- Email: [email protected]
Rare cancers are also not rare in Asia: The rare cancer burden in East Asia
Annals of Oncology 30 (Supplement 6): vi90–vi117, 2019 doi:10.1093/annonc/mdz338
ORAL SESSION : MINI-ORAL ABSTRACTS SESSION Awareness about Cervical Cancer and Its Prevention among the Female Respondents of General Hospital in Bangladesh
Nur-E- Alam1, Mst. Mahmuda Khatun2, Tarek Molla1, Hedayet Ullah1, Sumaiya Akter1, Humaira Nur Ifa1, Salma Akter1, Siratul Kubra Shifat1, Fabia Rayyan1, Rayhan Ali1, Tapon Chandra Sen1, Farzana Sultana3, A.k.m. Nazrul Islam4, Shariful Islam1, Rehana Pervin5, A. K. M. Mohiuddin1 1 Biotechnology and Genetic Engineering Department, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Bangladesh, 2Biochemistry and Molecular Biology Department, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail-1902, Bangladesh, 3Jahurul Islam Medical College, University of Dhaka, Bhagalpur, Bajitpur, Kishoregonj- 2336, Bangladesh, 4Department of Mechanical Systems Engineering, Tokyo University of Agriculture and Technology,224-16, Naka-cho Koganei-city, Tokyo 184-8588, Japan, 5Department of Gynaecology and Obstetrics, Tangail Medical College, Tangail-1900, Bangladesh Background: Globally, cervical cancer is one of the leading causes of morbidity and mortality amongst the gynecological cancers, especially in developing countries like Bangladesh. This present study was carried out to assess the knowledge and awareness about cervical cancer and its prevention among the female respondents of General Hospital of Tangail District in Bangladesh. Methods: A cross-sectional, face to face interview-based survey was conducted in September to January (2018-2019) using self-administered questionnaire to elicit information on demographic characteristics, knowledge, screening behaviors and determinants of cervical cancer. Results: A total of 478 patients participated in the screening process, out of which 71.4% (342) were illiterate whereas only 8.8% (42) were graduate. Of all the interviews conducted, 51.5% did not know cervical cancer risk factors as a disease. Only 48.5% of the respondents were aware concern cervical cancer risk factors. On the other hand, only 14% respondents were aware that infection is the most common cause of cervical cancer and the cervical cancer causing virus is Human Papilloma Virus (HPV). Only 19.9% of the study population was aware of HIV as a risk factor for cervical cancer. Our study shows that 7.1% recognized Pap smear as a screening test of cervical cancer. In total, only 251(52.5%) out of 478 respondents were aware of the treatment of cervical cancer. Conclusion: The present study revealed very low cervical cancer knowledge and poor understanding about the risk factors, diagnosis and the treatments among the women. Broad range epidemiology based study is strongly recommended in every general hospitals in Bangladesh for the proper awareness and concern about the cervical cancer risk factors and its early diagnosis.
