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e17545 Background: Androgen receptor-targeted agents Abiraterone and Enzalutamide (Abi/Ez) prolonged overall survival in metastatic castration resistant prostate cancer (mCRPC). Patients with very-low serum testosterone levels seem to have less benefit from these therapies as well as more aggressive prostate cancer. Methods: A retrospective observational cohort study was conducted to evaluate whether a serum testosterone measured at time of start first-line therapy with Abi/Ez is related to overall survival (OS) and time-to-treatment failure (TTF) in mCRPC patients. Kaplan-Meier survival estimates and Cox-regression models were used for time-to-event analyses. The best cut-off for testosterone was defined using Log-rank statistics (Lausen and Schumacher). X² test and Mann-Whitney U-test were applied to compare categorical and continuous variables, respectively. Logistic regression was used to assess characteristics related to serum testosterone levels. Statistical significance was fixed at 0.05. Results: From May 2012 to February 2017, 100 patients were assessed. Median follow-up was 27.8 months (range 2.23 to 68.26). Pts with a high testosterone level ( > 28.2; n = 20) achieved a significantly higher OS (median 66.0 vs 31.9 mo, testosterone > 28.2 HR: 0.206, 95% CI 0.074 to 0.571, p = 0.002) and TTF (median 30.6 vs 11.8 mo, testosterone > 28.2 HR: 0.408, 95%CI 0.219 to 0.762, p = 0.005) than pts with a low serum testosterone level ( < 28.2; n = 80), regardless of receiving therapy with either Abi (n = 69) or Ez (n = 31). Pts with a higher testosterone level were younger (median 67.7 vs 73.6 years; p = 0.026), had a higher body mass index (BMI) (28.5 vs 25.9, p = 0.023) and a lower PSA at start Abi/Ez (12 vs 26, p = 0.031) than pts with lower values. Age (OR 0.93, 95%CI 0.8 to 0.9, p = 0.021), BMI (OR 1.21, 95%CI 1.1 to 1.4, p = 0.006) and baseline PSA (OR 1.2, 95%CI 1.03 to 1.4, p = 0.020) were significantly associated with testosterone > 28.2. After 4 months of Abi/Ez treatment, PSA decrease > 50% of baseline was seen more frequently in high testosterone levels group than in low testosterone levels pts (90% vs 57.5% of pts, respectively, p = 0.007). Conclusions: Pts with high levels of testosterone ( > 28.2) achieved a better OS and TTF when treated with Abi/Ez in first-line mCRPC than those with low levels. Testosterone can be considered a prognostic and predictive biomarker in this scenario, and could be used in treatment decision for this population.

e17538 Background: mCRPC phenotype involves androgen-receptor signalling mechanisms that support the use of abiraterone/enzalutamide (Abi/Ez). These therapies improve overall survival (OS) and quality-of-life, with a favourable safety profile. There is no validated data defining the best drug or sequence to be used. Methods: A retrospective study evaluated if a nomogram helps the decision-making of first-line for mCRPC. The nomogram evaluated time-to-treatment failure (TTF) from Abi/Ez and Docetaxel (Doc) treatment and had C-índex of 0.726. Time from start of androgen deprivation therapy to Abi/Ez or Doc, pain, Gleason score, testosterone and the lowest PSA in castration-sensitive scenario were analysed. All patients (pts) in Doc group used second-line Abi/Ez. The outcomes were: to evaluate whether the nomogram scores were associated with TTF/OS in Abi/Ez population; to compare OS between Abi/Ez and Doc poor prognostic (PP) groups based on the nomogram scores. Kaplan-Meier and Cox-regression models were used for time-to-event analyses. The cut-off was defined by Log-Rank. Statistical significance was fixed at 0.05. Results: From May/12 to Feb/20, 123 pts were assessed (79 received first-line Abi/Ez and 44 Doc). Median follow-up was 25.7 months (1.6 to 93.7). Nomogram scores based on Abi/Ez treatment (medium score of 65, 0-225) were statistically associated with OS (HR 1.02, 95% CI 1.01-1.02, p < 0.001) and TTF (HR 1.02, 95% CI 1.02-1.03, p < 0.001). 79 pts who received Abi/Enz were stratified as having good (GP) (score < 46), intermediate (IP) (score 46-112) and PP (score > 112), and it was associated with 75%, 25-75% and 25% probability to 1-year free from treatment failure, respectively. Pts with GP (n = 24) had a median TTF of 29.8m (15.4-44.2), IP (n = 44) 9.8m (4.1-15.4) and PP (n = 11), 4m (2.5-5.5), p = < 0.001. Pts with GP achieved higher TTF than IP (HR 2.3 95% CI 1.3-4.2 p = 0.005) and PP (HR 8.9 95% CI 3.8-20.6 p < 0.001). The results were similar for OS, once the median for GP was 54.0m (30.5-77.6); IP 34.8m (32.2-37.5); and PP 13.6m (9.3-17.9), p = 0.023 (GP versus IP: HR 2.1 95% CI 1.01-4.4 p = 0.046; GP vs PP: HR 3.6 95%CI 1.4-9.6 p = 0.011). Pts with a higher score and PP from Abi/Ez group were compared with Doc pts at first-line (n = 44), showing worse OS (HR 2.4 95%CI 1.03-5.6 p = 0.042) when treated with Abi/Ez. Conclusions: The nomograns scores showed good correlation with TTF/OS. In PP groups, treatment with Doc was associated with better OS than Abi/Ez, suggesting a possible tool on the first-line decision making.

