Maria Pilar Solis-Hernandez

Background: Head and neck cancer (HNC) and its multimodal treatment substantially impair speech, swallowing, breathing, appearance, and psychosocial well-being. Patient-reported outcome measures (PROMs) improve symptom monitoring and quality of life in oncology, yet their integration into routine HNC care remains inconsistent. This study assessed patterns of PROM use, perceived value, and barriers to implementation among healthcare professionals (HCPs) involved in HNC care. Methods: A 30-item cross-sectional survey was distributed to HCPs treating HNC patients between June 2024 and April 2025. The questionnaire explored PROM use in clinical practice and trials, perceived relevance across care phases, and implementation barriers. Respondents were classified as non-users, occasional users, or regular users. Data were analyzed descriptively with comparisons between groups. Results: Among 133 respondents, 33.8% were non-users, 29.3% occasional users, and 36.8% regular users of PROMs. Users reported inviting half of patients to complete PROMs, predominantly via paper-based questionnaires (67.8%). PROMs were mainly applied during active treatment and early follow-up to monitor symptoms, overall health, and emotional well-being, and were less frequently used to guide treatment decisions. The EORTC QLQ-C30 and HNC-specific tools were most commonly reported. Compared with users, non-users more often cited lack of time, limited training in interpreting PROM data, insufficient institutional support, resource constraints, and lack of appropriate instruments (all p < 0.05). PROM use in clinical trials was associated with routine use (p < 0.001). Conclusions: Although PROMs are widely valued in HNC care, their integration into clinical decision-making remains limited. Addressing organizational, educational, and digital barriers is essential to support sustainable implementation.

Background: This study compared survival outcomes between upfront surgery +/−radiotherapy (RT) and definitive RT with or without chemotherapy (RT/CRT) in HPV-negative oropharyngeal squamous cell carcinoma (OPSCC). Methods: A retrospective matched-pair analysis included 150 patients treated between 1990 and 2020. Fifty (RT/CRT) cases (2009–2020) were matched 2:1 to 100 surgical cases (1990–2009) by sex, subsite, T/N classification, and AJCC 8th stage. Sixty-six percent of surgically treated patients received adjuvant RT. Only HPV-negative tumors confirmed by p16 and HPV DNA testing were analyzed. Survival was assessed with Kaplan–Meier and Cox regression. Results: RT/CRT achieved significantly higher 5-year overall survival (59% vs. 28%) and disease-specific survival (69% vs. 45%) compared with surgery. Matched-pair analysis showed increased overall mortality (HR 1.91; p = 0.008) and disease-specific mortality (HR 2.05; p = 0.022) in surgical patients. In stage III disease, RT/CRT provided markedly superior DSS (87% vs. 42%). No significant differences were found in local control or recurrence-free survival, but metastasis-free survival was significantly worse in the surgical cohort, and the incidence of second primary tumors was significantly lower in the RT/CRT group. Conclusions: These findings indicate that RT/CRT provides superior survival outcomes and better control of distant metastasis and second primary tumors compared with surgery in HPV-negative OPSCC, particularly in stage III disease. RT/CRT should be considered an effective organ-preserving option for this population.

Glioblastoma stands as the most frequent primary brain tumor. Despite the multimodal therapy for glioblastoma patients, the survival rate is very low, highlighting the need for novel therapies that improve patient outcomes. Immune checkpoint blockade strategies are achieving promising results in a myriad of tumors and several studies have reported its efficacy in glioblastoma at a preclinical level. ILT2 is a novel immune checkpoint that exerts an inhibitory effect via the interaction with classical and non‐classical HLA class‐I molecules. Herein, we report that ILT2 blockade promotes antitumor responses against glioblastoma. In silico and immunohistochemical analyses revealed that the expression of ILT2 and its ligands HLA‐A, ‐B, ‐C, and ‐E are highly expressed in patients with glioblastoma. Disruption of ILT2 with blocking monoclonal antibodies increased natural killer cell‐mediated IFN‐γ production and cytotoxicity against glioblastoma, partially reverting the immunosuppression linked to this malignancy. In addition, co‐treatment with temozolomide strengthened the antitumor capacity of anti‐ILT2‐treated immune cells. Collectively, our results establish the basis for future studies regarding the clinical potential of ILT2 blockade alone or in combination regimens in glioblastoma.

Small leucine-rich proteoglycans (SLRPs) regulate different processes and undergo significant alterations in various diseases. Colon carcinomas (CCs) are heterogeneous pathologies with important clinical and molecular differences depending on their location, which makes it interesting to analyze the alterations in SLRPs in right- and left-sided tumors (RS- and LSCCs). SLRP transcription levels were studied in 32 CCs using qPCR compared to healthy colon mucosae samples from the same patients, 20 of them from LSCCs and the remaining 12 from RSCCs. Protein expression of genes with significant differences in their transcriptions was analyzed by immunohistochemistry. The alterations observed were related to survival data. The arrangement of transcription of SLRPs was quite similar in ascending and descending colon, but RS- and LSCCs displayed different patterns of alteration, with a greater number of deregulations occurring in the latter. The analysis of protein expression also indicated changes in the location of these molecules, largely moving to the cell interior. While podocan underexpression showed a trend toward better outcomes, no differences were observed in terms of overall survival. In vitro studies using the HT29 tumor cell line suggest that deregulation of SLRPs could affect cell proliferation. SLRPs constitute new differential markers of RS- and LSCCs, showing differences dependent on the anatomical location of the tumor.

