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Background: Patients with advanced high-grade serous ovarian cancer (HGSOC) have a poor prognosis. Hence there have been attempts to find prognostic markers to identify patients with higher risk of relapse. Radiomic features have been proved as an emerging tool in different neoplasms. However, in ovarian cancer very few studies have investigated the role of metabolic parameters at diagnosis. The aim of our work was to assess the prognostic value of pretreatment 18F-FDG PET/CT quantitative metabolic parameters in patients with advanced high-grade serous ovarian cancer. A review of 47 patients diagnosed of advanced high grade serous ovarian cancer between 2016 and 2020 in our center was performed, evaluating pretreatment 18F-FDG-PET/CT metabolic parameters: maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG) and metabolic tumoral volume (MTV). The images were evaluated and quantitative parameters were obtained semiautomatically classifying VOIs as target, non target and total according to SULmax. Clinical data of relapse/progression and final status (exitus/alive) was collected. Disease-free survival (DFS) and overall survival (OS) were calculated. Optimal cutoff values with receiver operating characteristic curve/median values were used. Correlation between metabolic parameters and DFS/OS was made using univariate and survival-curves analysis. Results: Median DFS was 18 months (2.55-55) and OS 33.6 months (2.5-92). MTV total, MTV target, TLG total and TLG target were significantly associated with DFS (p 0.005, 0.011, 0.046 and 0.042 respectively). The survival-curves analysis showed a significant difference of DSF in patients with MTV total >427.8 cm3 and MTV target >434 cm3 versus patients with lower values (18.8 and 15.6 months vs 31 and 30 months, p 0.027 and 0.017 respectively). Patients with higher TLG total and TLG target values tended to have worse DSF, although not statistically significant (p 0.263 and 0.317, respectively). None correlation was found with OS. Conclusion: Pretreatment metabolic parameters MTV total and MTV target have prognostic value in patients with high-grade advanced serous ovarian cancer, being able to predict higher risk of relapse.

Introduction: obesity and DM-2 decrease trabecular bone mass even though cortical bone increase may coexist. Another common finding is presarcopenia/sarcopenia, possibly due to insulin resistance and oxidative stress. It remains to be clarified whether these changes depend on either early (prediabetes) or late (established DM) glucidic alterations, or rather they would be linked predominantly by excess fat mass in obese patients Objectives: to evaluate and compare body composition parameters (bone, muscle and adipose-visceral tissues) in overweight/obese patients grouped by whether or not they present glucidic metabolism disorders. Analyze if there are differences between FRAX vs FRAX adjusted to trabecular bone score TBS in both groups. Methods: sixteen overweight/obese patients were included. In all of them clinical-anthropometric evaluation, bioimpedance, DXA and analysis were performed. They were grouped by glycemia as: a) normal; b) impaired fasting glycemia (IFG); and c) DM-2. Non-parametric tests were performed. Results: no statistically significant differences were found among groups regarding bone microarchitecture, muscle mass or visceral fat. The IFG group showed the highest average muscle mass and visceral fat. Then, patients were reclassified in only two groups, normal glycemia in group 1 and altered glycemia in group 2 (IFG and DM-2), and statistically significant differences were found at the expense of lower trabecular bone microarchitecture in group 2 (p = 0.031) and phosphorus lower levels in group 1 (p = 0.042). Conclusions: in our study, the bone microarchitecture is impaired in patients with altered glycemia and obesity. Studies with larger sample size are needed to establish when these changes take place in the natural evolution of diabetes.Introducción: la obesidad y la diabetes mellitus tipo 2 (DM-2) disminuyen el entramado trabecular óseo aun cuando puede coexistir aumento del hueso cortical. Otro hallazgo en común es la presarcopenia/sarcopenia secundaria posiblemente a la insulinorresistencia y el estrés oxidativo. Queda por aclarar si estos cambios dependen fundamentalmente de las alteraciones glucídicas precoces (pre DM-2) o tardías (DM-2 establecida), o más bien estarían vinculadas de forma predominante por el exceso de masa grasa en individuos obesos. Objetivos: evaluar y comparar parámetros de composición corporal (compartimentos óseo, muscular y adiposo-visceral) en pacientes con sobrepeso/obesidad agrupados según