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Temozolomide monotherapy in patient of neuroendocrine carcinoma with resistant to platinum chemotherapy (Final Report)
Noritoshi Kobayashi, Yuma Takeda, Motohiko Tokuhisa, Yukihiko Hiroshima, Ayumu Goto, Yasushi Ichikawa Oncology Department, Yokohama City University Graduate School of Medicine Background: Neuroendocrine carcinomas (NEC) (high grade Ki67 > 20%) were poor prognostic and lethal disease. Platinum-based chemotherapy is usually chosen as a first line treatment for advanced NEC. However, this efficacy is temporary and there is no standard second-line treatment. Temozolomide (TMZ) based chemotherapy is one of the effective treatment options for advanced NEC in foreign countries, however it was not approved for NEC by Japanese authorities. The aim of this study is the efficacy and safety of TMZ monotherapy for advanced NEC patients with resistant to platinumbased chemotherapy. Methods: The dose of TMZ was 200mg/m2 from day1 to 5 every 4 weeks. This study was designed as prospective Phase II. Primary end point was response rate (RR) and secondary end point was disease control rate (DCR), progression free survival (PFS), overall survival (OS) and safety. We also evaluated the prevalence of O6-methylguanine DNA methyltransferase (MGMT) in NEC and correlated MGMT deficiency with treatment response to TMZ by immunohistochemistry (IHC) as accompanying study. Results: We recruited 13 cases pathologically diagnosed poorly differentiated and/or high grade NEC (man: 6, woman: 7, median age: 65). Primary lesions were pancreas (n ¼ 3), stomach (3), duodenum (1), colon (1), gallbladder (1), liver (1), uterus (1), bladder (1), and primary unknown (1). Median of Ki-67 leveling index was 60% (range 22-90%). RR was 15.4% and DCR rate was 23.1% (PR: 2, SD: 1, PD: 10). PFS was 55 days (95% C.I. 29.7-80.3). OS was 214 days (95% C.I. 32.7-395.3) and OS from first line treatment was 547 days (429.2-664.8). There were no severe hematological adverse
events, but Grade 3 nausea was occurred only one case (7.7%). One case (9.1%) was MGMT deficiency by IHC and this case achieved partial response. Conclusion: TMZ monotherapy for advanced NEC was safety but marginally effective treatment for patient with resistant to platinum-based chemotherapy.
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IMPACT OF TREATMENT DELAYS IN EWINGS SARCOMA IN A LOW RESOURSE SETTING
Prabani S Maddumarachchi, Mahendra Somathilake, Sanjeeva Gunasekera National Cancer Institute Sri Lanka, Sri Lanka Background: Ewing’s sarcoma is the second most common primary malignant bone cancer in children and adolescents. Outcome of the children with Ewing sarcoma (ES) is worse in Low and Middle Income Countries (LMIC) compared to High Income Countries (HIC). In HIC only factor that had a significant impact on outcome was the presence of metastasis at presentation whereas treatment delay is a recognized factor contributing to poorer outcome evident by the studies especially done in LMIC. The situation in Sri Lanka has not been described before. We analyzed the clinical features and the impact of treatment delays on 5 year Event Free Survival (EFS) in Sri Lanka. Method: All children with histologically proven Ewing sarcoma registered at the paediatric department from 01.01.2006 to 31.12.2011 were included. Demographic data, dates of first registration,chemotherapy, surgery, last contact and date of an event (Death, recurrence, progressive disease)were extracted from clinic records. EFS was calculated with Kaplan Meir curves and log rank test were used to calculate the level of significance. Results: Out of 49 patients commonest site of presentation was leg (n ¼ 19) followed by chest wall (n ¼ 16). 10% had metastasis (n ¼ 5) at presentation. 65% (n ¼ 32) had surgery as local treatment (LT) and rest had radiotherapy while 4 defaulted treatment before LT. Out of extremity tumours only 21% (5/23) had limb preservation surgery. 5 year EFS in the entire cohort were 23.8%. Mean delay in neoadjuvant chemotherapy (NAC), LT and adjuvant chemotherapy (AC) were 6, 5.59 and 9.69 weeks respectively. NAC (p ¼ 0.035) and LT(p ¼ 0.004) delays significantly impacted EFS. Conclusions: In spite of demographic and pathological data are similar to published data, 5 year EFS was is inferior to the accepted international standards. Delays in NAC and LT is the likely reason for inferior outcome.
