Tumori Journal Abstract Book - October 2020 - 19

A - Thoracic Cancers
Pts with a low NLR, 13 had PD (37%), 9 (25,7%) RP, 1
(2,8%) RC (complete response) and 12 (34,2%) SD, with a
CB of 62,7%.
Regarding PLR, 29/65 pts (44,6%) had high value, 36/65
(55,4%) had low value.
21 pts with high PLR had PD (72,41%) while 1 (3,4%) RP
and 7 (24,1%) SD, with a CB of 27.5%.
13 pts with low PLR had PD (36,1%), 10 (27,7%) RP, 1
(2,7%) RC and 12 (33.3%) SD, with CB of 63,7%.
We examined several immunocorrelated toxicities and for
some of these we found differences between the groups
examined: High NRL versus (VS) low NLR: Fatigue
(66.6%VS45,7%); Diarrhea/Colitis (33.3%VS20%); Rash
(46,6%VS14,2%);
Dyspnea
(70%VS31,4%);
Hematological
toxicity
(26.6%VS2,8%);
Itching
(30%VS8,5%); High PLR VS low PLR: Fatigue (75,8%VS
55.5%);
Hematological
toxicity
(24.1VS13.8%);
Itching(20.6%VS13.8%).
Conclusions: Our results suggest that high pre-treatment
NLR and PLR are associated with lower response rate and
greater incidence of toxicity patients treated with
Nivolumab. They could be considered prognostic and
safety markers.

A27
Italian Survey on unmet medical
needs in Small Cell Lung Cancer
(Ulysses)
Paratore C.1, Vallone S.2, Bungaro M.1, Pacchiana M.V.1, Conte P.3,
Cortinovis D.4, Galetta D.5, Lo Russo G.6, Mantini G.7, Mantovani C.8,
Martelli O.9, Mencoboni M.10, Menis J.11, Mortellaro G.12, Nardone
A.13, Pinto C.14, Rapetti S.1, Russo A.12, Sepulcri M.15, Novello S.1
1
Department of Oncology, University of Turin, San Luigi Hospital,
Orbassano, Turin; 2Women Against Lung Cancer in Europe, Orbassano,
Turin; 3Department of Surgery, Oncology and Gastroenterology, University
of Padua and Medical Oncology2, Veneto Institute of Oncology IOV-IRCCS,
Padua; 4UO Medical Oncology, ASST San Gerardo Hospital, Monza;
5
Medical Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo
II", Bari; 6Department of Medical Oncology, Fondazione IRCCS Istituto
Nazionale dei Tumori, Milan; 7Radiation Oncology Department GemelliART, Fondazione Policlinico Agostino Gemelli, Università Cattolica del S.
Cuore, Rome; 8Radiation Oncology Department, AOU Città della Salute,
University of Turin, Turin; 9U.O Medical Oncology, ASL Frosinone, Frosinone;
10
Oncology Unit, Villa Scassi Hospital, Genova; 11Department of Surgery,
Oncology and Gastroenterology, University of Padua and Medical Oncology2,
Veneto Institute of Oncology IOV-IRCCS, Padua; 12University Hospital Paolo
Giaccone, University of Palermo, Palermo; 13Radiotherapy Unit IRCCS
Oncologico Giovanni Paolo II, Bari; 14Medical Oncology Unit, Clinical Cancer
Centre, AUSL-IRCCS di Reggio Emilia, Reggio Emilia; 15Radiation Oncology
Department, Veneto Institute of Oncology IOV-IRCCS, Padua

Background: Small cell lung cancer (SCLC) is an aggressive tumor, with high rate of recurrence and metastatic
progression. About 90% of SCLC patients have extensive
disease. As there was no significant breakthrough, the current standard of care has remained unchanged for the past
20 years. The aim of this survey is to identify and gather

19
the unmet needs of patients and stakeholders involved in
the journey, to improve their outcomes and quality of life.
Methods: The study consisted of three steps: a first desk
analysis on the state of the art of SCLC, a second step of
qualitative research with individual interviews to clinicians and caregivers and monitoring the online conversations and, finally, a quantitative research through web
interviews to size the data collected. 110 subjects were
recruited: 50 oncologists, 30 radiotherapists and 30 caregivers from 11 Italian centers.
Results: More than half of caregivers reported delays in
health care system, mainly due to multiple visits with specialists and to the several diagnostic procedures required.
The average delay between the onset of symptoms and
diagnosis is 10-12 weeks. Some patients do not notice any
symptoms, and diagnosis of SCLC is incidental in around
12% of them.
More than 75% of clinicians consider SCLC to be complex, which requires a multidisciplinary approach, so 80%
discuss new cases in weekly meeting. The majority of clinicians have low satisfaction with current standards of
care, as in this area, there are no new therapies currently
approved. People interviewed believe that the therapeutic
options are limited and ineffective.
70% of clinicians and 90% of caregivers consider palliative care at home the best resources to manage the end of
life. According to clinicians, home assistance palliative
care is available in only 70% of cases.
Conclusions: These data reflect the urgent need to ensure
early diagnosis and novel treatment strategies for SCLC.
Education campaigns on populations and training to primary care doctors could improve awareness of SCLC and
facilitate early access to healthcare. Multidisciplinary
approach, including palliative care and psychological support, could lead to an early diagnosis and treatment and
improve quality of life of SCLC patients.

A28
Integrating molecular analysis
and radiomic features to surveil
clonal heterogeneity of EGFRmutated NSCLC
Cucchiara F.1, Del Re M.1, Valleggi S.2, Romei C.2, Petrini I.2, Lucchesi
M.2, Crucitta S.1, Rofi E.1, De Liperi A.2, Chella A.2, Russo A.3, Danesi R.1
1

A.O.U.P. "Santa Chiara" University Hospital, Pisa; 2A.O.U.P. "Cisanello"
University Hospital, Pisa; 3A.O.U.P., Palermo

Background: EGFR-mutated NSCLC is a dynamic entity
and tumor progression and resistance to treatment arises
from the accumulation over time and across different disease sites of subclonal genetic mutations. The concept of a
single-site biopsy to monitor disease dynamics is practically
unfeasible since it is invasive and may result in underestimation of such heterogeneity. Instead, a combined approach

Tumori Journal Abstract Book - October 2020

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