2054P Metastatic cancer patients hospitalized at initial diagnosis: When does rescue systemic therapy make sense? ONIRIS - A national, prospective study

Little is known about metastatic cancer patients who are hospitalized at diagnosis because of impaired performance status and/or severe symptoms. This study aims to explore their prognosis and the effect of systemic anti-neoplastic treatment (SANT) initiation on their outcomes. A prospective multicentric study of adult inpatients with a newly diagnosed metastatic solid tumor was conducted in seven cancer-facilities in France. During a three-month follow-up, socio-demographic characteristics, response rate and duration of response for patients receiving SANT, length of hospital stay and survival were collected. Correlation with clinical prognostic and predictive factors was analyzed. 107 patients were included from November 2021 to April 2022. Seventy-four (69%) underwent SANT. Median overall survival was 1.7 months for the entire cohort. Forty (37%) were alive at 3 months, including 39 patients that started SANT. Factors associated with the initiation of a SANT were young age (OR=0,94 [0,90; 0,98]), low Charlson Comorbidity Index (OR=0,56 [0,42; 0,73]), SANT initiated at patient’s or caregiver’s request (OR=0,07 [0,02; 0,17] and 0,17 [0,06; 0,42], respectively). Patients with biomarker-based targeted therapy had better outcomes at 3 months, while survival of patients treated with exclusive immunotherapy was poor. PALLIA-10 score superior to 5 was a significant predictive factor for mortality (HR=3,24; p<0,001). Metastatic cancer patients hospitalized at the time of diagnosis share a similar poor survival. The initiation of SANT does not always impact their outcomes. Larger prospective studies with longer follow-up are needed to better assess the effect of SANT in this population.