202 Background: Survival outcomes for metastatic castration resistant prostate cancer (mCRPC) patients (pts) have greatly improved following the approval of Docetaxel and abiraterone(Abi)/enzalutamide(Ez). However, it is not clear who is likely to benefit more from these therapies in real life clinical practice. Methods: A retrospective cohort study was performed with mCRPC pts treated with Abi/Ez in pre-Docetaxel setting. Primary endpoint: to identify predictive biomarkers of long time to treatment failure (TTF), develop a nomogram and convert it into a web app. Secondary endpoint: to correlate biomarkers with overall survival (OS). Kaplan Meier survival estimates and Cox Regression models were used for time-to-event analyses. Statistical analysis was made with R software. All statistical tests were two-sided and statistical significance was fixed at 0.05. Results: From May2012 to October2017, 117 pts were assessed, 81 received Abi and 36 Ez. Median follow-up of 21 months (mo), estimated median TTF was 12.8mo (95%CI 9.98-15.7) for the total population. Predictive biomarkers for TTF included in the first nomogram model were time from start of androgen deprivation therapy (tADT) to start of Abi/Ez, pain at baseline, Gleason score, baseline testosterone and lower PSA nadir in castration sensitive prostate cancer (CSPC). The second nomogram model included pain and Gleason plus neutrophil counts, tADT to CRPC and baseline PSA at CRPC. C-index: 0.726 and 0.731 respectively, providing a reliable prediction of long-term benefit with Abi/Ez in this setting. All these characteristics were significantly associated with OS. Conclusions: The two nomogram achieved a good internal validation and can work as a tool to the decision-making process of the best strategy to first-line therapy in mCRPC pts.[Table: see text]

e16540 Background: Metastatic castration-resistant prostate cancer (mCRPC) phenotype involves androgen-receptor signalling mechanisms that support the use of enzalutamide (EZ) and abiraterone (Abi). These therapies improve overall survival (OS) and quality-of-life, with a favourable safety profile. There is no validated data defining the best drug or sequence to be used. Methods: A retrospective cohort of mCRPC patients (pts) was analysed at AC Camargo Cancer Center. The primary objective was to compare progression-free survival (PFS) and OS in patients treated with EZ or Abi as first line (docetaxel naïve pts). Kaplan-Meier, Log-Rank Test and Cox Regression were used for survival analysis. To address unbalanced characteristics between the two treatment groups treatment efficacy was compared in a propensity score matched cohort. Results: From May, 2002 to September, 2017, 120 pts were treated with Abi (84%) or EZ (36%). Median follow-up was 21.2 months. Median age at diagnosis was 66 (48-84), the majority were Gleason score 7 (34%) and median baseline PSA was 14. Median PFS was 17.4 months in EZ and 10.6 months in Abi group (HR = 0.65; 95%CI: 0.39-1.10; p = 0.11). Median OS was not reached and 31.6 months for EZ and Abi, respectively (HR = 0.60; 95%CI: 0.27-1.36; p = 0.22). EZ was associated with a better PSA response in the first 4 months of treatment (p < 0.001). Independent prognostic factors for worse OS and PFS were ECOG ≥ 1, treatment toxicity ≥ G1 and lower PSA doubling time before treatment and for better OS and PFS were PSA response in the first 4 months and alkaline phosphatase and lactate dehydrogenase response at any time. In the propensity score matched cohort including 72 patients PFS was better in EZ group (HR = 0.36; 95%CI: 0.20-0.64; p < 0.001) but there was no difference in OS (HR = 0.66; 95%CI: 0.27-1.63; p = 0.37). Conclusions: EZ was associated with prolonged PFS and better PSA response, with no OS improvement when compared with Abi for mCRPC before docetaxel, in a propensity score matched analysis.

