity profile of maintenance therapy with a CYP17 inhibitor. Grade Toxicity 1 2 3 4 5 Asthenia 3 2 - - - Diarrhea 1 1 - - - Hepatotoxicity 1 1 - - - Hyporexia - 1 - - - Cephalea 1 - - - - Hot flashes 1 4 - - - Fluid Retention 1 2 - - - Pulmonary embolism - - - 1 - Disclosure All authors have declared no conflicts of interest.

Background Androgen deprivation therapy (ADT) is the standard treatment of hormone-sensitive metastatic prostate cancer (HSMPC). We performed a phase III multicentre trial to compare ADT alone with ADT plus docetaxel (D) in HNMPC. Methods Patients (pts) with HSMPC were randomly assigned to either arm A (ADT + D: 75mg/m q3w, up to 9 cycles) or arm B (ADT). The primary endpoint was overall survival (OS). The planned number of pts was 378 to detect an improvement in OS with a hazard ratio (HR) of 0.62, a power of 80% and an alpha risk of 0.05 (two-sided test). Secondary endpoints were biological progression-free survival (PFS) and clinical PFS. Data on toxicity and quality of life have been previously presented. Results From October 2004 to December 2008, 385pts were included. Baseline characteristics were well balanced between the two arms. Median age was 63 years (43-84), median PSA was 26.4 ng/ml (0.1-11900), Gleason score was ≥ 8 in 57%. Prognostic classification was as follows: good prognosis (49%), intermediate (29%) and poor (22%). The majority of pts had metastases at the time of diagnosis (72%), 28% developed metastases after local treatment failure. Median number of D cycles was 8 (range 0-9). The median follow-up was 50 months (mo) [95%CI: 49-54]. At 6 mo, a higher PSA response (≥ 50%) in arm A (94% vs 85%, p = 0.0096) and a higher PSA progression (≥ 25%) in arm B (10% vs 1%, p = 0.0015) were observed. Biological PFS was significantly longer in arm A: 22.9 vs 12.9 mo, HR; 0.72 [95%CI: 0.57-0.91] (p = 0.005). Clinical PFS was increase in arm A: 23.46 vs 15.44 mo, HR: 0.75 [95CI: 0.59-0.94] (0.015). OS was not significantly different (median: 58.9 mo in arm A and 54.2 mo in arm B, HR: 1.01 [95%CI: 0.75-1.36]. The median OS for each prognostic group was 69.1 [95%CI: 60.9-NR], 46.5 [95%CI: 37.7-NR] and 36.6 [95%CI9: 28.5-58.9] mo respectively in the good, intermediate, and poor prognosis groups (p = 0.001), with no difference between the two arms. At the cut-off time, 65% of pts from the ADT arm had received docetaxel since they developed castrate-resistant prostate cancer. Conclusion Combining docetaxel and ADT improves PFS over ADT alone in pts with HSMPC. However, no difference in OS was observed between the two arms. Disclosure G. Gravis: I have expert testimony to disclose: Sanofi Aventis, uncompensated. K. Fizazi: Participation to advisory boards and speaker for Sanofi-Aventis. F. Joly Lobbedez: advisory board/board of directors position: Sanofi, Roche, Pfizer, Novartis, Ferring; compensated consultant relationship: Roche, Novartis; honoraria: Sanofi, Roche, Pfizer, Novartis, Ferring, Ipsen,Takeda; travel remuneration: ASCO by Novartis, ESMO by Janssen. S. Oudard: I have an advisory relationship and honoraria to disclose: Pfizer Oncology, Bayer-Schering Pharma, Hoffman La Roche, Glaxo SmithKline, Novartis Pharma, Sanofi Aventis. D. Pouessel: Consultant role and honoraria: Sanofi, P. Beuzeboc: Presentations: Avantis, All other authors have declared no conflicts of interest.