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Epithelioid hemangioendothelioma is a rare connective tissue tumor of vascular origin. It is most commonly found in young to middle aged women, and its clinical behavior is remakably variable from an indolent metastatic tumor to an aggressive rapidly growing neoplasm. Most tumors are diagnosed in an advanced unresectable phase and when clinically aggressive, require systemic cytotoxic treatment of sarcoma. Then, the 5-year survival rate after chemotherapy does not exceed 30%. Antiangiogenics are active in selected sarcoma subtypes: pazopanib, the only anti angiogenic registered agent for sarcoma provides a median PFS of 4.5 months only in the pivotal study. Their activity in EHE has been reported but long term outcome of these patients remain unreported. We report a case of a female patient with HEH who was treated with pazopanib for almost 8 years. Pazopanib therapy resulted in clinical improvement of symptoms and durable stabilization of liver tumors and lung lesions.Conclusion: Pazopanib is a promising therapeutic option in patients with HEH.

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1012 Background: Advanced breast cancer (ABC) is common in older patients, resulting from the high incidence of breast cancer beyond age 70. This population is often limited in clinical trials. Endocrine therapy (ET) combined with a CDK4/6 inhibitor is the standard of care in ABC overexpressing hormonal receptors (HR+). Data specific to older patients are scarce in the literature, deserving further research. Methods: PALOMAGE is an ongoing French prospective study evaluating palbociclib (PAL) + ET in real life setting in women aged ≥70 with HR+ HER2- ABC, split in 2 cohorts: ET sensitive patients with no prior systemic treatment for ABC (cohort A), and ET resistant patients and/or with prior systemic treatment for ABC (cohort B). Data collected include clinical characteristics, quality of life (EORTC QLQ-C30 and ELD14) and geriatric description [G8 and Geriatric-COre DatasEt (G-CODE)]. This analysis reports on baseline characteristics and safety data for the whole population. Results: From 10/2018 to 10/2020, 400 and 407 patients were included in cohort A and B, respectively. The median age was 79 years (69-98), 15.1% with an age > 85. ECOG performance status (PS) was ≥2 in 17.9% patients, 68.3% had a G8 score ≤14 suggesting frailty, 32.1% had bone only metastasis, and 44% had visceral disease. 35.8% of patients in cohort B had no prior treatment for ABC. Safety data were available for 787 patients. The median follow-up was 6.7 months (IC95% = 6.1-7.6). At start of treatment, full dose of PAL (125 mg) was used in 76% of the patients: 62.6%, 68.7% and 71.6% of patients aged ≥ 80, those with ECOG PS ≥2 and those with a G8 score ≤14, respectively. In the safety population, 70% had ≥1 adverse event (AE), including 43.1% grade 3/4 AE, and 22.9% ≥ 1 serious AE. Most frequent AE reported were neutropenia (43.2%), anemia (17.5%), asthenia (16.3%) and thrombocytopenia (13.6%). Grade 3/4 neutropenia was observed in 32.3% of patients, with febrile neutropenia in 1.1%. Grade 3/4 AE PAL-related were reported in 40.1%, 31.4% of patients aged < 80, ≥80, respectively. Regarding PAL, 23.4% of patients had a dose reduction and 41.8% had a temporary or permanent discontinuation due to AE. Safety data were similar in both cohorts. Geriatric data and impact on safety will be presented. Conclusions: PALOMAGE is a unique large real-world cohort focusing on older patients treated with PAL in France. These preliminary data do not suggest any new safety signal, matching data derived from PALOMA trials. The occurrence of less grade3/4 AE related to PAL in patients aged 80 and beyond might reflect the 30% decrease of PAL dose upfront. Effectiveness analyses are eagerly awaited. Clinical trial information: EUPAS23012 .