588 Background: Data on 1st line treatment with tyrosine kinase inhibitors (TKI) in elderly patients(pts) with metastatic renal cell carcinoma (mRCC) is controversial, and there is rationale for inferior outcomes due to multiple comorbidities and polypharmacy. We aimed to compare the efficacy and safety between the elderly (E) and non-elderly (NE) in 1st line therapy, and to explore factors influencing survival and toxicity. Methods: We retrospectively reviewed all medical records of mRCC pts treated with 1st line TKI at our institution (2007 – 2018). Categorial variables were compared by Fisher’s exact test and continuous, Mann–Whitney. Survival was estimated by Kaplan-Maier method, prognostic factors adjusted by Cox regression model. Results: From 171 eligible pts, 64 (37.4%) had ≥ 65years old, with median age of 70.5 for E and 56 for NE. In both groups most were male, had clear cell histology, good/intermediate IMDC risk, prior nephrectomy and > 1 metastatic (mets) site. Sites of mets were evenly distributed. E pts had more diabetes (35.9 vs16.8%, p.009) , hypertension (67.2 vs 46.7%, p.01), cardiovascular disease (15.6 vs 6.5%, p.06), moderate/severe renal dysfunction (62.5 vs 28.8%, p < 0001), high Charlson Comorbidities Index (CCI≥3, 48.4% vs 20.8%, p < .0001), polypharmacy (34.4 vs15.9%, p.008), worst ECOG (≥2, 28.2 vs 12.3%, p.01), and a trend to worst nutrition (weight loss 35.9 vs 22.5%, p.07). Sunitinib was used for 60.9 vs 79.4%, Pazopanib 35.9 vs 18.7%, Sorafenib 3.1 vs 1.9%, comparing E and NE pts. Median overall survival (OS) and progression free survival (PFS) was 23.7 vs 25.6m (p.8) and 9.3 vs 10.9m (p.7), respectively. After adjusting for prognostic factors, age continues not to influence OS (HR 1.17, IC95 0.77-1.78, p.45). Grade (G) 3/4 toxicity was seen in 59.4 vs 53.3%, dose reduction in 54.7 vs 53.3% and suspension due to toxicity 25 vs 13.3% for E and NE, respectively. In the E, none of the comorbidities, CCI or polypharmacy impaired OS or toxicity, but pts using sunitinibe had greater G3/4 toxicity than with pazopanib (71.8 vs 39.1%, p.02). Conclusions: Elderly had similar outcomes to NE pts, despite greater comorbidities and polypharmacy, hence efficacious therapies shouldn’t avoided. Pazopanib seems to be safer in this subgroup.

