e22023 Background: Use of ICI changed the treatment of Advanced Cutaneous Melanoma Patients (ACMP). This paper analyzes the evolution of ACMP who develop vitiligo during ICI treatment at Instituto Oncológico Henry Moore (IOHM). Methods: We selected all ACMP that received ICI between August 2015 and December 2019. We collected clinical data and compared Group A (ACMP with vitiligo) with Group B (ACMP without vitiligo) on: response rate (RR), time from ICI treatment initiation to progression (TTP) and overall survival (OS), defined as time from ICI treatment initiation to death. Outcomes were assessed using table tests and Kaplan-Meier curves with log-rank test. Results: Out of 32 ACMP treated with ICI, 12 Pt (37%) were in Group A and 20 Pt (63%) were in Group B. Table shows group characteristics and outcomes. Conclusions: 1) During treatment with ICI, 12 out of 32 (37%) advanced cutaneous melanoma patients were afflicted with vitiligo. 2) Two out of three patients who responded to ICI treatment developed vitiligo and obtained better TTP and OS than those without vitiligo. 3) According to these results, vitiligo is the consequence of the immune system reactivation responsible for considerable clinical benefits. Further studies should analyze if it is feasible to reduce ICI doses in patients who develop this adverse effect. 4) In this small and retrospective series, Nivolumab was more frequently correlated with vitiligo and clinical benefits, but we need prospective studies to decide which ICI treatment is the most effective. [Table: see text]

6594 Background: "Deprescribing is the process of withdrawal of an inappropriate medication, supervised by a health care professional with the goal of managing polypharmacy and improving outcomes" ( Br J Clin Pharmacol 80:6, 1254. 2015). The aim of this paper is to present a model for deprescribing used at IOHM. Methods: Between 09/26/2012 and 09/26/2016, 10,053 pt filled out a Past Medical History Form, listing all the medications they were taking regularly. We selected all the pt. with advanced solid tumors (AST). In each pt the expected survival was established in order to evaluate the usefulness of the Tx. The drugs were classified in three groups: A) Green: Adequate (must be maintained); B) Yellow: Questionable (could be maintained or removed) or C) Red: Avoidable (must be removed). Results: We registered 2,103 pt who met the inclusion criteria. Sex F/M: 905 /1198. Median age 63 y (r = 19-99). A total of 1,629 pt. (77%) were taking medications on a regular basis. The total amount of medications was 5,679 . Median medications per patient: 3 (range: 1-14). Eighty percent of the pt (1,298 pt) were receiving questionable of avoidable medications. The following table shows the distribution of medications per group. Conclusions: A) In this cohort of 2,103 pt with AST, half of them had an average life expectancy of less than one year. B) 1,298 out of 1,629 pt (80%) were receiving a questionable medication C) 596/5,769 (10%) of the registered drugs, had to be suspended immediately and at least a thousand more could be eliminated. d) Obstacles to deprescribing were essentially medical ignorance, fear and inexperience. [Table: see text]

e24189 Background: Most cancer narratives are provided by skilled American and British writers (Broyard, Hitchens, Jobs, Kalanithi, Pausch, Sacks, Sontag or Wishart). This paper highlights the voice of ordinary Latin American patients who wrote about their experience. Methods: Between February 2, 2019 and March 3, 2019, the first author encouraged cancer patients to narrate their experience with the disease for an online literary contest (“ www.oncologiaesperanzadora.com ”). After studying all submissions, we grouped attitudes, feelings, metaphors and descriptions used in different domains related to the course of the disease. A text-mining study was conducted to identify the context of keywords in each of the domains. Results: In total, 224 literary works were submitted to the contest. Characteristics of the population: sex F/M: 184/40; age at time of contest: 53 yo (18-82); time between diagnosis and submission to contest: 8 y (1-73); country of origin: Argentina (201), other countries (23); diagnosis: breast (130), hematological (15), colorectal (13), melanoma (6), lung (5), head and neck (5), kidney (3), other (47). The table shows keywords found in each of the domains. Conclusions: 1) Cancer patients are willing to share their story if they are given the opportunity. 2) Through the narratives of the disease, it is possible to study its impact on patients’ lives and the different coping strategies. 3) Reading the experience of patients with the disease in their own voice is a valuable instrument for medical education. [Table: see text]

11002 Background: Caring for transgender patients requires specific knowledge and skills. Medical schools spend less than 5 hours on average training for treatment of LGBT patients (Obedin-Maliver, JAMA, 306 (9), 971). This paper assesses the knowledge on the topic and skills of postgraduate Oncology students from Universidad del Salvador at the Observational Standard Clinical Examination (OSCE) 2019 (JCO 34 (15), Abstract e18150, 2017). Methods: At one of the stations of OSCE 2019, students had thirty minutes to complete a clinical record of a simulated transman patient with ovarian cancer stage IIIC. Based on the real case of Robert Eads, actors were trained with the documentary on his life “Southern Comfort”. Students were assessed on: A) knowledge of the transman condition, B) use of preferred gender pronoun by the patient, C) discontinuation of testosterone treatment, D) recommendation of genetic study, E) treatment of ovarian cancer according to NCCN guidelines, F) moral discomfort with LGBT patient care. All interviews were filmed or recorded by an observer. All films, recordings and clinical records were reviewed to rate the students' performance. Results: A total of 25 postgraduate Oncology students took the OSCE 2019. Assessment: A) 5/25 (20%) lacked knowledge of the transman condition, B) 3/25 (12%) did not use the patient's preferred gender pronoun, C) 17/25 (68%) discontinued testosterone, D) 23/25 (92%) requested genetic study, E) all students treated ovarian cancer according to NCCN guidelines, F) none expressed moral discomfort with LGBT patient care. Conclusions: 1) It is feasible to assess the knowledge and skills required for treatment of transgender patients in Oncology. 2) We found shortcomings of student's medical training regarding transgender patients: one in five did not understand the patient's condition, three did not use the patient´s preferred gender pronoun during the interview and more than half suspended the necessary hormone therapy for their condition. 3) This emphasizes the need to deepen our medical and communication skills in order to assist the transgender population and should be included in future ASCO-ASH milestones for specialty accreditation.

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