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Rare cancers are also not rare in Asia: The rare cancer burden in East Asia
Tomohiro Matsuda1, Young-Joo Won2, Ruru Chun-Ju Chiang3, Jiwon Lim2, Kumiko Saika1, Annalisa Trama4 1 Cntr. for Cancer Ctrl. and Info. Services, National Cancer Center, 2National Cancer Center, Korea, 3Taiwan Cancer Registry, 4Istituto Nazionale dei Tumouri, Milano, Italia Introduction: Epidemiologic information on rare cancers is scarce out of the Western countries. The project of surveillance of rare cancers in Asian countries (RARECAREnet Asia) provides the first standardized incidence in Asia based on the latest cancer group based on ICD-O-3. Material and methods: We analyzed population-based cancer registry data on patients diagnosed from 2011 to 2015 in Japan, Korea and Taiwan in comparison with the data in EU. With recent difficulty of data centralization in international studies, the analysis was performed in each country based on SEER*Stat. Results: Data quality in the three Asian countries were as high as EU. Based on the revised RARECARE definition (crude incidence <6/100,000/year in tier-1), the incidence of all rare cancers was 93.9 in Japan, 106.1 in Korea and 103.5 in Taiwan and 67.8 in EU corresponding to 14%, 24.0%, 24% and 11% of all cancer diagnoses. Among rare cancer families, epithelial tumours of nasopharynx, oropharynx and oral cavity and lips were not rare in Taiwan. Epithelial tumours of oral cavity and lip was not rare in Japan, neither. Epithelial tumours of gallbladder and extra hepatic biliary tract was not rare in Japan and Korea. Thyroid cancer was not rare in all three Asian countries. As for the common cancer families, epithelial tumours of esophagus was not common in Korea. Epithelial tumours of corpus uteri was not common in Korea and ovary was not common in Korea and Taiwan. Skin melanoma was not common in Asia. Even among 215 cancer groups in tier-2s, 197 was rare in Japan, 203 was rare in Korea and 201 was rare in Taiwan patients, and 198 in EU. 197 was rare in all the 4 areas in the world. Conclusion: Most of the continental gaps found in the current study were due to well known risk factors, and we conclude that EU based RARECARE rarity threshold fits well to cancer incidence in East Asia.
C The Author(s) 2019. Published by Oxford University Press on behalf of the European Society for Medical Oncology. V
All rights reserved. For permissions, please email: [email protected].
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_6/mdz338.003/5583012 by Goteborgs Universitet user on 15 October 2019
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ORAL SESSION : MINI-ORAL ABSTRACTS SESSION Awareness about Cervical Cancer and Its Prevention among the Female Respondents of General Hospital in Bangladesh
Nur-E- Alam1, Mst. Mahmuda Khatun2, Tarek Molla1, Hedayet Ullah1, Sumaiya Akter1, Humaira Nur Ifa1, Salma Akter1, Siratul Kubra Shifat1, Fabia Rayyan1, Rayhan Ali1, Tapon Chandra Sen1, Farzana Sultana3, A.k.m. Nazrul Islam4, Shariful Islam1, Rehana Pervin5, A. K. M. Mohiuddin1 1 Biotechnology and Genetic Engineering Department, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Bangladesh, 2Biochemistry and Molecular Biology Department, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail-1902, Bangladesh, 3Jahurul Islam Medical College, University of Dhaka, Bhagalpur, Bajitpur, Kishoregonj- 2336, Bangladesh, 4Department of Mechanical Systems Engineering, Tokyo University of Agriculture and Technology,224-16, Naka-cho Koganei-city, Tokyo 184-8588, Japan, 5Department of Gynaecology and Obstetrics, Tangail Medical College, Tangail-1900, Bangladesh Background: Globally, cervical cancer is one of the leading causes of morbidity and mortality amongst the gynecological cancers, especially in developing countries like Bangladesh. This present study was carried out to assess the knowledge and awareness about cervical cancer and its prevention among the female respondents of General Hospital of Tangail District in Bangladesh. Methods: A cross-sectional, face to face interview-based survey was conducted in September to January (2018-2019) using self-administered questionnaire to elicit information on demographic characteristics, knowledge, screening behaviors and determinants of cervical cancer. Results: A total of 478 patients participated in the screening process, out of which 71.4% (342) were illiterate whereas only 8.8% (42) were graduate. Of all the interviews conducted, 51.5% did not know cervical cancer risk factors as a disease. Only 48.5% of the respondents were aware concern cervical cancer risk factors. On the other hand, only 14% respondents were aware that infection is the most common cause of cervical cancer and the cervical cancer causing virus is Human Papilloma Virus (HPV). Only 19.9% of the study population was aware of HIV as a risk factor for cervical cancer. Our study shows that 7.1% recognized Pap smear as a screening test of cervical cancer. In total, only 251(52.5%) out of 478 respondents were aware of the treatment of cervical cancer. Conclusion: The present study revealed very low cervical cancer knowledge and poor understanding about the risk factors, diagnosis and the treatments among the women. Broad range epidemiology based study is strongly recommended in every general hospitals in Bangladesh for the proper awareness and concern about the cervical cancer risk factors and its early diagnosis.
