69P Dose-dependent detrimental effect of proton pump inhibitors (PPIs) on clinical outcomes from immune checkpoint inhibitors (ICI) in patients (pts) with solid tumors

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were received node-sparing modified short-course radiotherapy (the irradiated planned target volume included only the primary tumour bed but not the tumour-draining lymph nodes, 25 Gy/5f, 5 Gy/f) followed by 4 cycles of CAPOX and tislelizumab.Total mesorectal excision (TME) will be performed at weeks 14-15.The primary endpoint is the rate of pathological complete response (pCR), with a hypothesis of an increased pCR of 30% compared with historical data of 10% after conventional CRT.Results: Between Aug 18, 2023 to Apr 20, 2024, a total of 46 patients were screened for eligibility.33 patients ultimately proceeded to surgery, all achieved R0 resection.pCR (TRG 0) and MPR (TRG0+1) were achieved in 78.8% (26/33) and 90.9% (30/33) patients, respectively.3(9.1%) patients reached TRG 2, no patients had TRG 3. Treatment-related adverse events (TRAEs) of any grade occurred in 29/34 (85.3%) patients.The most common TRAEs of grade 1 or 2 included proctitis (17/34, 50%), leukopenia (14/34, 41.2%), thrombocytopenia (11/34, 32.4%) and anemia (8/34, 23.5%).Grade 3 TRAEs occurred in 5.9% (2/34) of patients, and Grade 4 TRAEs occurred in 8.8% (3/34) of patients.No grade 5 adverse events and treatment-related deaths were recorded.Conclusions: The node-sparing radiation combined with chemo-immunotherapy regimens dramatically increased pCR rates in MSS/pMMR LARC with tolerable toxicity, which is a promising modality for the treatment of MSS/pMMR LARC patients.Clinical trial identification: NCT05972655.

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