Tumori Journal Abstract Book - October 2020 - 116

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Of the 54 pts whose age was under 65, 28(51.8%) developed neutropenia: 21pts (75%) experienced G3, 5pts
(17.8%) G4 and 2pts (7.2%) FN. Otherwise, of the 52 pts
whose age was over 65, 50 (96.1%) developed neutropenia: 12pts (24%) experienced G3, 26 pts (52%) G4 and
12pts (24%) FN. In pts who received no chemotherapies
but only hormonotherapy, G3 neutropenia occurred in 15
pts (31,25%) and G4 in 5 pts (10,41%); in one patient, FN
was observed. In pts who received adjuvant chemotherapy
(Anthracyclines and Taxanes), G3 neutropenia occurred in
32 pts (55,1%) and G4 in 26 ones(44,8%); in 13 pts
(22,4%) FN was observed. The risk of Palbociclib-induced
neutropenia was higher in pts over 65years (p<0.001) and
in those undergoing multiple lines of therapy (p<0.001).
The univariate and multivariate analysis revealed that both
age and the adjuvant chemotherapy were statistically associated with both G4 neutropenia and FN (p<0.001).
Conclusions: Palbociclib has shown significant improvement in survival in pts diagnosed with MBC, at the cost of
increased hematological toxicity. Older age and prior adjuvant chemotherapies are associated with increase in
Palbociclib-related neutropenia.

E32
Predictors of HER2
gene amplification in
immunohistochemistry score 2+
Early Breast Cancer according to
2018 ASCO/CAP guidelines: a single
institution analysis
Barbolini M.1, Omarini C.1, Bettelli S.1, Manfredini S.1, Dominici M.1,
Piacentini F.1
1

Università degli Studi di Modena e Reggio Emilia, Modena

Background: HER2 overexpression occurs in approximately 15-20% of invasive breast cancers (BC). From a
pathological point of view HER2 positivity is defined by
intense circumferential membrane complete staining in
more than 10% of tumour cells in immunohistochemistry
(IHC score 3+). When complete circumferential staining
is weak to moderate (IHC score 2+) double probe in situ
ibridation (ISH) is mandatory to define HER2 status. In
2018 ASCO/CAP guidelines were updated to provide
additional guidance in HER2 equivocal cases to allow a
greater discrimination between positive and negative
cases. Our aim is to find predictors of HER2 positivity
among IHC score 2+ early breast cancer specimens analysed according to 2018 ASCO/CAP guidelines.
Patients and methods: 253 cases of early BC diagnosed
at Modena Cancer Center between November 2013 and
August 2017 were identified. Stage, ISH result, hormonal
receptor status (HR), proliferation index (MIB1), and histological grade were captured; menopausal status was

Tumori Journal 106(2S)
available too. All IHC score 2+ cases were reclassified
according to 2018 ASCO/CAP guidelines. The association
between pathological tumour features, clinical characteristics and ISH positivity was assessed using Fisher test.
Results: Overall, 25.7% IHC score 2+ BC resulted HER2
amplified in double probe ISH. High tumour grade (G3 vs
G1-2) and MIB1 > 20% significantly predict HER2 ISH
amplification (p=0,0001). No correlation was found according to HR, stage, or menopausal status. The majority (185;
98.4%) of HER2-ve BC were reclassified as group 5 (HER2/
CEP17 ratio <2 and HER2 copy number <4 signals/cell)
except for 3 specimens classified as group 4 (HER2/CEP17
RATIO <2 and HER2 copy number ³4 but <6 signals/cell).
In HER2+ve group the majority (62; 95.3%) specimens
were group 1 (HER2/CEP17 RATIO >2 and HER2 copy
number =4 signals/cell), no specimen was group 2, and only
3 cases were classified as group 3 (HER2/CEP17 RATIO
<2 and HER2 copy number >6 signals/cell).
Conclusions: In this IHC score 2+ BC series, reclassification according to 2018 ASCO/CAP guidelines identified
only 4.6% group 3 and 1.6% group 4 cases. The routinely
assessment of grading and proliferation index could help
to predict HER2 amplification in IHC score 2+ samples
even if it must not substitute ISH assay in determining eligibility for HER2 targeted therapies.

E33
Extended adjuvant endocrine
treatment for premenopausal
patients: an attempt to reach
consensus through Delphi
methodology
Buono G.1, Arpino G.2, Del Mastro L.3, Fabi A.4, Generali D.5, Puglisi
F.6, Zambelli A.7, De Laurentiis M.8
1
Oncology Unit, Ospedale San Rocco, Sessa Aurunca, Azienda Sanitaria
Locale Caserta, Caserta; 2Department of Clinical Medicine and Surgery,
Oncology Division, Federico II University, Napoli; 3Department of Internal
Medicine, University of Genova; Ospedale Policlinico San Martino-IRCCS,
Genova; 4Division of Medical Oncology1, IRCCS Regina Elena National
Cancer Institute, Roma; 5Breast Cancer Unit, Azienda Socio Sanitaria
Territoriale di Cremona; Department of Medical, Surgery and Health
Sciences, University of Trieste, Cremona; Trieste; 6Department of Medicine,
University of Udine; Department of Medical Oncology, IRCCS Centro di
Riferimento Oncologico Aviano - National Cancer Institute, Udine; Aviano;
7
Medical Oncology, Ospedale Papa Giovanni XXIII, Bergamo; 8Department
of Breast and thoracic oncology, Istituto Nazionale Tumori IRCCS
"Fondazione G. Pascale, Napoli

Background: Endocrine therapy (ET) represents the
mainstay of adjuvant treatment for hormone receptor positive (HR+) early breast cancer (EBC). Currently, international guidelines recommend the use of ovarian function
suppression (OFS) plus aromatase inhibitors (AIs) as preferred choice in intermediate/high-risk premenopausal
patients, according to SOFT and TEXT study results. In
Tumori Journal Abstract Book - October 2020

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