Background: The excellent results of phase 3 randomized trials have rendered cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) combined with endocrine treatment (ET) as the new standard of care for both endocrine-sensitive and -resistant patients (pts). We performed a single institution retrospective review of pts with metastatic hormone receptor positive (HR+) HER2 negative (HER2-) breast cancer (MBC) receiving CDK4/6i in I line setting.

CIV was significantly higher in the aprepitant group compared to the control group overall (51% vs 22%; p¼0.007) and especially in the acute phase (59% vs 29%; p¼0.007).The time to the first episode of vomiting was also significantly higher in the aprepitant group (p¼0.0004).The reported adverse events were similar between the two groups.There was no difference in acute and delayed nausea.Conclusions: The use of aprepitant as add-on prophylactic anti-emetic during induction chemotherapy for AML significantly improves CIV rate in children especially in acute phase.

Background: Breast cancer (BC) is commonly diagnosed at early stage and more than 80% of patients (pts) are long-term survivors. Most cancer society guidelines recommend a non-intensive follow-up, that, after 5 years from diagnosis, consists of annual medical history, physical examination and surveillance mammogram. The role of family physician in the management of BC follow-up is still under discussion. Material and methods: Since 2013, we have launched a shared BC survivor follow up program involving family physicians working in the Province of Lecco. Pts with diagnosis of early BC have been referred to their family physician to continue surveillance with annual physical examination and mammogram at the completion of adjuvant treatment and after at least 5 years of follow-up, if no clinical evidence of disease recurrence was present. In case of suspicious disease recurrence, a direct access to our oncology unit has been offered. Results: From May 2013 to March 2017, 643 women have been enrolled in our program. All pts were disease free (as per clinical assessment), had completed adjuvant treatment and at least 5 years of follow-up at the time of enrollment. 11% of pts had ductal carcinoma in situ, 66% invasive ductal carcinoma, 7% invasive lobular carcinoma and 16% other histologic subtypes. 11% was hormonal receptor negative and 7% was HER2 positive. 44% was G2 and 34% G3. 25% received chemotherapy followed by hormonal treatment, 9% received adjuvant chemotherapy alone and 61% received hormonal treatment alone. Median follow up time was 8 years (range 5-23 years). 10/643 (1,6%) pts experienced BC recurrence: 3 had distant metastasis, 4 unilateral breast recurrence and 3 contralateral. Those with local recurrence underwent breast surgery followed by adjuvant chemotherapy in 1 case, chemotherapy and hormonal treatment in 1 and hormonal treatment alone in 5. Pts with distant metastasis are still alive and currently on treatment (1 with chemotherapy, 2 with hormonal treatment). Conclusion: This preliminary analysis has shown the feasibility of our program with a significant number of pts referred to their family physicians, reducing the need for specialist follow-up. Only a small proportion of pts experienced subsequent relapse requiring reassessment by the treating oncologist. Further analysis is planned to define the adherence to the shared follow-up.

Brain metastases are the most common brain tumors in adulthood. They arise from lung, breast, kidney, gastrointestinal cancer, melanoma and other primary cancers. A recent study (Sperduto, JCO 2012) has provided algorythms for prediction of the expected survival in patients with different histologies of the primary tumor, refining previously available risk stratification classes. Increase in survival in patients with brain metastases may be linked to earlier detection, availability of new treatments for primary tumor and adoption of stereotactic surgery/surgery in fit patients. The data obtained by Sperduto need to be validated in other populations of brain metastases patients. We assessed survival in a cohort of 156 patients with brain metastases (all undergoing neurosurgery) followed in 2 Hospitals (Lecco and Varese) in Lombardia over 12 years (2000 to 2012). 75 cases were from lung cancer, 36 breast, 21 melanoma and 12 colorectal and 12 from other sites. Mean time to metastatic brain disease was 4.6 months for lung, 35.4 for colorectal, 52.2 for breast, 61.2 for melanoma and 78.5 for kidney cancer, respectively. Mean survival after diagnosis of metastatic brain disease was 6.9 months for melanoma, 7.2 for colorectal, 14.5 for lung, 26.6 for kidney and 26.9 months for breast-derived metastases. Our data confirm that time to onset of metastatic brain disease is dependent on the type of primary tumor and - in agreement with those reported in Sperduto's graded prognostic assessment database - show the presence of a non-negligible percentage of patients with prolonged survival after diagnosis and treatment of brain metastatic disease.

e19675 Background: Cancer survivors are faced with physical and psychological problems. In follow-up care we have to give greater attention to the quality of life. The fear of cancer recurrence (FCR) is one the most disturbing aspects, resulting in pointless examinations and one of the most prevalent areas of unmeet needs. Yet few efforts have been made to better understand this phenomenon and to work out a validated measures. The goal of this study was to develop the Italian version of the Fear of Cancer Recurrence Inventory (FCRI). Methods: The FCRI is a multidimensional 42-items questionnaire evaluating seven fear components: Triggers, Severity, Psychological distress, Functioning impairments, Insight, Reassurance and Coping strategies. It was initially worked out and validated with French-speaking Canadian cancer survivors (Simard & Savard Supp Care Cancer 2009 17:241-251). A forward-backwards procedure was used to translate the original FCRI into Italian, then it was pilot tested in fifty Italian cancer survivors to assess face and content validity. Results: The partecipants were able to identify correctly the general content being measured (i.e. good face validity). Italian FCRI was considered to be clear, useful, simple to use and no time consuming; it could help to investigate the fears of patients facilitating the communication with physicians. It was found to be distressful only by one partecipant, but this was associated with a recent death of a relative. Partecipants were happy to collaborate in a project that could help other patients. 16% of interviewed suggested questions about God in coping strategies; in their mind God represents an important support to fight their fears. Conclusions: These findings provide preliminary evidence about the usefulness and the utility of FCRI in people with different culture. Further studies are needed to assess its validity and its transcultural availability. If cancer treatments move from cytotoxic agents to molecular ones, Physicians need to take care of survivors exploring more global perspectives. FCRI will be released at sebastien.simard@criucpq.ulaval.ca No significant financial relationships to disclose.