644 Background: The introduction of tyrosine kinase inhibitors (TKI) and recently immunotherapy has brought major survival benefits for metastatic renal cancer (mRCC) patients (pts). In Brazil, there is no approved 2nd line treatment for mRCC in the Public Health System (PHS). Our center is unique, because it provides care for both PHS and Private System (PrS) population, enabling us to make the comparison of overall survival (OS) of these pts. Methods: We retrospectively reviewed medical records of all mRCC pts treated with 1st line TKI at our service from 2007 to 2018. Categorial variables were compared by Fisher’s exact test and continuous by Mann–Whitney. Survival was estimated by Kaplan-Maier method, prognostic factors adjusted by Cox regression model. Results: 171 pts were eligible, 37 (21.6%) PHS and 134 (78.4%) PrS pts. Between the two groups, there was no differences in age, gender, number and sites of metastasis (mets). PHS pts had worst ECOG (≥2, in 35.1 vs 13.5%, p .007), a trend towards more poor IMDC risk (IMDC favorable 16.2 vs 26.6%, intermediate 51.4 vs 57%, poor 32.4 vs 16.4%, p.09), had less nephrectomies (73 vs 92.5%, p.008) and more non clear cell histology (32.4 vs 12.7%, p.01). Median lines of therapy were 1 for PHS vs 2 for PrS pts (p.03). Sunitinib was the 1st line agent for 91.9 vs 67.2%, and pazopanib 8.1 vs 29.9%, of the PHS and PrS pts, respectively. Median time from diagnosis of mets to treatment start was 2.29 vs 1.79 m (p.59). Median OS was 16.5 vs 26.5 m (p.0002) and progression free survival, 8.4 vs 11 m (p.01), for the PHS vs PrS. On multivariate analysis, after adjusting for factors that were present before the beginning of treatment and were statistically significant for OS in the univariate model, PHS pts still had higher risk of death (HR 1.85, IC 95 1.2-2.9, p.01), probably due to having received fewer lines of therapy (≥2 lines of therapy vs 1, HR 0.51, IC95 0.4-0.7, p .001). Conclusions: Brazilian PHS pts had significant worse OS compared to PrS pts, in part due to less access to drugs. Access to cancer drugs is a challenge worldwide, and in Brazil effort has to be done to change this reality.

e22027Background: Elderly population requires special attention to chemotherapy risks and comorbidities, which may limit the capacity to deliver optimal cancer care. We aimed to describe the featur...

335 Background: Despite therapeutic progress in the management of advanced prostate cancer during the past decade, metastatic castration-resistant prostate cancer (mCRPC) remains a disease that causes substantial morbidity and mortality worldwide. A greater understanding of biomarkers permits to guide personalized therapy and can inform clinical trials tailored to men most likely to derive benefit from a given therapy. We aimed to identify prognostic biomarker candidates of Abiraterone Acetate (AA) response in mCRPC patients. Methods: A retrospective clinical records analysis of mCRPC patients treated with AA at A. C. Camargo Cancer Center between January 2012 to December 2016 was realized. Baseline clinical parameters evaluated were: Age, ECOG performance status, metastatic disease at diagnosis, Gleason score, prostate-specific antigen (PSA), Neuroendocrine differentiation, duration of previous androgen-deprivation therapy (ADT), PSA doubling-time (PSAdt), Timing of AA (chemotherapy-naïve or not), PSA response and alkaline phosphatase (ALP) level. Data were analyzed in relation to progression free survival (PFS) stratified by each parameter. Results: We included 141 patients with mCRPC treated with AA to correlate prognostic biomarkers with PFS. Five risk factors individually were associated with poor prognosis and a high risk to progression during AA therapy and were included in the final model: ECOG ≥2 [Relative risk (RR) = 1.52]; PSAdt < 3 months (RR = 2.7); PSA response ( < 50% decline) (RR = 3.03); AA post docetaxel (RR = 1.63) and duration of previous ADT < 12 months (RR = 1.52). The probability to progression free survival in patients receiving AA calculated in 1, 2 and 3 years, was 39,2%, 15,2% and 6,2%, respectively. Conclusions: This analysis identified five factors used to model survival in mCRPC patients treat with AA in our institutional series. Whereas no biomarker has been validated as a predictor of response to a therapy in mCRPC, these those potential clinical biomarkers may help clinicians in distinguishing patients with mCRPC who would obtain the best survival benefit from AA treatment.

e566 Background: Cabazitaxel is an approved second-line treatment in metastatic castration-resistant prostate cancer therapy with a significant survival benefit compared to mitoxantrone. There are few data about cabazitaxel's toxicity in patients not selected. Objective: Evaluate the efficacy and toxicity among younger (< 70 years) and older (> 70 years) population. Methods: We selected 62 patients with metastatic castration resistant prostate cancer treated in AC Camargo Cancer Center from January 2011 to July 2015. 58 patients fulfilled the study criteria: diagnosis of adenocarcinoma prostate cancer, at least one session of cabazitaxel, with more than 18 years old. Results: We had in our sample 33 patients less than 70 years and 25 over 70 years. The initial dose of cabazitaxel was 25 mg/m2 in 75.8% of patients < 70 years and 52% in > 70 years patients. The use of granulocytics growing factor was observed in 64% of the older patients and more than 80% of this indication was in primary profilaxis. There were five deaths associated to the treatment, 4 lung infection and 1 kidney failure. The worst grade of adverse event up to 30 days after last administration was grade 2, including hematological and non-hematological events, both with no statistical significance between the groups. However, there was a greater number of febrile neutropenia in elderly people (28% versus 6%) with a statistical significance between < 70 e > 70 years (p 0.031). OS was 13,7 months (IC 9.16 – 18.2) and PFS was 4,6 months (IC 3.43 – 5.73). OS among the two groups was lower in < 70 years reaching 9,3 months (IC 2.06-16.5) versus 22.2 months (IC 4.86-39.50 ), p= 0.073. As well, PFS in < 70 years was 3.8 months (IC 3.26-4.36) versus 4.6 months (IC 2.4-14.1), p = 0.02. Conclusions: Treatment with cabazitaxel is tolerable, with manageable adverse events in a real-world patient population. In our cohort, elderly population (> 70 years) had more febrile neutropenia, suggesting dose reduction in this population, indication of granulocytic growing factor as primary profilaxis, close monitoring, and adequate patient counseling.

