Tumori Journal Abstract Book - October 2020 - 46

46	
Results: Between September 2016 and September 2019, a
total of 206 patients received perioperative FLOT at 15
Italian centers: of those, 24 (60.2%) received FLOT for at
least 4 full-dose cycles, 190 (92.2%) underwent surgery, and
142 (68.9%) started the postoperative phase. Among
patients who started the postoperative phase, 105 (51.0%)
received FLOT, while 37 (18%) received de-intensified
regimens (e.g. FOLFOX or 5FU/LV). The main reasons for
de-intensifying postoperative treatment were mainly the
deterioration of clinical conditions after surgery and the toxicities experienced in the preoperative phase. Pathological
complete response (pCR) was obtained in 7.3% of patients.
Safety profile was consistent with literature. Neutropenia
was the most commonly reported G 3-4 adverse events
(AE), affecting 19.9% of patients in the preoperative phase
and 16.9% of those who started the postoperative phase. No
toxic death was observed and 30-day postoperative mortality rate was 1.0%.Furthermore, FLOT regimen exhibited
similar tolerability also in elderly patients (⩾65 years). MSI
status was available for 93 patients and 9.7% were MSI-H.
A trend towards better disease-free survival (DFS) was
observed among MSI-H patients.
Conclusions: Perioperative FLOT is standard of care in
Italy for patients with resectable gastric or GEJ adenocarcinoma. These real-world data confirm the feasibility of
perioperative FLOT in a less-selected population, representative of the clinical practice. Pathological CR rate was
lower than expected, nevertheless we confirm pCR as a
predictive parameter of survival. In addition, MSI-H status
seems to be a positive prognostic marker also in patients
treated with taxane-containing triplets.

C03*
Guideline Application in Real
world: multi-Institutional
Based survey of Adjuvant and
first Line pancreatic Ductal
adenocarcinoma treatment
in Italy: the GARIBALDI trial.
Preliminary results
Reni M.1, Bergamo F.2, Giommoni E.3, Di Marco M.C.4, Cordio S.5,
Bernardini I.6, Cardellino G.G.7, Spada M.8, Milella M.9, Luppi G.10,
Silvestris N.11, Maiello E.12, Bozzarelli S.13, Giordano M.14, Cavanna
L.15, Ghidini M.16, Peretti U.1, Valente M.M.1, Torri V.17, Porcu L.17,
Giugliano V.17
IRCCS San Raffaele, Milano; 2IRCCS Istituto Oncologico Veneto, Padova;
AOUC Azienda Ospedaliero-Universitaria Careggi, Firenze; 4Ospedale
Policlinico Sant'Orsola Malpighi, Bologna; 5Ospedale Maria Paternò Arezzo,
Ragusa; 6Ospedale Ramazzini di Carpi e Mirandola, Carpi (MO); 7Azienda
Sanitaria Università Integrata di Udine, Udine; 8Fondazione Istituto Giglio,
Cefalù; 9Azienda Ospedaliera Universitaria Integrata Verona, Verona;
10
Azienda Ospedaliera Universitaria di Modena, Modena; 11IRCCS Istituto
Tumori "Giovanni Paolo II", Bari; 12Istituto Casa Sollievo della Sofferenza,
San Giovanni Rotondo (FG); 13IRCCS Istituto Clinico Humanitas, Milano;
14
ASST-lariana, Como; 15Azienda Ospedale Civile, Piacenza; 16ASST Cremona,
Cremona; 17Istituto Mario Negri, Milano

Tumori Journal 106(2S)
Background: Limited prospective information is available about therapeutic management of patients (pts) with
Pancreatic Ductal Adenocarcinoma (PDAC) and on adherence to Scientific Societies Guidelines in the 'real world'
out of clinical trials. The aim of this national, observational, multicenter, prospective trial is to describe the therapeutic management for pts with PDAC and evaluate the
agreement with recommendations provided by the Italian
Association of Medical Oncology (AIOM 2017).
Methods: Participating institutions were selected to adequately represent different geographical and expertise
areas (high-volume with >50 pts treated /year; mediumvolume with 25-50 pts treated /year; low-volume with
<25 pts treated /year). The attending physician indicated
treatment without restrictions. Since December 2017,
treatment-naïve consenting pts, > 17-year, with pathological diagnosis of PDAC were enrolled and grouped in 3 settings: 1) receiving adjuvant therapy after resection; 2)
receiving primary chemotherapy; 3) metastatic.
Here we present the results of pts accrued until October
31st 2019.
Results: 659 eligible pts were enrolled in 43 Italian centers: Nord 494 (75%), Centre 84 (13%), South 81 (12%);
high-volume 431 (66%); medium volume 121 (18%); lowvolume 107 (16%). Home to hospital distance was ⩽50
km for 88% of pts. Median age was 69 (range 36-89); 52%
male; 93% ECOG PS 0-1; clinical stage: 8% I, 15% II,
25% III, and 52% IV.
Guidelines adherence was 74% for group 1 (N=148); 97%
for group 2 (N=174); 98% for group 3 (N=337). The most
frequently administered regimens were gemcitabine (G)
39%; nab-paclitaxel + G (AG) and FOLFIRINOX 21%
each in group 1; AG 57%; FOLFIRINOX 26%; G 13% in
group 2; AG 74%; G 16%; FOLFIRINOX 6% in group 3.
The interval between symptoms and diagnosis was < 15
days in 85% of pts and > 1 month in 8%. The time between
diagnosis and start of treatment was < 15 days in 67% of pts
and > 1 month in 15%. The 1st physician involved by the pt
was the general practitioner (32%), emergency doctor (20%),
internal medicine (15%), surgeon (15%; in metastatic disease=14%), gastroenterologist (12%), oncologist 0.5%.
Conclusions: The data of our study, whose enrollment is
ongoing, show a very high rate of adherence with some attrition in the adjuvant setting. Data on interval between symptoms-diagnosis-treatment start are reassuring. The oncologist
is a neglected specialist in Italian culture of cancer.

1
3

C04
Comparative Efficacy of
Cabozantinib and Regorafenib
for Advanced Hepatocellular
Carcinoma
Daniele B.1, Kelley R.K.2, Mollon P.3, Blanc J.4, Yau T.5, Cheng A.6,
Valcheva V.3, Marteau F.3, Guerra I.7, Abou-Alfa G.K.8
Tumori Journal Abstract Book - October 2020

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