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The prognostic impact of neutrophil-lymphocyte ratio (NLR) in metastatic breast cancer (MBC) has been previously evaluated in early and metastatic mixed breast cancer cohorts or without considering other relevant prognostic factors. Our aim was to determine whether NLR prognostic and predictive value in MBC was dependent on other clinical variables. We studied a consecutive retrospective cohort of patients with MBC from a single centre, with any type of first line systemic treatment. The association of NLR at diagnosis of metastasis with progression free survival (PFS) and overall survival (OS) was evaluated using Cox univariate and multivariate proportional hazard models. In the full cohort, that included 263 MBC patients, a higher than the median (>2.32) NLR was significantly associated with OS in the univariate analysis (HR 1.36, 95% CI 1.00–1.83), but the association was non-significant (HR 1.12, 95% CI 0.80–1.56) when other clinical covariates (performance status, stage at diagnosis, CNS involvement, visceral disease and visceral crisis) were included in the multivariate analysis. No significant association was observed for PFS. In conclusion, MBC patients with higher baseline NLR had worse overall survival, but the prognostic impact of NLR is likely derived from its association with other relevant clinical prognostic factors.

The cooperation between the PC and the specialised mental health services of Catalonia is optimal in some aspects, but patient waiting time needs to be reduced for first visits to the AMHC and training activities offered by the CAMHC and the ACT need to be increased.

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PI group showed a non-statistically significant tendency towards presenting fewer relapses. This could be related to the improvement in adherence among patients that received the intervention.

205 Background: NEOCOPING study analyzes the influence of clinicopathological, personal and social variables on coping strategies and quality of life (QoL) in patients with resected tumors at the time of starting adjuvant chemotherapy. Methods: NEOCOPING is a prospective, multicenter, observational study that involves 19 centers and 34 researchers. Applied main questionnaires were: Mini-Mental Adjustment to Cancer (MAC), EORTC QLQ-C30, Brief Symptom Inventory (BSI-18), Shared Decision Making Questionnaire (SDM-Q) patient and doctor, and Multidimensional Scale of Perceived Social Support (MSPSS). Results: Table summarizes the characteristics of the first 71 patients enrolled. The most used coping strategies were fighting spirit (X=75.8, SD=25.9) and avoidance (X=64.6, SD=25); most patients were found to have good QoL (X=76.5, SD=16.6). Most did not have psychiatric symptoms, and were pleased with family and social support perceived. Patients were very satisfied with the information received (X=83, SD=19.9), and shared opinions with the doctor (X=90, SD=22.9). QoL was significantly negatively correlated with depression (r=-.688, r=.0001), anxiety (r=.-655, p=.0001), somatization (r=-.638, p=.0001) and hopelessness (r =-.287, p =.033). Depression and somatization predicted 54.8% of the QoL of this sample (F=23,636, p=.0001). Conclusions: Even though patients have a good QoL, adaptative coping strategies and no noticeable psychopathological symptoms at baseline, these symptoms may influence the well-being perception and modulate personal adaptations to the diagnosis and treatment of cancer at a curable stage. [Table: see text]

Background: Sequencing of single-agent chemotherapy (CT) is the current standard of treatment for endocrine-resistant metastatic breast cancer (MBC). However, shrinking benefit for consecutive lines of CT and lack of data from randomized trials may question the real value of advanced lines of treatment. Growth modulation index (GMI), the ratio of progression free survival (PFS) with PFS of previous line, has been reported as a marker of treatment benefit when equal to or above 1.3. This value is similar to the clinical benefit threshold proposed by ESMO and ASCO for non-curative CT. The aim of this work was to determine GMI change across the successive lines of CT for MBC. Methods: We retrospectively analyzed all MBC patients currently on treatment at our center. GMI was determined for each CT line and for each patient and a cut-off value of 1.3 was chosen as a marker of treatment benefit. Chi-squared test and Spearman's Rho were used for proportion comparison and correlations. Kaplan-Meier curves and log-rank test were performed for survival analysis. Results: 128 ABC patients were included; median age: 57; ECOG 0-1: 92.2%; visceral disease: 46%; bone-only disease: 46.9%; TNBC: 5.5%, HER2+: 23.5%, ER+HER2-: 71.1%; 50% more than 2 lines of CT. GMI and PFS values are shown in Table 1. GMI values were significantly associated with PFS values in all lines (p<0.001 for 2nd, 4th and 5th lines; p<0.01 for 3rd and 6th). GMI was neither significantly different between CT lines nor significantly correlated with GMI of previous line. No consistent association of GMI values with age, performance status, tumor subtype or visceral disease were found. Table 1. GMI and PFS values for each line of CTCT linenGMI Median (range)GMI ≥ 1.3PFS Median (95%CI)2nd630.88 (0.03-27)36.5%10.4 months (7.2-13.2)3rd390.62 (0.05-7.5)23.1%4.9 months (4.1-5.7)4th280.83 (0.05-12.6)21.4%5.3 months (1.1-9.4)5th200.68 (0.05-9.1)30.0%4.7 months (1.5-7.9)6th140.80 (0.25-22.8)42.9%4.5 months (2.0-7.1) Conclusions: GMI does not significantly change along successive CT lines for MBC. Our results, showing a constant rate of 20-40% of patients with GMI≥1.3 up to the sixth line of CT, suggest a benefit within the range of magnitude established by ASCO and ESMO framework for cancer care value. Although potential biases of this work warrant further evaluation with a cohort design, GMI, together with toxicity data and absolute gains of PFS, may be used as an additional tool to establish the real value of late lines of CT for MBC. Citation Format: Ayala de la Peña F, Ivars Rubio A, de la Morena Barrio P, Fernández Sánchez A, Luengo Gil G, García Martínez E, García Garre E, Marín Zafra G, Vicente V. Evaluation of growth modulation index as a marker of benefit for consecutive lines of treatment for metastatic breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-15-09.