E24098 Background: Patient reported outcomes measures (PROMs) represent a tool to objectively assess the health of cancer patients. PROMs may complement oncological evaluations by adding patients’ perspectives on their care priorities. Aim: to address more accurately the management of tumor related symptoms or drug related toxicities to bring he therapies more accurately to bring patients the best quality of life possible. Methods: Data was collected from our electronic registry after proper authorization and corresponding anonymization. Patients were systematically asked for symptoms as fever, diarrhea, dyspnea, vomiting and nausea. These symptoms were graded according to their severity using the Common Toxicity Criteria v5.0. Results: 49 patients admitted to Medical Oncology Hospitalization were included from July of 2020 to January 2021, 80% in advanced disease. Median age 63yo, 32% above 70 yo. Baseline data showed that 27% patients (19% stage IV) had fever at admission, decreasing at 48h to 4%. Patients who had vomiting at admission were 33% (28% stage IV) median grade 2 becoming 20% and grade 1 at 48h. Nausea was present in 49% patients (35% stage IV) at the time of admission with a median grade 1.5, and it decreased to 16% at 48h with a median grade 2. Diarrhea was reported in 12% patients (6% stage IV) median grade 2 at baseline and it was reduced to 10% median grade 1 at 48h. The median severity of diarrhea at admission was 2 and only 1 at 48h. At admission, 33% (all stage IV) of patients presented dyspnea with a median grade 3, while at 48h it was present in 26% of patients and reduced to median grade 2. Conclusions: By systematically measuring symptoms, patients achieved better control of diarrhea, dyspnea, vomiting and nausea after admission. It should be noted that nausea was the variable that decreased the most at 48h, followed by fever, vomiting, dyspnea and diarrhea. All patients with stage IV disease had dyspnea and most of them had nausea and vomiting. These results reflect that these symptoms are more usual in patients with advanced disease compared to those with localized disease. PROMS also help us educate patients by teaching them how to manage treatments, thus improving therapeutic adherence.

Background The purpose of our study was to analyse the usefulness of Choi criteria versus RECIST in patients with pancreatic neuroendocrine tumours (PanNETs) treated with sunitinib. Method A multicentre, prospective study was conducted in 10 Spanish centres. Computed tomographies, at least every 6 months, were centrally evaluated until tumour progression. Results One hundred and seven patients were included. Median progression-free survival (PFS) by RECIST and Choi were 11.42 (95% confidence interval [CI], 9.7–15.9) and 15.8 months (95% CI, 13.9–25.7). PFS by Choi (Kendall’s τ = 0.72) exhibited greater correlation with overall survival (OS) than PFS by RECIST (Kendall’s τ = 0.43). RECIST incorrectly estimated prognosis in 49.6%. Partial response rate increased from 12.8% to 47.4% with Choi criteria. Twenty-four percent of patients with progressive disease according to Choi had stable disease as per RECIST, overestimating treatment effect. Choi criteria predicted PFS/OS. Changes in attenuation occurred early and accounted for 21% of the variations in tumour volume. Attenuation and tumour growth rate (TGR) were associated with improved survival. Conclusion Choi criteria were able to capture sunitinib’s activity in a clinically significant manner better than RECIST; their implementation in standard clinical practice shall be strongly considered in PanNET patients treated with this drug.

Heparan sulfate proteoglycans (HSPGs) are complex molecules which play a role in the invasion and growth and metastatic properties of cancerous cells. In this work we analyze changes in the patterns of expression of HSPGs in left sided colorectal cancer (LSCRC), both metastatic and non-metastatic, and the results are also compared with those previously obtained for right sided tumors (RSCRCs). Eighteen LSCRCs were studied using qPCR to analyze the expression of both the proteoglycan core proteins and the enzymes involved in heparan sulfate chain biosynthesis. Certain HSPGs also carry chondroitin sulfate chains and so we also studied the genes involved in its biosynthesis. The expression of certain genes that showed significant expression differences were also analysed using immunohistochemical techniques. Changes in proteoglycan core proteins were dependent on their location, and the main differences between metastatic and non-metastatic tumors affected cell-surface glypicans, while other molecules were quite similar. Glypicans were also responsible for the main differences between RS- and LS- malignances. Regarding the biosynthesis of heparan sulfate chains, differential alterations in transcription depending on the presence or not of metastasis affected genes involved in the modification of uronic acid (epimerization and 2-O sulfation), and some isoforms responsible for sulfation of glucosamine (NDST1, HS6ST1). Moreover, in RSCRCs differences were preferentially found in the expression of genes involved in C6 and C3 sulfation of glucosamine, but not in NDSTs or SULFs. Finally, synthesis of chondroitin sulfate showed some alterations, which affected various steps, including polimerization and the modification of chains, but the main variations dependent on the presence of metastases were epimerization and 6C sulfation; however, when compared with RSCRCs, the essential divergences affected polymerization of the chains and the 6C sulfation of the galactosamine residue. We evidenced alterations in the expression of HSPGs, including the expression of cell surface core proteins, many glycosiltransferases and some enzymes that modify the GAG chains in LSCRCs, but this was dependent on the metastatic nature of the tumor. Some of these alterations are shared with RSCRCs, while others, focused on specific gene groups, are dependent on tumor localization.