MO1 2 1
Temozolomide monotherapy in patient of neuroendocrine carcinoma with resistant to platinum chemotherapy (Final Report)
Noritoshi Kobayashi, Yuma Takeda, Motohiko Tokuhisa, Yukihiko Hiroshima, Ayumu Goto, Yasushi Ichikawa Oncology Department, Yokohama City University Graduate School of Medicine Background: Neuroendocrine carcinomas (NEC) (high grade Ki67 > 20%) were poor prognostic and lethal disease. Platinum-based chemotherapy is usually chosen as a first line treatment for advanced NEC. However, this efficacy is temporary and there is no standard second-line treatment. Temozolomide (TMZ) based chemotherapy is one of the effective treatment options for advanced NEC in foreign countries, however it was not approved for NEC by Japanese authorities. The aim of this study is the efficacy and safety of TMZ monotherapy for advanced NEC patients with resistant to platinumbased chemotherapy. Methods: The dose of TMZ was 200mg/m2 from day1 to 5 every 4 weeks. This study was designed as prospective Phase II. Primary end point was response rate (RR) and secondary end point was disease control rate (DCR), progression free survival (PFS), overall survival (OS) and safety. We also evaluated the prevalence of O6-methylguanine DNA methyltransferase (MGMT) in NEC and correlated MGMT deficiency with treatment response to TMZ by immunohistochemistry (IHC) as accompanying study. Results: We recruited 13 cases pathologically diagnosed poorly differentiated and/or high grade NEC (man: 6, woman: 7, median age: 65). Primary lesions were pancreas (n ¼ 3), stomach (3), duodenum (1), colon (1), gallbladder (1), liver (1), uterus (1), bladder (1), and primary unknown (1). Median of Ki-67 leveling index was 60% (range 22-90%). RR was 15.4% and DCR rate was 23.1% (PR: 2, SD: 1, PD: 10). PFS was 55 days (95% C.I. 29.7-80.3). OS was 214 days (95% C.I. 32.7-395.3) and OS from first line treatment was 547 days (429.2-664.8). There were no severe hematological adverse
events, but Grade 3 nausea was occurred only one case (7.7%). One case (9.1%) was MGMT deficiency by IHC and this case achieved partial response. Conclusion: TMZ monotherapy for advanced NEC was safety but marginally effective treatment for patient with resistant to platinum-based chemotherapy.