presenten o no alteraciones glucídicas. Analizar si existen diferencias comparando FRAX vs. FRAX ajustado a trabecular bone score (TBS) en ambos grupos. Métodos: se incluyeron 16 pacientes con sobrepeso/obesidad. A todos se les realizó evaluación clínica-antropométrica, bioimpedanciometría, absorciometría de rayos X de energía dual o densitometría ósea (DXA) y análisis, y se les agrupó según glucemia en tres grupos: a) normal; b) glucemia basal alterada en ayunas (GBA); y c) DM-2. Para el análisis estadístico empleamos pruebas no paramétricas. Resultados: no se encontraron diferencias estadísticamente significativas en los grupos respecto a microarquitectura ósea, masa muscular o grasa visceral. El grupo GBA mostró el mayor promedio de masa muscular y grasa visceral. Tras reclasificar en solo dos grupos, glucemia normal en el grupo 1 y glucemia alterada en el grupo 2 (GBA y DM-2), encontramos diferencias estadísticamente significativas con detrimento de la microarquitectura ósea trabecular en el grupo 2 (p = 0,031) y cifras de fósforo con niveles inferiores en el grupo 1 (p = 0,42). Conclusiones: en nuestro estudio, la microarquitectura ósea está deteriorada en pacientes con glucemia alterada y obesos. Hacen falta estudios con mayor tamaño muestral para establecer en qué momento se instauran estos cambios en la evolución natural de la diabetes.

Introducción: la obesidad y la diabetes mellitus tipo 2 (DM-2) disminuyen el entramado trabecular óseo aun cuando puede coexistir aumento del hueso cortical. Otro hallazgo en común es la presarcopenia/sarcopenia secundaria posiblemente a la insulinorresistencia y el estrés oxidativo. Queda por aclarar si estos cambios dependen fundamentalmente de las alteraciones glucídicas precoces (pre DM-2) o tardías (DM-2 establecida), o más bien estarían vinculadas de forma predominante por el exceso de masa grasa en individuos obesos. Objetivos: evaluar y comparar parámetros de composición corporal (compartimentos óseo, muscular y adiposo-visceral) en pacientes con sobrepeso/obesidad agrupados según presenten o no alteraciones glucídicas. Analizar si existen diferencias comparando FRAX vs. FRAX ajustado a trabecular bone score (TBS) en ambos grupos. Métodos: se incluyeron 16 pacientes con sobrepeso/obesidad. A todos se les realizó evaluación clínica-antropométrica, bioimpedanciometría, absorciometría de rayos X de energía dual o densitometría ósea (DXA) y análisis, y se les agrupó según glucemia en tres grupos: a) normal; b) glucemia basal alterada en ayunas (GBA); y c) DM-2. Para el análisis estadístico empleamos pruebas no paramétricas. Resultados: no se encontraron diferencias estadísticamente significativas en los grupos respecto a microarquitectura ósea, masa muscular o grasa visceral. El grupo GBA mostró el mayor promedio de masa muscular y grasa visceral. Tras reclasificar en solo dos grupos, glucemia normal en el grupo 1 y glucemia alterada en el grupo 2 (GBA y DM-2), encontramos diferencias estadísticamente significativas con detrimento de la microarquitectura ósea trabecular en el grupo 2 (p = 0,031) y cifras de fósforo con niveles inferiores en el grupo 1 (p = 0,42). Conclusiones: en nuestro estudio, la microarquitectura ósea está deteriorada en pacientes con glucemia alterada y obesos. Hacen falta estudios con mayor tamaño muestral para establecer en qué momento se instauran estos cambios en la evolución natural de la diabetes, Introduction: obesity and DM-2 decrease trabecular bone mass even though cortical bone increase may coexist. Another common finding is presarcopenia/sarcopenia, possibly due to insulin resistance and oxidative stress. It remains to be clarified whether these changes depend on either early (prediabetes) or late (established DM) glucidic alterations, or rather they would be linked predominantly by excess fat mass in obese patients Objectives: to evaluate and compare body composition parameters (bone, muscle and adipose-visceral tissues) in overweight/obese patients grouped by whether or not they present glucidic metabolism disorders. Analyze if there are differences between FRAX vs FRAX adjusted to trabecular bone score TBS in both groups. Methods: sixteen overweight/obese patients were included. In all of them clinical-anthropometric evaluation, bioimpedance, DXA and analysis were performed. They were grouped by glycemia as: a) normal; b) impaired fasting glycemia (IFG); and c) DM-2. Non-parametric tests were performed. Results: no statistically significant differences were found among groups regarding bone microarchitecture, muscle mass or visceral fat. The IFG group showed the highest average muscle mass and visceral fat. Then, patients were reclassified in only two groups, normal glycemia in group 1 and altered glycemia in group 2 (IFG and DM-2), and statistically significant differences were found at the expense of lower trabecular bone microarchitecture in group 2 (p = 0.031) and phosphorus lower levels in group 1 (p = 0.042). Conclusions: in our study, the bone microarchitecture is impaired in patients with altered glycemia and obesity. Studies with larger sample size are needed to establish when these changes take place in the natural evolution of diabetes

