Tumori Journal Abstract Book - October 2020 - 150

150
hypothesized that patients (pts) that had received pazopanib
(PAZO) as a first-line treatment had a better outcome than
those treated with sunitinib (SUN) when receiving a second
line therapy with NIVO.
Material (Patients) and Methods: In a collaboration
between the Oncological Department of the University
Hospital of Pisa and three Oncology Units in the NorthWestern Area of Tuscany (Azienda USL Toscana Nord
Ovest) we retrospectively analyzed a series of pts who
received at least three lines of therapy and in whom a second
line therapy with NIVO was administered. We performed
Kaplan-Meier analysis for median progression-free survival
(mPFS) and median overall survival (mOS) of second-line
treatment with NIVO in the two subgroups PAZO>NIVO
and SUN>NIVO. We also registered immune-related
adverse events (IRAEs) in the two subgroups.
Results: 37 pts were included in the analysis: 20 received
the sequence SUN>NIVO and 17 PAZO>NIVO. mOS
for the second line treatment with NIVO was similar in the
two subgroups (44.77 months for PAZO>NIVO vs 42.1
months for SUN>NIVO, p = 0.36). mPFS of second-line
treatment with NIVO was slightly higher in the
PAZO>NIVO group, even if such difference was not statistically significant (14.03 months vs 8.73 months, p =
0.72). The immune-related toxicities were slightly more
frequent in the SUN>NIVO subgroup: 15 pts out of 20
had any kind of IRAEs, whereas only 8 pts out 17 had any
kind of IRAEs in the PAZO>NIVO group, though this difference was not statistically significant (Fisher's exact
test: p = 0.0536). As far as severe events are concerned,
we observed 2 grade-3 IRAEs in the SUN>NIVO group
(a hypothyroidism and a pneumonia) and 1 grade-3 colitis
in the PAZO>NIVO group (Fisher's exact test: p = 1).
Conclusions: In our series NIVO seems to be equally effective when administered after either SUN or PAZO. The toxicity rate of NIVO in the sequence SUN>NIVO seems to be
slightly higher than in the PAZO>NIVO subgroup, even if
such difference is not statistically significant.

H25
The "burned out" or "burnt
out" testicular cancer (BTC): an
analysis of a rare phenomenon in
a virtual cohort of patients

Tumori Journal 106(2S)
case series are available in the literature. Moreover, it has
never been reviewed systematically. Therefore, we reviewed
the literature to thoroughly describe the clinical and histological characteristics of patients (pts) diagnosed with BTC.
Patients and methods: Medline was appropriately searched
from inception to 19 April 2020. Eligible publications had to
be at least case reports or case series in English or European
languages, reporting clinical and histological relevant details.
Out of 451 papers resulting from the search, 57 were included
in the study and provided the pts' data of interest.
Results: A virtual cohort of 69 pts diagnosed with BTC was
created. The median age was 34 (17-64) years. At the diagnosis, prevalent symptoms were abdominal pain (31%) and
back pain (28%); only 4% of pts reported testicular swelling
or palpable mass. The most common mts site was retroperitoneum (75%), and the mts histology was compatible with
seminoma (SEM) and non-seminoma (nSEM) in 45% and
25% of pts, respectively. In orchiectomy specimens, a testicular scar/fibrosis was found in 86% of pts, germ cell neoplasia in situ in 26%, reduced spermatogenesis in 11%,
calcification in 11%, and microlithiasis in 8%. Our findings
highlighted some inconsistencies. Firstly, the BTC diagnosis was attributed to 6% of pts not having mts. Secondly,
BTC was diagnosed in 5% of cases only based on testicular
imaging, in the absence of a histological assessment on
orchiectomy specimens. Lastly, a partial regression was
detected in 23% of pts' testes, as demonstrated by the presence of residual tumor, attributed to SEM and nSEM in 40%
and 27% of cases, respectively.
Conclusions: Our large virtual cohort of pts offers a detailed
and updated picture of BTC's clinical and histological features. SEM is the most common histotype associated with
BTC. The high occurrence of retroperitoneal mts in BTC pts
indicates that it must be considered in the diagnostic workup
for retroperitoneal extragonadal germ cell tumors. The
inconsistencies that emerged in the study highlight the need
for a clearer definition of this phenomenon. Larger, multiinstitutional registries are needed better to understand the
phenomenon of BTC and its clinical implications.

H26
Prognostic impact of age on
metastatic prostate cancer
treated with new drugs

Iannantuono G.M.1, Torino F.1, Capotondi B.1, Dell'Aria F.1, Filomeno
L.1, Guerriero S.1, Martinelli F.1, Roselli M.1

Cerma K.1, Vitale M.G.1, Baldessari C.1, Fanelli M.1, Caputo F.1,
Bardasi C.1, Riggi L.1, Pipitone S.1, Dominici M.1, Sabbatini R.1

Background: The BTC indicates the spontaneous and complete regression of a testicular germ cell tumor (TGCT) in
the presence of distant metastases (mts) at the diagnosis.
Features describing BTC are sparse, as only case reports and

Background: New treatments (abiraterone acetate, enzalutamide, cabazitaxel, Radium-223) have changed the natural history of metastatic prostate cancer (mPC). The
objective of this study is to evaluate the impact of age on
clinical outcomes of mPC patients (pts).

Oncologia Medica, Dipartimento Medicina dei Sistemi, Università Roma Tor
Vergata, Roma

University Hospital of Modena, Division of Oncology, Modena, Modena

Tumori Journal Abstract Book - October 2020

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