525 Background: TKI have improved the prognosis of patients with mRCC, but rarely lead to durable response. Predictive clinical biomarkers have been studied in the last few years, but most are still controversial. Objective: Identify the role of the clinical and laboratorial biomarkers of prognosis and outcome in mRCC. Methods: A retrospective study with mRCC treated with VEGFR-TKi in first line at A C Camargo Cancer Center (Jan-07 to Apr-16). Studied biomarkers: induced hypertension (HTN), acquiried hypothyroidism, proteinuria, and neutrophil to lymphocyte ratio (NLR). Data were analized in relation to progression free survival (PFS), overall survival (OS), and objetive response rate (ORR) stratified by each marker. Results: We included 94 patients (76.6% sunitinib, 21.3% pazopanib, 2.1% sorafenib). Overall, ORR to VEGFR-TKI was 41.1%; clinical benefit rate was 82.1% (43% Stable disease). Median PFS was 11.4 months (mo)(CI 95% 8.7-14.1) and median OS was 32.1 mo(CI 95% 23.4-40.8). HTN was numerically associated with longer PFS (20.1 vs. 8.2 mo) and OS (37.2 vs. 28.2 mo), but not statistically significant. Only high level TSH (>10) was associated with significant longer PFS and OS, p=0.001 and paweek) predicted poor OS (9.6 vs 33.9 mo). A “NLR conversion” (before ≥3, turn to

e21522Background: Education in GO is of extreme importance, due to epidemiology and since aging is a important risk factor for cancer. The oncology community has to deal with how to educate the wor...

e21520Background: Colorectal cancer is the third most frequent cancer in men and women, corresponding about 9% of tumors in both sexes. Regarding mortality rate, it also ranks as the third one. Esp...

e22036 Background: CTCs have demonstrated promising results as a prognostic tool in patients with mCCR. The purpose of our study was to prospectively correlate CTCs counting with clinical outcomes ...

e22020 Background: The presence of circulating tumor cells (CTCs) is a necessary process for cancer progression. In fact, its detection has surged as a potential biomarker for clinical response in ...

e22021 Background: Pancreatic cancer has a high mortality rate. Given the aggressiveness of the disease, we still lack molecular markers for predicting prognosis. Circulating tumor cells (CTCs) hav...

e21520 Background: TACE local palliative therapy has been increasingly employed in clinical practice for managing patients (pts) harboring chemotherapy (CT) refractory RMAMT. Relief of symptoms, e....

9549 Background: Ageing is a global phenomenon, also in Brazil. That shift in demographics has huge impact in healthcare. Although still emerging in developing nations, there is no major national i...

e22016 Background: CRC is the third most prevalent cancer worldwide. New prognostic markers are needed to identify patients with worse prognosis and to aid the development of more effective therape...

e18078 Background: First-line treatment of advanced nonsquamous non-small cell lung cancer (NSCLC) with platinum-based doublets, including pemetrexed (P) or bevacizumab (B), has achieved more than 12 months of survival. At the moment, there are no phase III head-to-head comparisons of these combinations. Methods: We retrospectively analyzed, from 05/2007 to 02/2011, in a single institution, all pts with stage IIIB or IV nonsquamous NSCLC treated with B or P combined with platinum compounds in first-line treatment to determine differences in OS, PFS, ORR and toxicity. We performed multivariate analysis to identify prognostic factors for survival. Results: Of the 82 pts included, 40 pts (48,8%) received carboplatin/paclitaxel or cisplatin/gemcitabine combined with B (BEV group), while 42 pts (51,2%) received cisplatin or carboplatin combined with P (PEM group). BEV had significantly fewer pts with age > 70 years (p=0,01) and CNS metastases (p

