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106 Background: AML is a disease of older adults (median age 67 years). Although standard AML treatment is intravenous (IV) chemotherapy, availability of oral anti-cancer medications has increased , providing benefits and risks to patients. Patients prefer their convenience, absence of IV infusions, potential for fewer clinic visits, and increased subjective feeling of control over their disease. Poor adherence can increase toxicity risk and compromise treatment effectiveness. We aim to identify barriers to adherence to oral medications in patients with AML and proposed solutions for improvements. Methods: Following IRB approval, patients with AML and their caregivers were recruited to participate in focus groups. An experienced moderator conducted the groups using an interview guide developed by AML experts. Participants received gift cards for their participation. Sessions were digitally recorded, transcribed verbatim, and analyzed for thematic content using Dedoose qualitative software. Results: 11 patients (5 65 years) and 4 caregivers participated in sessions lasting 60-75 minutes. Three central themes emerged: medication adherence challenges, managing an oral adherence plan, and strategies to improve oral adherence. Adherence challenges: number and size of pills, different directions, cost, availability, and side effects. An adherence plan was recommended: written schedules, take medications around meals, and use of pillboxes and alarms. Main sources of information: health care team and bottle directions. Recommendations for providing adherence assistance included better instructions, assistance with scheduling, making pills smaller, and consistency in packaging. Conclusions: Patients are an important source of insight into barriers and solutions to oral medication adherence. These responses were used to develop a survey to be administered to 100 patients with AML. Results will inform development of an intervention to improve oral medication adherence in the AML population.

105 Background: The incidence of AML is increasing, in part due to an aging population. Amid established intravenous (IV) or subcutaneous chemotherapies , recent drug approvals have ushered in an era of oral medication (OM) approaches to treating AML, shifting the burden of daily adherence from clinicians to patients. We aimed to identify and summarize adherence to oral therapy in this population. Methods: Our mixed methods study design used focus groups (FG) and patient surveys. After IRB approval, 11 patients and 4 caregivers participated in 4 focus groups. Results were used to develop a 37-item OM adherence needs assessment. Subsequently, AML patients were recruited and consented at three cancer centers to complete surveys (online, at the clinic, hospital, or from home). Results: 100 patients completed the OM survey. Most were male (62%), racial/ethnic diversity (33%), < 65 years (59%), and college-educated (52%). The to be taken was the most frequent and troublesome challenge. Loss of appetite was the most commonly reported and problematic side effect. Although half of the patients stated, “no side effect would cause them to stop taking OM”, another 25% indicated nausea would cause non-adherence. The best strategy to support taking OM was to make it part of the daily routine. Directions for taking OM were most commonly found on medication bottles or received from the health care team (HCT); patients felt HCTs were the best source of directions. Nearly 1/3 of patients indicated they skip the OM dose altogether when they forget to take it. When asked what would help improve adherence: smaller pills, easier packaging, and scheduling assistance were most frequently reported. Older individuals (>65 years) had a slightly more positive attitude towards oral medication (p =.51). Younger patients (

2087 Background: This study evaluated the safety and immune responses to an autologous dendritic cell vaccine pulsed with class I peptides from tumor associated antigens (TAA) expressed on gliomas and overexpressed in their cancer stem cell population (ICT-107). These TAA epitodes AIM-2. TRP-2, HER2 and AIM-2, are also overexpressed on glioblastoma multiforme (GBM) cancer stem cells. Methods: TAA epitopes included HER2, TRP-2, gp100, MAGE-1, IL13Rα2, and AIM-2. HLA-A1 and/or HLA-A2 positive glioblastoma (GBM) patients with gross total resection were eligible. Mononuclear cells from leukapheresis were differentiated into dendritic cells, pulsed with TAA peptides, and administered intradermally three times at two-week intervals in the axilla region after a standard treatment with concurrent temozolomide (TMZ) and radiation therapy for newly diagnosed (ND-GBM). Results: Twenty-one patients were enrolled with 17 ND-GBM and three recurrent GBM patients and one brainstem glioma. Immune response data on 15 newly diagnosed patients showed 33% responders. TAA expression by qRT-PCR showed all patient tumors expressed at least three TAA with 75% expressing all six. Correlations of increased PFS and quantitative expression of MAGE1, AIM-2, gp100 and HER2 were observed. A decrease or absence of CD133 expression was seen in five patients who underwent a second resection. As of February 1, 2012, six of 16 ND-GBM patients showed no evidence of tumor recurrence (44-63 months). Median progressive free survival (PFS) in newly diagnosed patients was 16.9 months with a two-year PFS rate was 43.8% (95%CI,19.8-66.0 ). The median overall survival rate (OS) was 38.4 months and a two-year OS was 80.3% (95%CI,58.6-96.7). Conclusions: Expression of four ICT-107 targeted antigens in the pre-vaccine tumors correlated with prolonged overall survival and PFS in ND-GBM patients. The goal of targeting tumor antigens highly expressed on glioblastoma cancer stem cells is supported by the observation of decreased or absent CD133 expression in the recurrent areas of gadolinium-enhanced tumor.

2097 Background: Active immunotherapy offers the potential for high tumor-specific toxicity and sustained tumoricidal activity. We therefore have developed this protocol to exploit the most current...