Background: Totally implantable central venous catheters are widely used in the management of patients (pts) with malignant diseases in order to facilitate drug delivery for the new therapeutic protocols. These are based on continuous administration and higher doses of chemotherapeutic agents with relative phlebitis problems and supportive treatment. Staff of our department, specially trained on the routinely implant of central venous accesses were in charge of the procedure. The technique was carried out under local anesthesia in a special suite of day hospital, under strict aseptic measures without fluoroscopic control. Methods: From Sep 94 to January 2017, 1665 devices (port-a-cath systems [PS]) were implanted in 1627 pts, with a median age of 50.5 yr (range 14-81), and median K.I. 70% (50-100), female 982/male 683. Venous access: right interior jugular 983, left subclavian 316, right subclavian 333, left interior jugular 33. A thorax X-ray was performed after each procedure and in 216 pts prophylactic antibiotics were given. Results: The venous access remained implanted a median of 438 days (1- +2210). Complications occurred in 266 placements (16%): Infections 116 (7%); deep venous thrombosis 66 (4%) obstruction 10 (0.6%); malpositioned 16 (2%); fractures/migration 28 (1.7%); pneumothorax 6 (0.32%); local skin necrosis 7 (0.6%). Five hundred and twenty devices were removed, three hundred and forty-seven (66%) after completing planned therapy and 173 (34%) due to complications [Infections (92), migration (22), malposition (12), venous thrombosis (26), obstruction (11) and skin necrosis (10)]. Cost-effectiveness of venous catheters in a non-surgical scenery compared to devices implanted by interventional vascular radiologists in operating room turned out to be 1000 euro cheaper for each device. Conclusions: Our experience suggests that implant of vascular access devices by medical oncologist in a non-surgical scenery has similar or even less complications and is more cost effective with regard to radiology suite and operating room placement procedures. Legal entity responsible for the study: Emilio Esteban, Oncología Médica, Hospital Universitario Central de Asturias. Funding: None

Background: Colorectal cancer (CRC) is a heterogeneous disease defined by anatomic, functional and molecular differences depending on the primary tumor location (PTL). Several molecular phenotypes have been associated with aggressive behavior, and some of these markers are related with proteoglycans, which in turn show alterations in CRC. Small leucine-rich proteoglycans (SLRPs) are a family of molecules encoded by18 genes that may appear coupled to different glycosaminoglycan chains ––including chondroitin/dermatan or keratan sulphate–– or not, depending on the specific species. They are ubiquitously expressed in extracellular matrices, and it’s been described their role in organ size and shape regulation during embryonic development. This study aims to investigate the expression patterns of SLRPs in CRC depending on the PTL. Methods: A transcriptomic approach was carried out by using qPCR to analyze SLRP core protein transcriptions in 32 tumor specimens and their respective healthy tissue: 12 right-sided & 20 left-sided. When significant differences were detected, immunohistochemical techniques were used to enhance the test. Results: While right-sided (R) CRC displayed significant alterations in 2 genes (biglycan BGN overexpression p = 0.015, osteoglycin OGN underexpression p = 0.048), left-sided (L) showed differences in 5 genes (BGN overexpression p = 0.0019 and underexpression of OGN p = 0.0016, prolargin PRELP p = 0.0049, chondroadherin CHAD p = 0.0180 and podocan PODN p = 0.0061). In L tumors CHAD was the most affected gen underexpressed by 16 times, while in R it was present in only 50% of healthy tissue. Transcripts for opticin and nyctalopin were not detected in most patients regardless of PTL. Lumican, decorin, keratocan, asporin, ECM2, fibromodulin, tsukushi, osteoadherin, osteomodulin, epiphycan and PODN-like 1 were detected with no significant differences compared to healthy tissue. Conclusions: Normal mucosa of the large bowel expresses most SLRP. BGN and OGN seem to be dysregulated in both L and R CRC, but CHAD, PRELP and PODN appear to show differences only in L CRC. These alterations could be related to the interaction with different ligands and modulation of homeostasis.