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A 57-year-old man with a heavy smoking and alcohol consumption history, but no comorbidities, presented with pharyngeal pain to his primary care physician’s office. He received empirical treatment with oral antibiotics and experienced partial improvement. A couple of months later, he developed a left cervical mass with progressive growth. A head and neck CT scan revealed a hypopharyngeal tumor. Results of a tumor biopsy indicated an ulcerated, moderately differentiated squamous cell carcinoma (SCC) with lymphovascular invasion. The patient was sent to our institution for treatment.

Objective: Evaluate impact after 223 Ra therapy and 18 F-NaF (sodium fluoride) PET/CT in the selection and evaluation of response in patients treated with 223 Ra in six different solid tumors. Material and Methods: Twenty patients with metastatic castration-resistant prostate cancer (mCRPC), seven metastatic castration-sensitive prostate cancer (mCSPC), three osteosarcoma, two breast cancer, two non-small cell lung cancer (NSCLC), one chondrosarcoma, one chordoma and one patient lung neuroendocrine carcinoma. Three groups of study were defined according total skeletal tumor-burden obtained by 18 F-NaF PET/CT, group 1 3000cm 3 VOI´s. A semi-quantitative comparison was performed measuring the SUVmax values of VOIs values in all bone metastases in each patient previous to receive the first cycle of 223 Ra, after 3 and 6 cycles. Results: 30 patients non-progress disease was documented after 24±4 weeks. 8 patients progress disease was presented after three cycles of 223 Ra, two patients with osteosarcoma, four patients with mCRPC, one patient with chondrosarcoma and one patient with NSCLC. Group 1 patients showed better response rates compared to group 3 (p

Despite having a favorable response to platinum-based chemotherapies, ~15% of Testicular Germ-Cell Tumor (TGCT) patients are platinum-resistant. Mortality rates among Latin American countries have remained constant over time, which makes the study of this population of particular interest. To gain insight into this phenomenon, we conducted whole-exome sequencing, microarray-based comparative genomic hybridization, and copy number analysis of 32 tumors from a Mexican cohort, of which 18 were platinum-sensitive and 14 were platinum-resistant. We incorporated analyses of mutational burden, driver mutations, and SNV and CNV signatures. DNA breakpoints in genes were also investigated and might represent an interesting research opportunity. We observed that sensitivity to chemotherapy does not seem to be explained by any of the mutations detected. Instead, we uncovered CNVs, particularly amplifications on segment 2q11.1 as a novel variant with chemosensitivity biomarker potential. Our data shed light into understanding platinum resistance in a Latin-origin population.

427 Background: MST is a rare entity defined as the development of somatic non-germ cell malignancies within GCT, its incidence varies between 2.7% and 8.6% of GCT’s. Previously reported favorable prognostic factors include synchronous diagnosis of MST and GCT, absence of non-pulmonary visceral metastases (NPVM) and presence of rhabdomyosarcoma. Methods: Retrospective study to describe prognostic factors of MST in GCT in a Hispanic population. Patients (pts) with diagnosis of MST from 2006 to 2019 were identified from the GCT database of the NCIM. Pts’ characteristics and outcomes were collected from clinical charts and recorded. Overall survival (OS) was performed with the Kaplan Meier (KM) method in the whole cohort and in patients with advanced disease (AD) (stage II and III). Comparisons were calculated with the log-rank test for KM and Chi squared test for categorical factors. Results: Seventy-one pts with MST were included in the overall population (OP). Non-seminoma 95.8%; testicular primary 97.2%; clinical stage (CS) I 32.4%, II 16.3%, III 49.3%; S2-S3 42.3%, 39.6% poor IGCCCG prognosis, 11.3% NPVM. Type of MST: 56.3% rhabdomyosarcoma (RMS), 21.1% spindle cell sarcoma, 12.7% PNET, 9.9% adenocarcinoma. 18.3% more than 1 MST histology. Median follow-up: 43.8 months (m). For the OP, mOS 71.1m (95% CI 80.0 – 119.2). OS for CS I have not been reached (NR). Forty-seven pts with AD were included, mOS 37m (95% CI 9.69 – 64.36). Characteristics associated with prognosis for OS for the OP and the AD cohorts are summarized in table. Pts with AD and RMS had more frequently a synchronous tumor (87.5% vs 58.3%, p=0.02) and absence of surgery for MST (70.8% vs 37.5%, p=.02). Conclusions: As far as we know, this is the largest cohort of hispanic pts with MST. Prognostic factors differed between OP and AD cohorts. Pts with MST and AD have a poor prognosis. Synchronous diagnosis of MST and presence of rhabdomyosarcoma are adverse prognostic factors for AD pts. Further study with a larger population is needed to verify these findings. Univariate analysis for OS.[Table: see text]