MO1 2 4
IMPACT OF TREATMENT DELAYS IN EWINGS SARCOMA IN A LOW RESOURSE SETTING
Prabani S Maddumarachchi, Mahendra Somathilake, Sanjeeva Gunasekera National Cancer Institute Sri Lanka, Sri Lanka Background: Ewing’s sarcoma is the second most common primary malignant bone cancer in children and adolescents. Outcome of the children with Ewing sarcoma (ES) is worse in Low and Middle Income Countries (LMIC) compared to High Income Countries (HIC). In HIC only factor that had a significant impact on outcome was the presence of metastasis at presentation whereas treatment delay is a recognized factor contributing to poorer outcome evident by the studies especially done in LMIC. The situation in Sri Lanka has not been described before. We analyzed the clinical features and the impact of treatment delays on 5 year Event Free Survival (EFS) in Sri Lanka. Method: All children with histologically proven Ewing sarcoma registered at the paediatric department from 01.01.2006 to 31.12.2011 were included. Demographic data, dates of first registration,chemotherapy, surgery, last contact and date of an event (Death, recurrence, progressive disease)were extracted from clinic records. EFS was calculated with Kaplan Meir curves and log rank test were used to calculate the level of significance. Results: Out of 49 patients commonest site of presentation was leg (n ¼ 19) followed by chest wall (n ¼ 16). 10% had metastasis (n ¼ 5) at presentation. 65% (n ¼ 32) had surgery as local treatment (LT) and rest had radiotherapy while 4 defaulted treatment before LT. Out of extremity tumours only 21% (5/23) had limb preservation surgery. 5 year EFS in the entire cohort were 23.8%. Mean delay in neoadjuvant chemotherapy (NAC), LT and adjuvant chemotherapy (AC) were 6, 5.59 and 9.69 weeks respectively. NAC (p ¼ 0.035) and LT(p ¼ 0.004) delays significantly impacted EFS. Conclusions: In spite of demographic and pathological data are similar to published data, 5 year EFS was is inferior to the accepted international standards. Delays in NAC and LT is the likely reason for inferior outcome.
MO1 3 4
Rare cancers are also not rare in Asia: The rare cancer burden in East Asia
Tomohiro Matsuda1, Young-Joo Won2, Ruru Chun-Ju Chiang3, Jiwon Lim2, Kumiko Saika1, Annalisa Trama4 1 Cntr. for Cancer Ctrl. and Info. Services, National Cancer Center, 2National Cancer Center, Korea, 3Taiwan Cancer Registry, 4Istituto Nazionale dei Tumouri, Milano, Italia Introduction: Epidemiologic information on rare cancers is scarce out of the Western countries. The project of surveillance of rare cancers in Asian countries (RARECAREnet Asia) provides the first standardized incidence in Asia based on the latest cancer group based on ICD-O-3. Material and methods: We analyzed population-based cancer registry data on patients diagnosed from 2011 to 2015 in Japan, Korea and Taiwan in comparison with the data in EU. With recent difficulty of data centralization in international studies, the analysis was performed in each country based on SEER*Stat. Results: Data quality in the three Asian countries were as high as EU. Based on the revised RARECARE definition (crude incidence <6/100,000/year in tier-1), the incidence of all rare cancers was 93.9 in Japan, 106.1 in Korea and 103.5 in Taiwan and 67.8 in EU corresponding to 14%, 24.0%, 24% and 11% of all cancer diagnoses. Among rare cancer families, epithelial tumours of nasopharynx, oropharynx and oral cavity and lips were not rare in Taiwan. Epithelial tumours of oral cavity and lip was not rare in Japan, neither. Epithelial tumours of gallbladder and extra hepatic biliary tract was not rare in Japan and Korea. Thyroid cancer was not rare in all three Asian countries. As for the common cancer families, epithelial tumours of esophagus was not common in Korea. Epithelial tumours of corpus uteri was not common in Korea and ovary was not common in Korea and Taiwan. Skin melanoma was not common in Asia. Even among 215 cancer groups in tier-2s, 197 was rare in Japan, 203 was rare in Korea and 201 was rare in Taiwan patients, and 198 in EU. 197 was rare in all the 4 areas in the world. Conclusion: Most of the continental gaps found in the current study were due to well known risk factors, and we conclude that EU based RARECARE rarity threshold fits well to cancer incidence in East Asia.
C The Author(s) 2019. Published by Oxford University Press on behalf of the European Society for Medical Oncology. V
All rights reserved. For permissions, please email: [email protected].
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_6/mdz338.003/5583012 by Goteborgs Universitet user on 15 October 2019
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