Glioblastomas with multiple foci at presentation (mGBMs) account for 2–35% of all GBMs. mGBMs have limited existing data and no standardized treatment. This study aims to determine their incidence, demographic and clinical features, outcome, and prognostic factors in terms of overall survival. We performed a monocentric retrospective study, reviewing patients treated at the Istituto Oncologico Veneto. Inclusion criteria were: new diagnosis of GBM and presence of multiple lesions on pre-treatment MRI. ECOG PS was used to evaluate clinical condition, RANO criteria for radiological assessment, and CTCAE v5.0 for treatment-related adverse events. The incidence of newly diagnosed mGBM was 7.2% and the study population consisted of 98 patients. Median age was 63 years, M:F ratio of 1.8:1, and a surgical approach was undertaken in 73 patients (mostly partial resection). MGMT was methylated in 47.5%, and 82 patients received active oncological treatment (65.9% radiotherapy plus temozolomide (RT + TMZ)). The disease control rate with RT + TMZ was 63%. Median OS of the entire study population was 10.2 months (95% CI 6.6–13.8), and median PFS was 4.2 months (95% CI 3.2–5.2). The ECOG PS, the extent of resection, and the RT + TMZ were significant prognostic factors in the univariate analysis for OS, but only the RT + TMZ was a significant independent OS predictor in the multivariate analysis (HR = 3.1, 95% IC 1.3–7.7, p = 0.014). The incidence of mGBM is not rare. RT + TMZ is confirmed to be an independent prognostic factor for survival and a safe and effective treatment. When feasible, RT + TMZ should be considered as a possible first-line treatment. The role of the extent of resection is still unclear.

E15696 Background: GEM still represents one of the mostly adopted treatments for PC. Combination treatments provided some improvement in response rate (RR) and progression free survival (PFS), although almost invariably associated to increased toxicity. Aiming to find a complementary therapy to GEM in advanced PC, we tested a preparation of curcumin complexed with phospholipids (Meriva) to increase bioavailability. Curcumin has antinflammatory, antioxidant and potential antitumor properties, seemingly, descending from the activation of nuclear factor Nrf2 and inhibition of NFkB. From this pattern of nutraceutical effects of Curcumin, Meriva emerges as a good candidate for complementary therapy, while also improving quality of life (QoL). Methods: This was a single centre, single arm prospective phase II trial. Inclusion criteria were: previously untreated patients with histologically confirmed metastatic or locally advanced PC, ECOG performance status (PS) of 0-2, adequate organ function and written informed consent. Patients received GEM (1,000 mg/mq in 100 minutes on day 1,8,15 every 28 days) and Meriva (2,000 mg/die, continuously) until progression, unacceptable toxicities or refusal. Primary endpoint was RR (according to RECIST 1.1), secondary endpoints were PFS, OS, tolerability and finally QoL. Serum samples collection for inflammatory biomarkers was also performed. Results: Between October 2012 and February 2015 a total of 57 consecutive patients were enrolled. Forty-four patients (15 females and 29 males; 13 locally advanced and 31 metastatic) were suitable for primary endpoint evaluation. Median age was 66 years (range 42-87); all patients except two had ECOG PS 0-1. The median number of treatment cycle was 4.5 (range 2-14). The overall RR was 27,3% (all partial responses), stable disease was reported in 34% of cases with a disease control rate of 61.3%. Grade 3/4 toxicity was observed as neutropenia (7.9%) and anemia (3%). Conclusions: Meriva as complementary therapy to GEM was safe and translate in good disease control rate in first line therapy of advanced PC. Biomarker screening is ongoing to identify patients who get the best benefit from this combination.

Aim: The efficacy of temozolomide(TMZ) plus radiation therapy(RT) in elderly patients(EP) with glioblastoma(GBM) is unclear. We describe our experience of combining RT with concurrent TMZ in EP. Methods: Medical records of patients ≥65 years old with newly GBM, histologically confirmed and treated at Venetian Institute of Oncology – Padua, were reviewed. Concomitant TMZ was 75mg/m2/die. The adjuvant treatment consisted of TMZ 150-200mg/m2/die for six cycles. Results: We analyzed 67 consecutive patients(PTS), 35 males and 32 females; the average age was 71 (range 65-86); ECOG PS was 0-1 in 37 PTS and 2-3 in 30 PTS; complete surgery was performed in 41 PTS, partial surgery in 24 PTS. MGMT was analyzed in 46 PTS: methylated(met) MGMT in 21 PTS (46%). 36 PTS were treated with RT 40Gy in 15 fractions, 23 PTS with RT 60Gy in 30 fractions, 8 PTS with only TMZ. For all PTS, PFS and OS was 7 and 12.4 ms, respectively. PFS was 7.2 vs 6.7 ms (p = 0.5), OS was 11.9 vs 13.8 ms (p = 0.3), for PTS treated with RT 40Gy and 60Gy, respectively. PFS was 7.2 vs 4.5 ms (p = 0.04), OS was 13 vs 7.3 ms (p < 0.01), for PTS treated with RT + TMZ vs only TMZ, respectively. Among PTS treated with RT + TMZ, 46 were evaluable for MGMT: 21 with metMGMT. OS was 11.7 vs 18.6 (p < 0.01) for unmet and met MGMT, respectively. We had no significant difference in terms of PFS and OS between partial and complete surgery. On multivariate analysis, RT + TMZ treatment (HR 0.2, 95% CI 95% 0.09-0.6) and metMGMT (HR 0.35, 95% CI 0.1-0.7) were independent predictors of longer OS. Regarding toxicity: grade 1-2 haematological toxicity was 19%, 23% and 42%, grade 1-2 asthenia was 25%, 23% and 42% of PTS receiving RT 40Gy + TMZ, RT 60Gy + TMZ and TMZ alone, respectively; nausea/vomiting was 5% and 3% of PTS receiving RT 60 and 40Gy; grade 3-4 haematological toxicity was 6% in PTS receiving RT + TMZ, no severe haematological toxicity and asthenia was reported in PTS receiving TMZ alone. Conclusions: RT plus TMZ is effective and safe in EP with GBM. RT + TMZ treatment seems more effective than only TMZ. PFS and OS were not statistically different between RT 40Gy or 60Gy. RT + TMZ treatment and met MGMT were independent predictors of longer survival. In contrast, severe haematological toxicity was higher in PTS with RT + TMZ compared to TMZ alone. Disclosure: All authors have declared no conflicts of interest.