Melanoma represents one of the most aggressive malignancies and has a high tendency to metastasize. The present study aims to investigate the molecular mechanisms of two pathways to cancer transformation with the purpose of identifying potential biomarkers. Our approach is based on a meta-analysis of gene expression profiling contrasting two scenarios: A model that describes a transformation pathway from melanocyte to melanoma and a second model where transformation occurs through an intermediary nevus. Data consists of three independent, publicly available microarray datasets from the Gene Expression Omnibus (GEO) database comprising samples from melanocytes, nevi and melanoma. The present analysis identified 808 differentially expressed genes (528 upregulated and 360 downregulated) in melanoma compared with nevi, and 2,331 differentially expressed genes (946 upregulated and 1,385 downregulated) in melanoma compared with melanocytes. Further analysis narrowed down this list, since 682 differentially expressed genes were found in both models (417 upregulated and 265 downregulated). Enrichment analysis identified relevant dysregulated pathways. This article also presented a discussion on significant genes including ADAM like decysin 1, neudesin neurotrophic factor, MMP19, apolipoprotein L6, C-X-C motif chemokine ligand (CXCL)8, basic, immunoglobulin-like variable motif containing and CXCL16. These are of particular interest because they encode secreted proteins hence represent potential blood biomarkers for the early detection of malignant transformation in both scenarios. Cytotoxic T-lymphocyte associated protein 4, an important therapeutic target in melanoma treatment, was also upregulated in both comparisons indicating a potential involvement in immune tolerance, not only at advanced stages but also during the early transformation to melanoma. The results of the present study may provide a research direction for studying the mechanisms underlying the development of melanoma, depending on its origin.

e15535 Background: Preoperative nutritional status in gastric cancer patients is not only correlated with postoperative complications, also, prognostic nutritional index or Onodera´s nutritional index (PNI) may relate with overall survival (OS) after gastrectomy. There is no available data of preoperative nutritional status in Mexican population. We decide to explore these variables and analyze its impact in outcomes reported in our population. Methods: This is a retrospective included a total of 91 patients patients with locally advanced gastric cancer confirmed by laparoscopy treated in the National Cancer Institute in México between January 2010 and June 2016. The PNI level was determined according the following formula: 10 x serum albumin (g/dl) + 0.005 x total lymphocyte count (per mm3). The optimal cutoff value of PNI in our population was set at 38.7 according the median, we stratified patients in high (PNI > 38.7) or low (PNI < 38.7) nutritional status, clinicopathologic features were compared. Results: We analyzed 91 patients, the mean patients age was 58, 61.5% were man, the 51.6% went to total gastrectomy with D2 dissection, 56% were pathologic stage III and 61.5% of the patients received adjuvant chemotherapy. The patients with high nutritional status had a OS of 46 months vs patients with low nutritional status with 25 months (p = 0.009). Patients with body mass index (BMI) > 23 had a OS of 41 months vs patients with BMI < 23 with 19 months of OS (p = 0.001), finally the patients with albumin > 3.75 had a 39 months of OS vs 23 months with albumin < 3.75 (p = 0.011) Conclusions: The low PNI group had worse OS than the high PNI group (46 months vs 25 months, p = 0.009). Preoperative is a simple and useful marker to predict overall survival in patients with locally advanced gastric cancer

e15548 Background: TGCT is the most common malignant solid neoplasm in young men. Those with advanced disease have survival rates between 40 to 80%, 30% will relapse. Treatment and prognostic facto...

e15546 Background: Testicular germ-cell tumor (TGCT) is the most frequent solid neoplasm in young adults. Current guidelines recommend that CS IS patients should be treated with cisplatin-based che...