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ObjectiveTo assess efficacy and tolerance of EGFR tyrosine-kinase inhibitors (TKIs) for advanced EGFR-mutated non-small cell lung cancer (NSCLC) in octogenarians.Patients and methodsPatients aged 80 years or older with EGFR-mutated NSCLC treated by EGFR TKI between January 2011 and March 2015 whatever the line of treatment were retrospectively selected.Results20 centers retrospectively included 114 patients (women, 77.2%; Caucasians, 98.3%; mean age, 83.9 years). A performance status of 0–1 or 2–3 at diagnosis was reported for 71.6% and 28.4% of patients, respectively. Overall, 95.6% of patients had adenocarcinomas and histological stage at diagnosis was stage IV for 79.8% of patients. EGFR mutations were identified mainly on exon 19 (46.5%) and exon 21 (40.4%). A geriatric assessment was performed in 35.1% of patients. TKI treatment was administered to 97.3% of patients as first or second line of treatment. Overall response rate and disease control rate were 63.3% (69/109) and 78.9% (86/109), respectively. Median progression-free survival was 11.9 months (95% confidence interval [CI], 8.6–14.7) and median overall survival was 20.9 months (95% CI, 14.3–27.1). After progression, 36/95 (37.9%) patients received a new line of chemotherapy. Main toxicities were cutaneous for 66.7% of patients (grade 3–4, 10%), diarrhea for 56.0% (grade 3–4, 15%; grade 5, 2%) and others for 25.7% (grade 3–4, 41%).ConclusionsOctogenarians with EGFR-mutated NSCLC treated by EGFR TKI had clinical outcomes and toxicity profile comparable to younger patients. Geriatric assessment appeared to be underused in this population.

Background:In France, more than 1 in 3 women diagnosed with breast cancer (BC) is 70 years old or older. Given the many factors that may impact on the success of treatment in these older patients, especially with advanced BC (ABC), treatment feasibility (i.e. receiving the optimal duration of treatment) should be assessed carefully in real life. Methods:PALOMAGE is a French prospective study evaluating palbociclib (PAL) + endocrine therapy (ET) in real life setting in women aged ≥70 with hormone receptors positive (HR+) HER2- ABC, either ET-sensitive with no prior systemic treatment for ABC (cohort A), or ET-resistant (relapse during or &lt; 1 year after the end of adjuvant ET) and/or with prior systemic treatment for ABC (cohort B). Quality of life data (EORTC QLQ-C30 and ELD14) and geriatric data [G8 and Geriatric-COre DatasEt (G-CODE)] were collected. This analysis in cohort B reports on the primary endpoint: treatment feasibility based on the rate of permanent PAL discontinuation at 6 months (mo) for any reason including progression, toxicity, patient’s choice, or death. Two-sided 95% binomial confidence interval (CI) was used. Results:From 10/2018 to 07/2020, 406 patients were included in cohort B: median age 78 years (69-98) (15.8% &gt; 85), 15.8% ECOG performance status (PS) ≥2, 67.8% G8 score ≤14, 86.7% Charlson score ≥4, 49.3% visceral metastasis (liver 25.9%, lung 27.6%), 24.4% ≥2 lines of systemic treatment for ABC, 52.4% prior chemotherapy. PAL starting dose was 125, 100 and 75 mg in 72.6%, 22.1% and 5.2% of patients, respectively, combined with fulvestrant or an aromatase inhibitor in 65.3% and 34.7%, respectively.The primary endpoint analysis was performed on the full analysis set of cohort B: amongst 378 patients, 109 (28.8%; 95%CI=24.3-33.7) had a permanent PAL discontinuation at 6 mo due to progression (67 patients/17.7%), toxicity (14 patients/3.7%), death (14 patients/3.7%), or patient’s choice (11 patients/2.9%). Visceral progression was observed in 32 patients (8.5%), mainly in liver. Neutropenia (including 1 febrile neutropenia) was the main toxicity leading to PAL discontinuation. No death was considered PAL-related by investigators. Treatment discontinuation rate at 6 mo according to PAL starting dose 125/100/75 mg was 28% (95%CI=22.7-33.6), 30.5% (95%CI=20.8-41.6), and 35.3% (95%CI=14.2-61.7), respectively. With a median follow-up of 11.3 mo, 33.6% of patients were still on PAL treatment. Median time to treatment failure (TTF) was 11.6 mo (95%CI=10-13). Efficacy, safety and quality of life will be presented according to geriatric status. Conclusion:PALOMAGE is a unique French real-world study dedicated to older patients treated with PAL for ABC. In this cohort B analysis, treatment discontinuation rate at 6 mo was 28.8%, close to what has been observed in PALOMA 3 study, and did not differ according to PAL starting dose. Although not controlled, these data are reassuring and suggest that PAL treatment is feasible in resistant and/or pretreated women aged ≥70. Citation Format: Etienne Brain, Marina Pulido, Elena Paillaud, Jessica Grosjean, William Mina, Philippe Caillet, Louis Tassy, Pierre Soubeyran, Fanny Bouteiller, Nada Rifi, Jean-Michel Vauthier, Claire Falandry, Elisabeth Carola. Feasibility of palbociclib in women aged 70 and older with resistant and/or pretreated advanced breast cancer in the PALOMAGE study [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P1-18-04.