Tumori Journal Abstract Book - October 2020 - 182

182	
Personeni N.1, Mineri R.2, D'Alessio A.1, Cammarota A.1, Michelini
A.3, Bozzarelli S.1, Smiroldo V.1, Pressiani T.1, Giordano L.4, Sandri
M.T.2, Santoro A.1, Rimassa L.1
1
Medical Oncology and Hematology Unit, Humanitas Cancer Center,
Humanitas Clinical and Research Center - IRCCS, Rozzano; 2Molecular
Biology Section, Clinical Investigation Laboratory, Humanitas Clinical and
Research Center - IRCCS, Rozzano; 3Department of Biomedical Sciences,
Humanitas University, Pieve Emanuele; 4Biostatistics Unit, Humanitas Cancer
Center, Humanitas Clinical and Research Center - IRCCS, Rozzano

Tumori Journal 106(2S)
Carnio S.1, Capizzi I.1, Mariniello A.1, Paratore C.1, Reale M.L.1,
Rapetti S.G.1, Artusio E.1, Olmetto E.1, Capelletto E.1, Bertaglia V.1,
Pignataro D.1, Bironzo P.1, Passiglia F.1, Bitossi R.1, Sperone P.1,
Buttigliero C.1, Palesandro E.1, Brizzi M.P.1, Napoli V.1, Novello S.1
1
Department of Oncology,University of Turin, AOU San Luigi, Orbassano
(TO), Italy

Background: IRI is widely used in the treatment of
advanced gastrointestinal cancers. Consistent with current
guidelines, UGT1A1 genotyping may drive IRI dose
reductions, but the usefulness of this approach, performed
in a prospective manner, is still unclear. We assessed the
incidence of grade ⩾3 neutropenia in patients who undergo
IRI-based chemotherapies after upfront genotyping of
UGT1A1 polymorphisms.
Methods: We genotyped UGT1A1*28 polymorphisms in
247 patients receiving second or third line IRI-based
chemotherapy in clinical practice at a single academic
center. Concomitant DPYD sequencing was performed in
179 patients receiving also fluoropyrimidines. Based on
the results of the UGT1A1 genotyping, in UGT1A1 6/6
and 6/7 carriers full-dose IRI was delivered, whereas in
UGT1A1 7/7 carriers initial IRI dose reductions by at least
30% were done. We compared the incidence of grade ⩾3
neutropenia occurring in UGT1A1 6/6 and 6/7 carriers,
and in UGT1A1 7/7 carriers.
Results: The incidence of UGT1A1 7/7, 6/7, 6/6 genotypes
was 11.3%, 51.4%, and 37.2%, respectively. IRI dose reductions were significantly more frequent with UGT1A 7/7 and
6/7 genotypes (odds ratio [OR] = 9.5; 95% confidence
interval [CI]: 4.3-21.7), and combination chemotherapy
(OR = 3.8; 95%CI: 1.3 - 11.1). Other clinical parameters,
including sex, cancer type, baseline neutrophils levels, baseline bilirubin levels, performance status were not significantly associated with dose reductions. Despite initial IRI
reductions, UGT1A1 7/7 genotype was associated to an
increased, albeit non-significant, risk of grade ⩾3 neutropenia, compared to patients with UGT1A1 6/6 and 6/7 genotypes who received full-dose IRI (incidence: 39% versus
21%; OR = 2.4; 95%CI: 0.85 - 7.03).
Conclusions: UGT1A1 testing is a determinant of IRI
dose reductions, however this strategy does not reduce the
burden of grade ⩾3 neutropenia in UGT1A1 7/7 carriers.
Further studies beyond the UGT1A1*28 genotype are
needed to fully understand the determinants of severe neutropenia in these patients.

Background: Cancer patients (pts) often experience
weight loss or even cachexia, in severe cases. Malnutrition
can affect quality of life and response to treatment, ultimately leading to poor prognosis.
Methods: A nutrition clinic has been set up in our
Department. The intervention included: a malnutrition
screening through two validated tests (NRS 2002 and
MST), a nutritional counselling for malnourished pts and
nutritional care for malnourished or at high-risk pts. Also,
a quality of life assessment (through ESAS questionnaire)
was administered at each visit.
Results: From February 1th to December 31th 2019, 240
pts (57.9% men) were evaluated. Mean age was 67 years
(range: 39-85). Two hundred twenty-six pts (94%) had an
ECOG performance status of 0-1 and 156 pts (65%) were
stage IV. The most common malignancies were lung
(n=137), breast (n=18), esophagus-gastric-pancreatic and
biliary tract cancers (n=18). Two hundred and nine pts
were on active treatment. At baseline, 81 pts reported nausea (moderate-severe grade in 63 pts) and 123 experienced
loss of appetite (severe-moderate in 94 cases). At the first
screening, an average weight loss of 3.5% and 5.2% was
observed for the previous 3 and 6 months, respectively.
Across the two screening tests, the scores diverge when
considering patients not at risk, where, in the NRS test, 1
point is given for cancer diagnosis and 1 additional point
for pts aged 70 and over. On the other hand, the 2 screening tests seem to be consistent in the identification of pts at
high nutritional risk, in both cases about 24%. Oral supplements (ONS) were prescribed in 81 pts (34%). An important reduction in the percentage of pts at high nutritional
risk was observed 7 months after the first visit. MST
detected no pts at high nutritional risk, while NRS 2002
detected only one case. 83.3% of the study population had
an NRS screening score of 1 or 2, suggestive for a low
nutritional risk. The mean weight loss after 7 months was
1.7% (a small, non significant loss of weight).
Conclusions: Nutritional counselling should be wellplanned starting from the first oncological visit to identify
and follow cancer pts at risk of malnutritionand and ultimately improving treatment adherence.

T13

T14

Nutritional counseling in
oncology: what impact? A single
institution experience

Prognostic impact of steroid use
in immunotherapy treatment in a
real world setting



Tumori Journal Abstract Book - October 2020

Table of Contents for the Digital Edition of Tumori Journal Abstract Book - October 2020

Contents
Tumori Journal Abstract Book - October 2020 - Cover1
Tumori Journal Abstract Book - October 2020 - Cover2
Tumori Journal Abstract Book - October 2020 - I
Tumori Journal Abstract Book - October 2020 - II
Tumori Journal Abstract Book - October 2020 - Contents
Tumori Journal Abstract Book - October 2020 - IV
Tumori Journal Abstract Book - October 2020 - V
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