Tumori Journal Abstract Book - October 2020 - 105

E - Breast Cancer	

105

founder variants present in several European populations
were observed also in some Sicilian families. Globally, thirty
PVs were more frequently observed in the Sicilian population, but only some of these showed a specific territorial prevalence, unlike other Italian and European regions. This
difference could be attributed to the genetic heterogeneity of
the Sicilian people and its historical background due to the
crucial geographical location of Sicily in the centre of
Mediterranean Sea, crossroads of several cultures. Therefore,
hereditary breast and ovarian cancers in Sicily could be predominantly due to BRCA1/2 PVs different from those usually detected in other geographical areas of Italy and Europe.
Conclusions: Our investigation led us to hypothesize that a
higher prevalence of some germline BRCA PVs in Sicily
could be a population-specific genetic signature. Populationbased genetic approaches, in the future, could help to
increase the BRCA carrier detection rates and maximize
prevention strategies.

E12
Value of genomic test (Oncotype
DX®) in elderly patients: an
Italian survey
Barni S.1, De Placido S.2, Masetti R.3, Naso G.4, Santini D.5, Tondini
C.A.6, Cognetti F.7
ASST Bergamo Ovest, Treviglio; 2Policlinico Federico II, Napoli; 3Policlinico
A. Gemelli, Roma; 4Policlinico Umberto I - Università La Sapienza, Roma;
5
Policlinico S. Orsola-Malpighi, Bologna; 6ASST-PG23, Bergamo; 7Istituto
Nazionale Tumori Regina Elena, Roma

Patients Characteristics
Ki67
<10%
10-20%
21-30%
> 30%
RS group
0-17
18-30
>30

N

%

19
87
72
52

8%
38%
30%
23%

132
73
25

57%
32%
11%

Results: This subgroup of patients > 70 years of age presented relatively higher clinical risk based on clinical and
pathological features yet a significant proportion had lower
Recurrence Score results suggesting, based on the landmark TAILORx study, they would not benefit from chemotherapy. A reduction of chemotherapy recommendation
based on the RS results was observed for 32 women (14%)
who were initially recommended chemotherapy. This represent a relative reduction in chemotherapy use of 38%.
This study was conducted prior to the publication of the
TAILORx results, a simulation using the TAILORx cut off
would estimate a larger reduction in chemotherapy of 62%.
Recommendations for chemo-endocrine therapy or endocrine therapy before and after knowledge of RS results:

1

Background: The PONDx national decision impact study,
initiated in 2016, collected data on real-life use of the
Oncotype DX® assay in current clinical practice for 1788
Italian patients and results were consistent with other international decision impact studies showing changes in treatment decisions for more than 50% of cases with a
significant change of recommendations from adjuvant
chemo-endocrine therapy to endocrine therapy only.
Material and methods: Data from 230 patients aged > 70
were collected and analyzed to assess how the genomic
test was used in this subset of patients to guide treatment
decisions.
Patients characteristics (N=230):
Patients Characteristics
Nodal status
N0
N+
Tumour grade
G1
G2
G3

N

%

172
58

75%
25%

28
123
79

12%
53%
34%
(Continued)

Treatment

Pre-test

Post-test

Chemo+Endocrine therapy
Endocrine therapy
Others

84
140
6

52
173
5

Conclusions: In this Italian real-life setting, the Oncotype
DX test provides critical information that changed and
supports final treatment decisions also in elderly breast
cancer patients clinically identified as higher clinical risk
according to traditional tumor grade and high Ki67 levels.
38% of the women who would have been treated with
chemotherapy were able to spare it. This is particularly relevant in this subset of patients for whom chemotherapy is
most likely to produce acute and late toxicity.

E13
Safety and efficacy of abemaciclib
plus endocrine therapy (ET) in
elderly patients with hormone
receptor-positive/human epidermal
growth factor receptor
2-negative (HR+, HER2-) advanced
breast cancer: an age-specific
subgroup analysis of MONARCH 2
and 3 trials
Tumori Journal Abstract Book - October 2020

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