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Previous studies suggested that obesity pro-inflammatory state could improve immune checkpoint inhibitors (ICI) clinical efficacy. This is a retrospective, multicenter, and observational study that included patients treated in a private Brazilian Oncology Group. Primary outcomes were the association of body mass index (BMI) category with overall survival (OS) and progression free survival (PFS). Secondary outcomes were association between BMI and objective response rate (ORR). In the total cohort, 448 patients were classified as a normal weight (43%), overweight (36%), obese (17%) and underweight (4%). The patients were predominantly male gender (62%), with stage IV lung cancer (57%) and melanoma (19%). The obese group (BMI ≥ 30 kg/m2) had a not statistically significant longer median OS than the non-obese group (BMI < 30 kg/m2) - 21.8 months (95% CI NR - NR) versus 14.9 months (95% CI 8.3 - 21.5); HR = 0.82, (95% CI 0.57 - 1.18, P = 0.28). Obese patients treated with anti-CTLA4 did not reach the mOS, while the non-obese group had a mOS of 23.1 months (P = 0.04). PFS did not differ between subgroups. Obese patients had also lower ORR, but without reaching statistical significance. In conclusion, this study did not report an improved OS among high BMI patients treated with ICI.

Aims: To assess non-small-cell lung cancer (NSCLC) patient-centered outcomes in the real world. Methods: This is a prospective study of NSCLC patients treated at a private cancer care institution in Brazil between 2014 and 2019. Results: The report comprises 337 patients. Advanced stage was associated with higher symptom burden – fatigue (p = 0.03), pain (p

Background Developing countries like Brazil often present a dichotomous health care system, where patients may be treated in either public or private institutions that differ substantially in terms of level of access to diagnostic and therapeutics procedures. Herein, we present the first report of a comprehensive study to assess real-world data in breast cancer patients treated in the private health care in Brazil. Methods This is a prospective study of breast cancer patients treated in a private health care institution, comprising six unities in Rio de Janeiro and surroundings. Eligible patients were at least 18 years old and had a histology-proven diagnosis of breast cancer between July 2012 and November 2016. For this analysis, only female patients with an invasive component were included. Patients with prior malignancies and those who initiated therapy in other institutions were excluded. Patients or relatives were contacted by telephone to ensure that all information was annotated. Data quality was certified by regular monitoring. This study was approved by the local Research Ethics Committee. Results One thousand three hundred and ninety patients were enrolled. One hundred sixty were excluded in this analysis, 11 due to male gender and 151 with exclusively in situ carcinoma. The report comprises 1230 female patients, predominantly diagnosed in early (79.0% stages I-II) or locally advanced (16.1% stage III) stages. One thousand thirty-three (84.0%) patients had hormone receptor (HR)-positive tumors, and 185 (15.0%) were HER2 positive. One hundred twenty-six (10.2%) cases were triple negative. The primary tumor was resected in 89.0% of times, most often through breast-conserving surgery (55.1%). Axillary lymph nodes were assessed in 83.4% of cases, and 32.0% required complete axillary dissection. Chemotherapy was used in 61.3% of cases, and radiation therapy in 59.6%. Patients with locally advanced disease received more aggressive therapy than patients with early stage (higher rates of mastectomy, axillary dissection and chemotherapy use). After a median follow up of 22.5 months (95% CI, 21.09-23.90), 54 (4.4%) deaths were reported. The estimated 2-year overall survival (OS) was 95.3%. 2-year OS was significantly longer among patients with stages I-II (97.9% and 97.5%, respectively) than in stages III and IV (89.4% and 69.5%, respectively) (p Conclusion To our knowledge, this is the most comprehensive and best-annotated study in breast cancer patients treated in the private health care in Brazil. More oncological interventions were used in advanced stages, reflecting international recommendations, but also a need to pursue early diagnoses, where outcome is optimal despite less aggressive therapy. Outcomes are favorably similar to the current literature from developed countries in all stages. The data provided helps comprehending the current scenario of breast cancer presentation and treatment in Brazil, and may serve as a foundation to guide resource allocation in the years to come. Citation Format: Boukai A, Gonçalves AC, Andrade PM, Carvalho N, Almeida T, Lemos F, Padoan M, Teich NS, Araujo LH. Outcome of breast cancer patients treated in the private health care in Brazil [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-08-25.

