EP05.02-003 Durvalumab after Chemoradiotherapy (CRT) in Unresectable Stage III NSCLC. Comparative Study of Two Cohorts in the Real-World Setting

[EN] Introduction: Durvalumab is the new standard of care for unresectable locally advanced NSCLC, with PD-L1 _1% and who did not have progression after CRT treatment in the European Union. Our study compares the effectiveness and the frequency of radiation pneumonitis in patients treated with concurrent CRT with or without durvalumab consolidation during the same period in real clinical practice. Methods: A single-center retrospective study. 71 treated patients with unresectable stage III NSCLC were included between March 2018 and December 2021, 37 with CRT followed by durvalumab and 34 with CRT alone. Real-world progression-free survival (rwPFS) and real-world overall survival (rwOS) were calculated since the date of the end CRT. Propensity score matching (PSM) 1:1 was used to account for differences in baseline characteristics. Results: Median age was 67 years (range 46-82). 25.4% of the patients were _75 years old. 78.9% were men and 53.5% former smokers. 54.9% had squamous histology and 28%, 51% and 21% stage IIIA, IIIB and IIIC disease, respectively. The most used scheme was carboplatinpaclitaxel (43.7%), receiving induction chemotherapy in up to 54.9% of patients. 73.2% received between 60-66 Gy doses of radiotherapy. Median time from end of CRT to onset durvalumab was 44 days (range 13-120) with a median of 14 infusions (range 6-27). Of the 34 patients without durvalumab treatment, the expression PD-L1 <1% (58.8%) was the most frequent cause for rejecting consolidation therapy. After PSM analysis, patients distributions were well balanced. With a median follow-up of 19.7 months (range 1.4-36.6); median rw-PFS was 9.3 months (95% CI, 5-13.5) without durvalumab and 17 months (95% CI, 11-22.9) with durvalumab (p¼0.013). Median rw-OS was 19.3 months (95% CI, 3.8-34.8) without durvalumab and 29.9 months (95% CI, 23.3-36.6) with durvalumab (p¼0.241) with a rw-OS% at 6, 18 and 24 months of 90%, 62% and 49% vs 100%, 86% and 74%, respectively. The rate of radiation pneumonitis was more frequent with durvalumab consolidation (56.8% against 44.1%), (p¼0.346), especially within 3 months after CRT. G3 pneumonitis was only observed in the consolidation therapy. Conclusions: Our results demonstrate the effectiveness of durvalumab consolidation after CRT in real-world patients with unresectable stage III NSCLC. Further sample and longer follow-up are required to obtain more accurate results. Active surveillance and appropriate management for radiation pneumonitis are needed, in especially in candidates for consolidation treatmentS

EP05.02-002 Who Benefits More of Durvalumab after Chemoradiotherapy (CRT) in Real-World Patients with Locally Advanced Non-Small-Cell Lung Cancer (NSCLC)?

[EN] Introduction: Durvalumab received EMA approval as consolidation therapy (CT) for unresectable stage III NSCLC with PD-L1 _1% and who did not have progression after CRT. Our objective was to analyze in real clinical practice the effectiveness of durvalumab and explore the clinical factors that may be associated with the benefit from CT. Methods: Retrospective study was made at Hospital of Leon (Spain), including 37 patients with locally advanced NSCLC treated with durvalumab after CRT treatment between March 2018 and october 2021 (40.5% patients were included in the durvalumab early access program). The neutrophil-to-lymphocyte ratio (NLR) could identified after CRT as a factor that may be benefit from durvalumab. Results: Median age was 67 years (range 46-82 years). 40.5% of patients were _70 years old. 78.4% were male and 51.4% smokers. 54% had non-squamous histology. PD-L1 expression was <1% in 5% and not available in 8% patients. 2.7% ROS1 rearrangements, 5.4% KRAS mutations and not available in 43.2% patients. Stage IIIA, IIIB, IIIC disease were 24.3%, 54.1% and 21.6%, respectively. Median time from end of CRT to onset durvalumab was 44 days (range 13-120 days). Overall median CT duration was 214.8 days (range 69-399 days) with a median of 14 infusions (range 6-27 infusions). With a median follow up of 19.7 months (range 1.4-34.9 months); 67.6% had stopped CT: 37.8% due to completing treatment, 16.2% disease progression, 10.8% adverse event and 2.7% due to COVID19 infection. Median real-world progressionfree survival (rwPFS) was 17 months (95% CI, 11-23). Median realworld overall survival (rwOS) was 29.9 months (95% CI, 23.3-36.6). % rwOS at 6, 18 and 24 months were 100%, 86.9% and 74.5%, respectively. For patients with post-CRT NLR not exceeding the cohort median value of 6, receipt of durvalumab was associated with an improvement in rwOS (median not reached vs 25.7 months; p¼0.025). 56.8% patients had any grade of radiation pneumonitis (median time from CRT start: 119 days [range 36-241 days]). Of these, 19% patients developed worsening of radiation pneumonitis with durvalumab. 54,1% developed immune-mediated toxicity, mostly G1-2 (85.1%). Conclusions: Our results demonstrate the effectiveness of durvalumab consolidation in this patients population in a real-life setting. We identified low NLR after CRT as a potentially predictive factor for the benefit of CT in locally advanced NSCLC.S

Productive Development Policies in Latin American Countries: The Case of Peru, 1990-2007

This paper assesses the institutional setting and productive impact of selected productive development policies (PDPs), institutions, and programs implemented in Peru during the period 1990-2007. The assessment is based on a simple, basic framework of a series of economic or market failures that may have constrained the transformation of the productive structure, the process of innovation, and the growth of total factor productivity. Evidence indicates that the PDPs and structural reforms implemented in Peru did not significantly alter the productive structure of the Peruvian economy. If the objectives of the PDPs are to transform the productive structure, increase total factor productivity, and enhance innovation, government interventions need to focus directly on the source of market failures and create quality productive changes within the private sector

Comportamiento y conducta sexual en gestantes

La reproducción, además de un fenómeno biológico, es una cuestión social y cultural, ya que, el comportamiento de los individuos de forma general, se encuentra determinado por la sociedad en que viven y por determinadas normas sociales; de allí, que pueda decirse que, el embarazo, como evento crucial del proceso reproductivo, es vivido de manera distinta por hombres y mujeres, y puede afectar a la vida y a la sexualidad de diversas maneras según el sexo. En el caso del comportamiento sexual femenino, suele percibirse que, aun cuando este hecho, ha ido evolucionado a lo largo de la historia sigue recibiendo influencias sociales, culturales e inclusive educativas, determinando de alguna forma la conducta  sexual  y todos aquellos aspectos relacionados con su sexualidad, llevando a que continuamente sean incorporados nuevos conceptos  los cuales al ser adoptados por las mujeres influyen en el cambio del comportamiento sexual desde una esfera cognitiva y  emocional. De esta manera, cuando una pareja se entera de la existencia de un embarazo, la sexualidad pasa a otro plano. Situación errónea puesto que el placer contribuye al mantenimiento de la misma. Por falta de información las parejas suelen actuar influenciados por pensamientos equívocos o prefieren no practicar las relaciones sexuales, abandonando este hábito y descuidando su patrón sexual. Entiéndase así, que las creencias sociales y tabúes que se tienen al respecto, no son un buen aporte, dado que representan un determinante que influye sin duda alguna en el bienestar y la sexualidad de la pareja; lo que lleva a considerar que el tema de la sexualidad durante la gestación necesita ser abordado mediante informaciones positivas. De allí, la importancia del presente artículo, destinado a analizar, a través de un estudio de tipo documental, el comportamiento y conducta sexual en gestantes