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The follow-up of treated low-grade glioma (LGG) requires the evaluation of subtle clinical changes and MRI results. When the result is inconclusive, additional procedures are required to assist decision-making, such as the use of advanced MRI (aMRI) sequences and nuclear medicine scans (SPECT and PET). The aim of this study was to determine whether incorporating 18F-fluorocholine PET/CT in the follow-up protocol for treated LGG improves diagnostic accuracy and clinical utility. This was a prospective case-series study in patients with treated LGG during standard follow-up with indeterminate clinical and/or radiological findings of tumour activity. All patients underwent clinical evaluation, aMRI, 201Tl-SPECT and 18F-fluorocholine PET/CT. Images were interpreted by visual evaluation complemented with semiquantitative analysis. Between January 2012 and December 2013, 18 patients were included in this study. The final diagnosis was established by histology (five surgical specimens, one biopsy specimen) or by consensus of the Neuro-Oncology Group (11 patients) after a follow-up of >6 months (mean 14.9 ± 2.72 months). The global diagnostic accuracies were 90.9 % for aMRI (38.8 % inconclusive), 69.2 % for 201Tl-SPECT (11.1 % inconclusive), and 100 % for 18F-fluorocholine PET/CT. 201Tl-SPECT led correctly to a change in the initial approach in 38.9 % of patients but might have led to error in 27.8 %. The use of 18F-fluorocholine PET/CT alone rather than 201Tl-SPECT led correctly to a change in the approach suggested by routine follow-up in 72.2 % of patients and endorsed the approach in the remaining 27.8 %. Our results support the need to complement structural MRI with aMRI and nuclear medicine procedures in selected patients. 18F-Fluorocholine PET/CT can be useful in the individualized management of patients with treated LGG with uncertain clinical and/or radiological evidence of tumour activity.

Prostate tumors are the most frequent malignant cancer among men. In recent years, we have seen a significant progress in the knowledge of the carcinogenesis of prostate cancer, leading to the development of effective drugs in this scenario. Prostate cancer patients had no effective therapeutic alternatives after docetaxel failure, limiting their survival rates. However, new drugs have markedly improved this. Cabazitaxel, a new generation taxane, has shown improved patient survival, despite the disease progression seen after docetaxel treatment. Herein, we present the case of a prostate cancer patient with poor prognosis and lung metastases in < 6 months postdocetaxel treatment. The patient was treated with cabazitaxel, achieving a long and maintained response. Later, on developing a new progressive disease, the patient was retreated with cabazitaxel, achieving a partial response and obtaining a widespread survival and clinical benefit. We currently have no predictive response factors to establish the most appropriate therapeutic sequence. Close monitoring of these patients is of paramount importance to detect early disease progression and try a new line of treatment, while the patient still has the chance to respond.

Primary tumor location was pancreas in 13 pts (25.5%), lung in 11 pts (21.6%), small or large intestine in 8 pts (15.7%), appendix in 5 pts (9.8%), and other locations in 14 pts (27.5%). Results: Thirty-two pts had low grade (Ki67 20%). 49% (25) of the pts were metastatic at diagnosis. Octreoscan was positive in 15 pts with well-differentiated tumors (low and intermediate grade) and in 3 with poorly differentiated tumors (high grade). Resection of the tumor was possible in 24 pts (75%) with low-grade, three (42.9%) with intermediate and 2 (16.7%) with high grade tumors (Chi squared test, p = 0.002). All high grade NETs were treated with chemotherapy (CT) with cisplatin-etoposide. Only 8 low grade tumors and 5 intermediate grade tumors were treated with CT. Eighteen pts with low grade, 4 with intermediate and 1 with high grade tumor were treated with somatostatin analogues. Median survival was 31.36 months for pts with low grade tumors, 21 months for those with intermediate grade and 14.63 months for high grade tumors, with statistically significant differences (Chi square test, p = 0.002). Conclusion: Grade of differentiation, defined by the expression of cell proliferation marker Ki 67 protein, determines differences in the therapeutic strategy of NETs. Our results coincide with the literature regarding the significant correlation among grade of differentiation and survival in pts with NETs. It is established as the main prognostic factor that also modifies the therapeutic approach.

Background: Bevacizumab has efficacy in first-line treatment of advanced colorectal cancer. The overall response with Bevacizumab is low in some studies. Not know the ideal method of assessing response to therapy with bevacizumab. Metabolic imaging of tumor viability with 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET), and simultaneous anatomic localization provided by low-dose non-enhanced computed tomography (CT), can be obtained in a combined modality FDG-PET/CT scan. The purpose of this study was to evaluate the possible contribution of FDG-PET/ CT as a surrogate marker to evaluate treatment response in patients with metastatic colorectal cancer (mCRC) who had been treated with bevacizumab and standard chemotherapy. Methods: Retrospective analysis of 28 patients with advanced colorectal cancer who had been treated in the Hospital Universitario Virgen de las Nieves in Granada. Analyses included all patients who initiated bevacizumab in combination with either first-line oxaliplatin or irinotecan based regimens. FDG-PET/CT scans were performed before the start of the treatment and after six cycles of therapy. Results were compared to concurrent contrast-enhanced CT. Response to treatment was determined according to RECIST size criteria obtained from data from thin (3-5mm) slice CT, and changes in uptake of 18F-FDG uptake on PET. Results: A total of 28 patients were evaluated. Overall, 22 patients had favorable response to treatment, and only 6 had progression of disease. Complete response (CR) was evident on FDG-PET in 6/28 (21,4%) patients whereas only 5 were deemed CR by CT and partial response (PR) in 15/28 (64,3%) with both techniques. Similarly, only 1/ 28 (3,6%) lesion appeared stable by FDG-PET and CT criteria. Progression of disease (PT) was evident on FDG-PET in 6/28 (21,4%) patients whereas only 5 were deemed PT by CT. There was a strong correlation between metabolic response (changes in SUV) and objective response (r = 0.81, P

TPS4672 Background: Advanced transitional cell carcinoma of the urothelium (TCCU) on progression after previous cisplatin-based combination is generally an incurable disease. The appropriate management of these patients is still an unmet need. Many drugs have shown modest or no activity in previous phase 2 trials. Population heterogeneity in these studies emerges as one of the key determinants that could explain the variable outcomes. Recently, in a phase III study in this setting, prognostic factors (PF) for overall survival were identified (Bellmunt J et al, JCO 2010). Taxanes are active drugs in 2nd-line metastatic TCCU. Cabazitaxel (C) is a semi-synthetic taxane that is a poor substrate for the multidrug resistance system. C could be a valid alternative in this patient population. Methods: This is an open label phase II study of C in patients (pts) with advanced or metastatic TCCU who have progressed within 12 months after receiving a 1st-line platinum based chemotherapy. There are three treatment arms as patients will be assigned to one of three groups previously defined based on the presence of 0, 1 or 2-3 PFs as defined by Bellmunt et al. The activity of C will be assessed separately in each group and overall. The primary endpoint is response rate (RR) evaluated according to RECIST 1.1, a maximum of 35 pts are needed in each subgroup (maximum number of pts required: 105). Secondary objectives are RR in the whole population, toxicity, progression-free survival and overall survival. In addition, an external validation of the prognostic model proposed by Bellmunt will be conducted, as well as a pharmacogenomic study in order to better define the toxicity profile of the drug and the potential responders.