466 Background: Sunitinib, a multitarget tyrosine-kinase inhibitor, has become a standard of care for first-line low and intermediate risk metastatic renal cell carcinoma (mRCC). Sunitinib-induced hypothyroidism and hypertension have been correlated with better outcomes in those patients. Methods: Fifty patients with mRCC, treated in the first-line with sunitinib, were retrospective analyzed at one brazilian institution, for overall survival (OS), progression free survival (PFS), overall response rate (ORR) and toxicity. We evaluated clinical and laboratory parameters, such as hypothyroidism (TSH level > 5,5 mIU/L) and hypertension, to identify prognostic factors. Results: The median age of patients was 58 years (range: 37-73 years), 82% were male, 54% were ECOG 0 or 1, and 76% were classified in low or intermediate risk. Nefrectomy was performed in 96% of cases. Lung and bone were the most common sites of metastases. The incidence of hypothyroidism and hypertension during treatment were 40% and 34%, respectively. ORR for the entire population was 40% and it was statistically superior in patients that developed hypothyroidism during treatment (90% vs. 20%; p Conclusions: Efficacy in survival and toxicity profile of sunitinib in first-line treatment of mRCC in patients out of clinical trials were comparable to prior studies. Hypothyroidism, MSKCC criteria and ECOG were independent prognostic factors for survival.

e18067 Background: The combination of pemetrexed plus cisplatin (PC) was recently approved in the initial treatment of advanced stage non-small cell lung cancer (NSCLC). Studies reported comparable...

109 Background: Radical prostatectomy (RP) is the treatment of choice for patients with localized prostate cancer (PC). Previously, surgery was applied to patients with good clinical condition and aged Methods: The main objective of this cohort study is to evaluate clinical evolution according to localized PC submitted to RP in patients in extreme ages. We analysed age, PSA, ASA classification,pathological stages, Gleason scores, urinary continence, D'Amico risk classification (group 1:low; 2:intermediate; 3:high), biochemical recurrence and clinical progression. Descriptive analysis of the population was performed. Fisher's exact test or chi-square tests were used to evaluate association between clinicopathologic characteristics.Biochemical recurrence was defined by PSA more than 0.2 ng/mL post-RP. Results: In 262 patients, mean age was 63.4 years (SD 12.4; range: 41 to 83). In D'Amico's group 1 there were 96 patients (37.2%) with=70. The mean follow-up in group 1 was 55.9 months (SD 41.7) and group 2 was 53.6 (SD 41.4), p=0.6770. Biochemical relapse occurred in 21 patients (15.44%) in D'Amico risk group 1, 27 (36.99%) in group 2 and 29 (59.18%) in group 3 (p0.05). Clinical progression occurred in 2 patients (1.47%) in D'Amico risk group 1, in 3 patients (4.11%) in group 2 and in 3 patients (6.11%) in group 3 (p=0.230). There was no significant difference in relation to time to biochemical recurrence, as well as biochemical relapse rate and progression of this disease among the groups. Younger patients (in group 1) recovered earlier from urinary incontinence, as well as most were continent in final follow-up. Conclusions: Based on our results, the differences in younger or more aged patients with PC are not related to pathological variables, or rates of biochemical recurrence and clinical disease, but better preoperative clinical features and better recovery of urinary continence are seen in younger patients. No significant financial relationships to disclose.

406 Background: Pheochromocytomas/paragangliomas (PC/PG) are rare diseases, but may be responsible for lower quality of life to patients,if progressive or metastatic when malignant. Recently, some benefit has been reported with the use of palliative tyrosine-kinase inhibitors (TKI),such as sunitinib, already approved for kidney cancer. Methods: Review of litearure with a Medline search for PC/PG and suninitib, due to the need to treat a patient with progressive advanced malignant PC, refractory to chemotherapy (CT). Our plan is to contribute reporting safety and efficacy in an additional PC patient. Results: We expose the data found in a table below,with most relevant features related to PC/PG treatments and TKI. Conclusions: Sunitinib as a treatment option to refractory PC/PG may be active and should be further evaluated in this context. A phase II trial is under way (SNIPP; NTC00843037). Other therapies may be evaluated, such as sorafenib, bevacizumab, temozolomide, temsirolimus, thalidomide, and other potential molecular strategies, also with other small molecules, target therapies, and antiangiogenic factors. We plan to follow the reported PC patient and show additional data in the near future. [Table: see text] No significant financial relationships to disclose.

