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e19036 Background: Both pemetrexed-cisplatin and bevacizumab-based therapy are treatment options for patients with advanced non-squamous NSCLC. The objective of this study was to explore efficacy a...

e20718 Background: OEC frequency in elderly patients is increasing around the world and it’s expected to continue rising in the future. PPC is an entity with a similar behaviour. OEC is the most common cause of gynaecologic cancer-related death and it’s the fifth leading cause of cancer associated mortality among women; its relative risk is higher among elderly patients. In this study we try to identify clinical factors in elderly OEC and PPC patients in order to improve current medical management and to enhance clinical outcomes. Methods: From January 2007 to December 2011 a total of 53 elderly patients were included (≥65 years old). PPC: 11.3%; OEC: 88.7%. ECOG 0/1/2/3/4: 24.5/34/26.4/7.5/5.7%; 1.9% unknown. Stage at diagnosis: III (52.8%); IV (30.2%). Ca125 was increased in 79.2% of the cases; 64.2% of the patients underwent debulking surgery. The majority of patients (94.4%) received chemotherapy: monotherapy (13.2%) or polychemotherapy (86.8%). Results: Among 38 evaluable patients, partial response was observed in 45.4%, complete response in 27.2%, stable disease in 24.4% and progression in 3%; 18% of patients were retreated with the same schedule (platinum sensitivity) and 26.4% of the patients received more than one line of chemotherapy (range 2-5). Significant differences in overall survival (OS) were observed in multivariate analysis according to performance status (p=0.018). Median OS for all patients was 131 weeks. Conclusions: In our experience, results in elderly patients are comparable to those expected in younger patients. In this population, treatment options must be optimized.

e14712 Background: Preoperative concomitant QT-RT has shown to improve sphincter preservation and local control in LARC. We analyzed two cohorts of pts diagnosed of LARC treated with QT-RT with CAP or CAPOX. Methods: Pts with LARC (T3-T4 and/or N+) were treated with pelvic radiotherapy (45Gy in 25 fractions) concomitant with oxaliplatin (50mg/m2 day 1, 8, 22 and 29) and capecitabine (1650mg/m2 on days 1 to 14 and 22 to 35) or CAP (825mg/m2 bid for 5 days/week). Surgery was scheduled 6 weeks after completion QT-RT. Main end points assessed were: toxicity of preoperative chemotherapy, rate of sphincter preservation, pathological complete response (pCR) rate, and progression-free survival (PFS). Results: From Aug 2002 to Nov 2012, 254 pts with LARC were included; 53 pts received preoperative chemotherapy with CAP (cohort A) and 201 pts with CAPOX (cohort B). Median age: 65. Pts characteristics in cohort A: ECOG 0/1/2: 13/35/5; upper/mid/distal rectum 5/25/23; stage II/III 10/43. Pts characteristics in cohort B: ECOG 0/1/2: 48/149/4; upper/mid/distal rectum 29/105/67; stage II/III 27/174. 51 pts in cohort A (96.2%) and 192 (95%) in cohort B received full dose of preoperative QT-RT. Main toxicities in cohort A were diarrhea grade 2/3: 2/3 and neutropenia grade 2/3: 1/0; in cohort B were diarrhea grade 2/3: 42/24, neutropenia grade 2/3: 2/1 and neurotoxicity grade 1/2: 94/7. Surgery: 53 pts (100%) in cohort A and 198 pts (98.5%) in cohort B. Sphincter preservation and R0 resections were achieved in 58% pts and 98% pts respectively in cohort A, and 62% pts and 91.5% pts in cohort B. pCR was achieved in 11% pts in cohort A and 17% pts in cohort B. 3-year PFS and overall survival were 62% and 82% respectively in cohort A, and 75% and 83% in cohort B. Adding oxaliplatin in pts cT4/N- or N+ does not improve PFS (p=0.73). Downstaging in cohort A and B was achieved in 69.8% pts and 65% pts respectively. Conclusions: Combination QT-RT based in CAP or CAPOX is a well tolerated regimen and achieved encouring rates of pCR, R0 resection, sphincter preservation and tumor downstaging without differences in PFS in high risk pts with LARC.