Abstract 2940 Poster Board II-916 Introduction. Nasal NK/T cell lymphoma (NNK/TCL) is a tumor with a low prevalence but is more frequent in Asia and South America. There is no standard treatment for these patients, although radiotherapy is usually recommended. Few reports describe the frequency of central nervous system (CNS) involvement in this type of lymphoma and, in consequence, little is known about the benefit of carrying out screening procedures such as cerebrospinal fluid (CSF) cytology or image studies, nor it is known if prophylactic radiotherapy to the CNS or intrathecal chemotherapy improves the outcome of these patients. Patients and methods. We reviewed the clinical files of 63 patients of the National Cancer Institute in Mexico City with a diagnosis of angiocentric, centrofacial or NNK/TCL between january 1996 and december 2008. We excluded those patients who had a doubtful histopathological diagnosis, who were not completely studied or who did not received treatment in our institution. We collected the following variables: age, gender, histopathological diagnosis, localization of the tumor, clinical stage, symptoms at presentation, IPI score, CNS involvement, CSF cytology, image studies, LDH level, type of treatment and global response to treatment. Results. We found a total of 48 patients with a diagnosis of primary nasal lymphoma who met the inclusion and exclusion criteria. The mean age was 45.6 (range 16-81) years. The male to female ratio was 2:1. The most frequent localization and histopathological type was the nasal T cell lymphoma (58.3% and 43.8%, respectively). Thirty one percent of the tumors were classified as diffuse large cell and small cell lymphomas due to the lack of immunopathology at the time of diagnosis. Most of the patients were at stage I or II (81.3%) of the disease and had a low or low intermediate IPI score (85.4%). Of the 48 patients 89.6% recieved combined treatment with chemotherapy (CHOP) and radiotherapy, the other 10.4% recieved treatment with radiotherapy alone. Thirty nine point six percent and 23% of the patients had complete and partial response to the treatment, respectively. The remaining patients had either stable or progressive disease. Only 10.9% of the patients complained of neurologic symptoms and 85.4% had a spinal tap done. Nine patients had central nervous system infiltration (18.8%), 55.5% presented with neurological symptoms. Seven of the nine patients with CNS infiltration were diagnosed with a positive CSF cytology (77.8%). Two patients had a negative CSF cytology but had a positive MRI (22.2%). None of these patients had a positive CT scan for CNS involvement. Eight of the nine patients were treated with combined chemo and radiotherapy and 1 patient was treated with radiotherapy alone. Three patients achieved complete response (33.3%). Although there is a great difference in complete response between the patients with and without CNS involvement (6.25% vs 54.17% respectively, p= 0.07), this difference was not statistically significant. This can be due to the small number of patients with CNS involvement. There was no significant difference in the IPI score, LDH levels, stage of the disease or age between the groups. Conclusions. CNS involvement is present in a considerable proportion of patients with primary nasal lymphoma. Based on these data we think CSF cytology should be done in all patients. The results also suggest that the CT scan is not sensitive enough to detect CNS involvement. The treatment of these patients is an open question because there is virtually no data in the literature regarding therapy for this complication. Disclosures: No relevant conflicts of interest to declare.

ResumenLa neutropenia inducida por quimioterapia es una complicación frecuente y grave del tratamiento oncológico. Una de sus consecuencias es la interrupción del tratamiento citotóxico, situación que afecta la respuesta de los pacientes oncológicos y su calidad de vida. Asimismo, produce un incremento en los costos de la atención médica. El manejo de la neutropenia inducida por quimioterapia debe incluir estrategias preventivas y terapéuticas de las cuales debe estar alerta el oncólogo clínico tanto para tomar en cuenta el potencial mielosupresor de la quimioterapia como para implementar los abordajes de tratamiento adecuados. Los factores estimulantes de colonias de los granulocitos son la piedra angular para el manejo de esta complicación y han resultado herramientas efectivas.AbstractChemotherapy-induced neutropenia is a frequent and serious complication of the oncological treatment. One of its consequences is the interruption of the cytotoxic treatment, which affects the patient response and quality of life, as well as increasing the cost of medical care. Management of chemotherapy-induced neutropenia must include preventive and therapeutic strategies, which the oncologist must take into account when considering the potential myelosuppressive agent and to implement the appropriate treatment approaches. Granulocyte colony stimulating factors are the cornerstone for the management of this complication and have become quite effective treatment tools.