Objective: Bone mineral density (BMD) loss, a risk factor for osteoporosis, has been attributed to HIV infection and antiretroviral therapy (ART), including regimens containing tenofovir disoproxil fumarate. Design: Study 202094 is an open-label, parallel-group, sub-study of the phase III SWORD-1 and SWORD-2 studies (ClinicalTrials.gov identifier, NCT02478632). Methods: HIV-1-infected adults with HIV-1 RNA less than 50 copies/ml who received ART containing tenofovir disoproxil fumarate for at least 6 months were randomized to receive dolutegravir with rilpivirine or continue current ART regimen. Total hip and lumbar spine BMD were measured by dual-energy X-ray absorptiometry (DXA) scans. The primary endpoint was percentage change from baseline in total hip BMD. Results: DXA scans were evaluable for 81 participants at baseline and Week 48. Percentage increase in total hip BMD was significantly greater in participants who switched to dolutegravir with rilpivirine (1.34%) compared with participants who continued current ART (0.05%; treatment difference, +1.29%; 95% CI 0.27–2.31; P = 0.014). Lumbar spine BMD significantly increased in the dolutegravir with rilpivirine group by 1.46% (95% CI 0.65–2.28) compared with 0.15% (95% CI –0.79 to 1.09) in the current ART group (treatment difference, 1.32; 95% CI 0.07–2.57; P = 0.039). Participants in the dolutegravir with rilpivirine group experienced significantly greater reductions in bone formation and resorption biomarkers compared with the current ART group. Conclusion: Switch to dolutegravir with rilpivirine was associated with significant improvement in BMD and bone turnover markers compared with tenofovir-based three-drug regimens, providing a robust option for preserving bone health while continuing suppressive ART.

Background HIV infection and antiretroviral therapy (ART), particularly tenofovir (TDF), is associated with loss of bone mineral density (BMD). The SWORD studies demonstrated noninferiority of the 2-drug regimen (2DR) dolutegravir (DTG) + rilpivirine (RPV) to continuing current triple-therapy ART (CAR) at 48 weeks and continued viral suppression on DTG+RPV through Week 148. A substudy of SWORD 1 and 2 evaluated a change in BMD by DEXA for those participants who switched from triple ART containing TDF to DTG+RPV. The primary analysis reported at 48 weeks showed a significant increase in total hip and lumbar spine BMD and a significant decrease in bone turnover markers in patients receiving DTG+RPV compared with CAR. Here we present data through Week 148. Methods HIV-infected adult patients with HIV-1 RNA < 50 c/mL received ART containing TDF for ≥6 months prior to randomization to DTG+RPV (Early Switch group, ES) or CAR on Day 1 (Baseline, BL) through Week 48 in SWORD-1/2. CAR patients suppressed at Week 48 switched to DTG+RPV at Week 52 (Late Switch group, LS). Hip and lumbar spine BMD were measured by DEXA scans read centrally. Secondary endpoints include a change in BMD and bone turnover markers through Week 148. Results Following switch to DTG+RPV significant increases were observed for total hip in the ES and LS groups through 100 weeks with a non-significant increase at Week 148 in ES (Figure 1a). Lumbar spine BMD significantly increased from BL at 48 weeks post switch, remained increased, though not significantly from BL through Week 148 (Figure 1b). The BMD of the LS group was similar to that of the ES group through 100 weeks exposure. The majority of patients remained in their pre-switch T-score category or improved a category for both hip and spine through Wk148 (Table 1). Through Wk148, BMI increased minimally and bone turnover markers significantly decreased (P < 0.001 to 0.042 across markers) from BL/LS BL except Type I Collagen C-Telopeptide at Wk148 in the LS group (P = 0.279). Conclusion Switch to the DTG+RPV 2DR was associated with sustained improvements in BMD through Week 148, along with a reduction in bone markers. The favorable effects on skeletal health were observed despite the ageing of study patients and other factors decreasing BMD. A switch to DTG+RPV in suppressed patients provides a robust option for preserving bone health while continuing suppressive HIV treatment. Disclosures All authors: No reported disclosures.