e21009 Background: Although several studies have shown the presence of estrogen receptors (ERs) in lung tumors, published reports show inconsistent conclusions. Biological role of ER-α, ER-β and aromatase in the development of NSCLC is unclear. Aim of this study was to investigate the prognostic value of ERs and aromatase mRNA-protein concentration in resected NSCLC. Methods: Lung tumor and normal lung were analyzed for expression of ER-α, ER-β and aromatase using a 7900HT Applied Biosystem Fast PCR System. Reverse transcription-polymerase chain reaction (RT-PCR) analysis was performed for the detection of ER and aromatase expression using RNA from lung cancer tissues immediately submerged in RNA Later (Qiagen) after surgery. Aromatase protein was detected with an enzyme-linked immunosorbent assay kit for human aromatase (USCN Life Science). Results: We included 96 patients (80 male/16 female) with resected NSCLC; 51% adenocarcinoma, 43% squamous, 6% others. Pathological stages: 43% I, 33% II, 22% III and 2% IV. Mean expression of ER-α in normal lung was significantly higher than in lung tumor (0.1554 vs. 0.1182, p < 0.0001). Tumoral expression of ER-β inversely correlated with cigarette consumption in current smokers (p=0.046). Patients with the highest values of tumoral ER-α mRNA had better overall survival than those with the lowest values (< p50 =107 weeks >p50 = 139 weeks; p= 0.037). Aromatase protein mean concentration in tumor lung was significantly higher than in normal lung (10.411 vs. 2.125, p

e17522 Background: Adjuvant chemotherapy in operable non small cell lung cancer (NSCLC) has been shown to improve overall survival in many meta-analysis. The use of cisplatin and gemcitabine combination is considered one of the standard regimens for first-line treatment of advanced NSCLC, with mild side effects. The aim of the study was to evaluate the clinical feasibility and toxicity of the cisplatin-gemcitabine combination in adjuvant setting. Methods: Resected NSCLC patients who met criteria for recommending adjuvant chemotherapy received treatment with cisplatin 75 mg/m2 on day 1 and gemcitabine 1.200 mg/m2 on days 1 and 8 of each 21 days cycle. A maximum of four cycles were delivered. Main objectives were clinical feasibility, drug delivery, and efficacy. Results: From November-2004 to July-2011 a total of 89 patients (73 male/16 female, median age 57) were included. Surgery: lobectomy 62.9%, pneumonectomy 29.2%, bilobectomy 5.6%, wedge resection 2.2%. Tumor stages: 19.1% IB, 55.1% II, 23.6% III, 2.2% IV; histology: 48.3% squamous, 43.8 % adenocarcinoma, 3.4 % large cell carcinoma and 4.5% NSCLC not otherwise specified. ECOG 0: 62.9%, ECOG 1: 37.1%. Toxicity: grade 3/4 neutropenia 19.1%/6.7 %; grade 3 febrile neutropenia 3.4%; grade 3/4 anaemia 6.7%/1.1%; grade 3/4 thrombocytopenia 6.7%/4.5%; grade 3 ototoxicity 1.1%; no grade 3/4 nephrotoxicity was reported. There was one toxic death. Compliance: 85.4% of the patients received 4 cycles of the combination chemotherapy. Cisplatin dose intensity was 24.6 mg/m2/wk and gemcitabine dose intensity was 773.6 mg/m2/wk. Median overall survival and progression free survival has not yet been reached. With a median follow up of 36 months, 77.5% of the patients are still alive and 61.8% without documented relapse. Reported 3 year overall survival in patients with ECOG 0 was 82%, and in patients with ECOG 1 54%, being this difference statistically significant. Conclusions: Combination chemotherapy with cisplatin and gemcitabine in adjuvant setting is safe and feasible with a good toxicity profile. Those patients with ECOG 0 benefit most. Our data are similar to those obtained in previously reported trials.