e15066 Background: Obesity is linked to an increased risk of cancer development. The excess of body fatness seems to be associated with alterations in hormonal, metabolic and inflammatory pathways, that may lead to activation of the carcinogenesis process. Previous studies suggested this obesity pro-inflammatory state could improve ICI clinical efficacy. Methods: Baseline characteristics and clinical outcomes were retrospectively collected from advanced cancer patients of any primary site, and treated with ICI in our institution. The BMI was determined for all pts and categorized into 2 groups: obese (BMI≥30) and non-obese (BMI < 30). Primary outcomes were the association of BMI category with overall survival (OS) and progression free survival (PFS) assessed by log-rank statistic, and both were stratified by sex, age, treatment agent and primary tumor site using the Cox-regression. Secondary outcome was the association of BMI with objective response rate (ORR). Results: We collected data from 448 advanced cancer pts - 192 (43%) as normal weight, 159 (36%) as overweight, 78 (17%) as obese and 19 (4%) as underweight. A total of 370 pts (83%) were included in the non-obese group (BMI < 30) and 78 (17%) patients in the obese group (BMI≥30). The majority of pts (387 - 84%) received anti-PD-1/anti-PD-L1; 128 pts (28%) were treated at 1st line and 200 pts (44%) at 2nd line. The obese group experienced longer mOS than the non-obese group - 21.8 months (95% CI NR - NR) vs. 14.9 months (95% CI 8.3 -21.5); HR = 0.82, (95% CI 0.57-1.18, P = 0.28). However, this was not statistically significant and even after stratification. The obese group had an inferior mPFS than the non-obese group - 4.7 months (95% CI 3.8- 5.7) vs. 5.3 months (95% CI 3.45-7.15); - HR = 0.99, (95% CI 0.76 -1.30), P = 0.95. There was no significative difference in mPFS and ORR according to BMI. Conclusions: Although study did not report an improved OS among high BMI pts treated with ICI, our results suggested a trend in survival benefit. The BMI should be explored as a stratification variable in the design of prospective trials with advanced cancer pts and ICI treatment.

Purpose Middle-income countries like Brazil often have a dichotomous health care system in which patients may be treated in either public or private institutions that differ substantially in terms of level of access to diagnostic and therapeutic procedures. Patients and Methods This was a prospective, observational study to assess real-world data in 1,230 female patients with breast cancer who were treated in a private health care institution between 2012 and 2016 in Brazil. Results Breast cancer in these patients mostly was diagnosed at early (79.0% stages I or II) or locally advanced (16.1% stage III) stages. The primary tumor was resected in 89.0% of cases, most often through breast-conserving surgery (55.1%). Patients with locally advanced disease received more aggressive therapy (eg, higher rates of mastectomy, axillary dissection and chemotherapy use) than patients with early-stage disease. The estimated 2-year overall survival (OS) was 95.3%. Survival was significantly longer among patients with stage I or II disease (2-year OS, 97.9% and 97.5%, respectively) than those with stage III or IV disease (89.4% and 69.5%, respectively; P < .01). Tumor grade was also correlated with OS in the overall cohort ( P = .05); triple-negative status was only prognostic for patients with stage III disease ( P < .01). Conclusion The data provided aid understanding of the current scenario of breast cancer presentation and treatment in the Brazilian private health care system and may serve as a foundation to guide resource allocation. Our results reinforce the need to pursue adequate access to cancer care in low- and middle-income countries to optimize patient outcome.

e12629 Background: Globally, breast cancer is the most frequently diagnosed type of cancer and the leading cause of cancer death in women. In the United States (US), it is the second most common ca...