Background: Positron emission tomography / computed tomography with fluorodeoxyglucose (FDG-PET/CT) is widely accepted for staging and for end treatment assessment in patients with DLBCL, and has demonstrated to have prognostic impact when used to evaluate early response to chemotherapy (CT) in this group of patients. In the last years, many changes in the way of interpreting PET/CT have been proposed, both for interim and for end of treatment (Barrington SG, J Clin Oncol 2014;32:3048-3058) We present preliminary data of the first Spanish centralized PET/CT review in a Phase 2 randomized trial in young patients with poor prognosis diffuse large B-cell lymphoma (DLBCL), which compares 6 cycles of RCHOP versus 6 cycles of a modified RCHOP regimen, Bortezomid-R CAP (BRCAP). ClinicalTrials.gov Identifier: NCT01848132. The main objective is to evaluate concordance between reviewers in interim and final PET, in order to stablish the best criteria for PET/CT assessment. PET2 ability to predict PET4 result is also analyzed. Methods: A blinded, prospective, centralized review in real time of PET/CT images was realized by the GELTAMO PET network. For each patient, images of basal (PET0), interim PET2 and PET4 and final PET after completion of chemotherapy (PET 6) were sent to a central platform, and then analysed by the review panel composed of seven expert nuclear medicine physicians. PET2 and PET4 were interpreted visually based on Deauville criteria (considering scores 4 and 5 as positive), and also semiquantitavely (considering a positive PET2 when ΔSUVmax≤66% and a positive PET4 when ΔSUVmax≤70%). PET6 was interpreted following Deauville criteria. Final result of every PET/CT was defined as positive or negative by the central review panel. When discordance between visual and semiquantitative analysis was found in interim PET, semiquantitative method was determinant of final result. A positive PET4 result determined dropped out from trial. Concordance between all readers was analysed using Cohen's kappa coefficient. Results: Of the first 76 patients that underwent PET/CT, 64 patients completed PET0, PET2 and PET4; 34 patients underwent PET0, PET2, PET4 and PET6. In the central review, 44/64 patients (69%) were PET2(-) and 20/64 (31%) were PET2(+); 44/64 (69%) were PET4(-) and 20/64 (31%) PET4(+); 21/34 (62%) were PET6(-) and 13/34 (38%) were PET6(+). We found 43 patients with negative PET2 and PET4, 19 patients with positive PET2 and PET4, 1 patient with positive PET2 and negative PET4, and 1 patient with negative PET2 and positive PET4. PET2 result was predictive of PET4 (p Concordance between reviewers for PET2 using visual assessment was good (median kappa=0,74) and very good using semiquantitative analysis (median kappa: 0,83). Concordance between reviewers for PET4 using visual assessment was good (kappa=0,72) and very good when semiquantitative analysis was used (median kappa=0,87). For PET6, concordance between readers was moderate (kappa=0.45). Conclusion: In this homogeneus group of patients, a centralized semiquantitative analysis of interim PET after 2 and 4 cycles of chemotherapy improves concordance between readers in comparison with visual analysis. When semiquantitative method is used, PET2 is predictive of PET4 result. In the same way, visual analysis of PET6 using Deauville criteria seems to have a worse concordance between readers, but more patients need to be analyzed to confirm this result. Disclosures No relevant conflicts of interest to declare.