548 Background: Locally advanced rectal carcinoma is associated with high rate of abdomino-perineal amputation. We analyzed a cohort of patients (pts) diagnosed of locally advanced rectal cancer, treated with neoadjuvant chemoradiotherapy (QT-RT) with capecitabine and oxaliplatin (XELOX) followed by four cycles of adjuvant XELOX after surgery. Methods: Patients with locally advanced rectal cancer (T3-T4 and/or N+) were treated with oxaliplatin (50mg/m2 day 1, 8, 22 and 29) and capecitabine (1,650mg/m2 on days 1 to 14 and 22 to 35) combined with pelvic radiotherapy (180 cGy/day; 45Gy in 25 fractions). Surgery was scheduled 4 to 6 weeks after completion QT-RT. Four cycles of adjuvant XELOX were administered (capecitabine 2,000mg/m2 on days 1 to 14 and oxaliplatin 130mg/m2 on day 1) every 3 weeks. Main end points assessed were: rate of sphincter preservation, pathologic complete response (pCR) rate and the feasibility of postoperative chemotherapy. Results: From March 2007 to April 2010, 98 pts with locally advanced rectal cancer were included. M/F: 66/32; ECOG 0/1: 19/79; median age: 64 (38-81); upper/mid/distal rectum: 13/50/35; clinical stage: cT3/N- 9, cT2-T3/N+ 72, cT4/N- 4, cT4/N+ 13. Full dose of preoperative QT-RT was administered in 93 pts (95%). Main toxicities were grade 1/2 neurotoxicity (56/4) and grade 2/3 diarrhea (23/10). After treatment 96 pts underwent surgery. Sphincter preservation, R0 resections and pCR were achieved in 57, 93 pts and 17 (18%) patients, respectively, and 65 pts (66%) received all 4 cycles of adjuvant XELOX. Grade 3/4 toxicities included diarrhea 3/0, vomiting 2/0, neurotoxicity 5/0, hand-foot syndrome 1/0, neutropenia 4/0 and thrombopenia 0/4. 3-year progression-free and overall survival were 66% and 72%, respectively. No toxic deaths were reported. Downstaging in T/N stage was achieved in 53/71 pts (55/74%) respectively. Conclusions: Combination preoperative QT-RT with capecitabine and oxaliplatin is a well tolerated regimen and achieves encouraging rates of pCR, R0 resection, sphincter preservation and tumor downstaging in patients with locally advanced rectal cancer. No significant financial relationships to disclose.

e22216 Background: Early diagnosis in lung cancer could improve its treatment and, subsequently, its prognosis and survival. New proteomic techniques can identify potential diagnostic and prognostic markers. The aim of this study was to find protein markers in bronchial fluid which could enable early diagnosis in NSCLC. Methods: We have included 96 patients with NSCLC diagnosed using bronchoscope (64 scamous/29 adenocarcinoma/3 others) and 49 consecutive patients with non pathological bronchoscope. Bronchial fluid was obtained from each patient and potential protein markers were studied. Bronchial fluid was centrifuged and supernatant proteins were analysed using bidimensional electrophoresis with poliacrilamid gel stained with silver nitrate. Gel was scanned and analysed with Progenesis PG6220 program, which measures intensity of each spot. Resultant intensities in each group of patients (NSCLC/non pathological bronchoscope) were compared using T-Student method. We selected as potential markers those spots with a p value of less than 0.05. We calculated “fold change” of each spot as the ratio between mean intensity in NSCLC bronchoscopes samples and non pathological bronchoscopes samples. Results: We analysed 300 spots in each sample and we found 31 potential markers whose fold-change ranges from 1.49 to 7.41; 15 of the markers were expressed in a higher level in NSCLC samples and the other 16 were expressed in a lower level. Conclusions: We have identified 31 differential protein markers in bronchial fluid among our patients. These results could lead in an early diagnostic test which must be validated in future studies. No significant financial relationships to disclose.

22088 Background: Several genetic changes have been described associated with CRC, but the prognostic significance of most of them remains controversial. We analysed the distribution and the association with survival of some molecular markers in CCR tissues. Methods: From March-04 to June-05 73 patients were included with recent diagnosis of CRC: 53M/20F with a mean age of 70y (46–88). There were 25 rectal tumors (34%) and stage distribution was I:11, IIA:24, IIB:2, IIIA:3, IIIB:9, IIIC:8 and IV:16. During the anatomopathologic exam of the resected specimens, fresh samples were obtained (tumoral tissue and normal tissue), and they were stored in freezer vials at −86°C. In every sample all the following analysis were performed: LOH of the APC and DCC genes, MSI and Kras mutations using different biological techniques, and mutations of the p53 gene (exons 5 to 9) by sequence analysis. Results: LOH of DCC was found in 62% of the tumors, LOH of APC in 46% and MSI in 22% (MSI-LOW in 12 patients and MSI-HIGH in...