608 Background: Distress is psychological suffering, and DT is its efficient screening scale. Objectives: 1) Translate,culturally adapt,and validate DT to Brazilian Portuguese. 2) Evaluate distress in gastrointestinal cancer patients. Methods: Inclusion: >=200 patients with advanced gastrointestinal cancer, age>=18. Exclusion criteria: uncontrolled psychiatric disorder, not knowing diagnosis, difficulty in understanding informed consent. They answered Brazilian Portuguese translated version of DT, and Hospital Anxiety and Depression Scale (HADS). Obtained data used to calculate validity and reliability of the DT (cutoff Results: Preliminary relevant results (n=85) shown in the table. Conclusions: Data confirm importance of emotional assistance to patients with oncologic diseases and need of interdisciplinary palliative care. We plan to present updated data in ASCO GI Meeting, and be able to show validation of DT to Brazilian Portuguese. [Table: see text] [Table: see text]

e20524 Background: Desmoids are a rare, slow growing, soft-tissue tumors with a locally agressive behavior. These tumors are often unresectable at diagnosis and there is no standard first line chemotherapy. Methods: We present a retrospective review of the outcomes of patients treated with the same regimen comprised by doxorubicin (DOX) 20mg/m2 daily plus dacarbazine (DTIC) 150 mg/m2 daily over four days of drip infusions at a single institution from June 2005 to December 2009. Results: A total of five patients were analyzed. All of them had a diagnosis of familial adenomatous polyposis (FAP). There were three men (60%) and the median age at diagnosis was 30 (range, 18 to 38 years). Four patients had intrabdominal tumors (80%) and were considered unresectable. The protocol DOX plus DTIC was the first line therapy for them. The remaining patient had tumor in abdominal wall and it was resected at diagnosis. This patient received tamoxifen to local relapse that occurred thirty-two months after surgery. In th...

19536 Background: Neoplastic lymphangitis, or lymphangitis carcinomatosa, is a rare and distressing form of lung metastasis, for which symptom improvement is strongly necessary. Since measuring quality of life is an important step toward improving symptom management in cancer patients, and dyspnea in pulmonary lymphangitis is a complex syndrome in end-of-life care, we focused on evaluating a cohort of those individuals. Methods: 52 consecutive patients with neoplastic pulmonary lymphangitis (NPL) were prospectivelly followed in 3 services, with quality of life (QoL) evaluation also, using Medical Outcomes Study 36-item Short-Form Health Survey (SF- 36) and Saint George's Respiratory Questionnaire (SGRQ). Results: 65% (34) of patients were female; age ranged from 37 to 84 years (median: 60). Primary tumor sites were: 28 lung (54%), 18 breast (35%), 5 digestive (9%) and 1 bone cancer. Histological findings were of adenocarcinoma in most cases (71%). Karnofsky performance scale ranged from 10 to 90% (median: 60%); 52% (27) patients had other comorbidities (Charlson index ranged from 6–10; median 7); 48% (25) were previous smokers; hemoglobin levels ranged from 4.9 to 16.7 g/dL (median: 12). We also evaluated 33 patients with echocardiography, and 13 (43%) of them had signs of associated pulmonary hypertension; ejection fraction ranged from 46 to 83% (median: 69%); diastolic dysfunction was present in 22 and pericardial effusion in 10 patients. At accrual, median QoL scores were of: 32% (range: 0–84%) for SF-36 (scale with 0 worst) and 66% (range: 0–100%) for SGRQ (scale with 100% worst). Treatment is showed in a table below. Median survival was of 4 months (range: 0.2–40+ months); 22 (42%) of the patients had an unusual longer survival of more than 6 months, still showing good QoL scores. Conclusions: Despite the fact that QoL is generally poor and survival is short for patients with NPL, some patients may have longer survival time and some improvement is possible with active palliative care. [Table: see text] No significant financial relationships to disclose.