I–III disease, have limited access to the treatment. This could be because, in the absence of a reliable registry, policy makers and health professionals are ill informed of the poor survival outcome in the local population and the potential effect of modern therapies to improve outcome. Patients would naturally seek treatment when they could afford to pay for it, thus creating a natural experiment to explore the effect of trastuzumab in this population. Methods: We identified 189 HER2-positive breast cancer patients with sufficient data from a cohort previously enrolled in an observa- tional study to evaluate cancer care performance in 2011–12. 39 (21%) of these patients were treated with trastuzumab while 150 (79%) were not. We use Cox proportional hazards model to estimate the effect of trastuzumab on overall survival. Prognostic covariates included were age, stage, and tumour size. Findings: The median age of the patients was 52 years; 36% was aged <50 years, almost all paid for their care out-of-pocket. 65% of patients had early breast cancer, 20% locally advanced breast cancer and 4% metastatic breast cancer. Overall, treatment with trastuzumab was associated with a 35% improvement in survival, though this was not statistically significant. This corresponded to 12% improvement in survival at 5 years for locally advanced breast cancer and 15% for metastatic breast cancer. Interpretation: Trastuzumab treatment in a routine setting is associated with better survival outcome but this could not be statistically demonstrated as too few patients were treated in this population. http://dx.doi.org/10.1016/j.ejca.2015.06.096 P0172 CLINICAL RELEVANCE OF A PHARMACOGENETIC APPROACH USING MULTIPLE TRANSPORTER GENES TO PREDICT RESPONSE AND RESISTANCE TO IMATINIB THERAPY IN MALAYSIAN PATIENTS WITH CHRONIC MYELOID LEUKAEMIA Ravindran Ankathil a,* , Anthony Au a , Azlan Husin b , Abdul Aziz Baba b,c . a Human Genome Center, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia, b Department of Internal Medicine and Clinical Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia, c International Medical University, Kualalumpur, Malaysia Background: Despite success with imatinib mesylate in patients with chronic myeloid leukaemia (CML), emergence of clinical resistance in 30% of patients treated with imatinib mesylate still remains a problem. Resistance could be due to a heterogenous array of mechanisms. Pharamcogenetic variability as a result of genetic polymorphisms in the imatinib mesylate transporter genes ABCB1, ABCG2, ABCC1, and ABCC2 could be potential determinants of variability in imatinib mesylate disposition and efficacy. This study investigated the associa- tion between ten polymorphisms of ABCB1 (1236 T>C, 2677G>T/A, 3435C>T), ABCG2 (34G>A, 421 C>A), ABCC1 (2012G>T, 2168G>A), and ABCC2 (À24C>T, 1249G>A, 3972 C>T) genes and response to imatinib mesylate with the ultimate aim of identifying putative genotypes and haplotypes associated with good response or resistance. Methods: Blood samples from 215 patients with CML (107 with a good response to imatinib mesylate and 108 who were resistant to ima- tinib mesylate) were genotyped for the 10 polymorphisms using PCR-RFLP. After determining the genotype and haplotype frequencies, their association with imatinib mesylate response was determined with odds ratio (OR). Findings: Resistance was significantly associated with patients who had homozygous ABCB1 1236CC genotype (OR 2.79, p = 0.01). ABCG2 421AA genotype was associated with a good response (OR 0.29, p = 0.01) while 421CC genotype was associated with imatinib mesylate resistance (OR 1.87, p = 0.02). Haplotypes ABCB1 C 1236 G 2677 C 3435 and ABCC2 T- 24 G 1249 T 3972 were associated with ima- tinib mesylate resistance (p = 0.04 and p = 0.03 respectively) while ABCG2 A 34 A 421 haplotype was associated with a good response to imatinib mesylate (p = 0.03). Interpretation: Genetic variation in these imatinib mesylate trans- porter genes might have consequences on mRNA stability, expression, protein folding degradation, intracellular localisation, substrate bind- ing, and/or transporter kinetics and thus modulate variation in response. Pretreatment genotyping of these SNPs in patients with CML could be useful for predicting imatinib mesylate resistance which may allow the best choice of drug treatment for patients with CML. http://dx.doi.org/10.1016/j.ejca.2015.06.097 P0175 PATIENTS’ PERSPECTIVES ON THE CURRENT STATUS OF CANCER PAIN MANAGEMENT IN ASIA Lye Mun Tho a , Maria Minerva P. Calimag b , Jin Seok Ahn c , Ta-Chung Chao d , Kok-Yuen Ho e , Yong-Chul Kim f , Zhong-Jun Xia g , Lois Ward h , Hanlim Moon i,* . a Beacon International Specialist Centre, Malaysia, b University of Santo Tomas Faculty of Medicine and Surgery and the UST Hospital, Philippines, c Samsung Medical Center, South Korea, d Taipei Veterans General Hospital and National Yang-Ming University, Taiwan, e Raffles Hospital, Singapore, f Seoul National University School of Medicine, South Korea, g Sun Yat-Sen University Cancer Center, China, h Mundipharma Research Ltd, UK, i Mundipharma Pte Ltd, Singapore Background: ACHEON is the first and largest cross-sectional anal- ysis conducted to determine the current practices of pain management across Asia. This survey included responses from patients suffering from cancer pain in 10 countries or regions (China, Hong Kong, Indonesia, South Korea, Malaysia, Philippines, Singapore, Taiwan, Thailand, and Vietnam). Methods: Patients were P18 years (>20 years for Korean and Taiwanese patients) with cancer pain in the last month. Patients were recruited by random selection from patient associations, patient refer- rals, online panels, hospital intercepts or doctor referrals. Patients were asked “yes” or “no” statements or questions with a five-point Likert scale ranging from “agree completely” to “disagree completely”. Findings: 1190 cancer patients (32% male, 68% female) with a mean age of 54 years were included. Moderate-to-severe pain (median score 6 [IQR 3]) was reported by 86% of patients, while overall median dura- tion of pain was 12 months (IQR 19). Although most patients (83%) were asked about pain by physicians at every visit, 49% of patients reported no scale was used for pain assessment. Opioid use was con- firmed in 53% (285/538) of patients who remembered the type of pain medication prescribed. In all, 81% of patients claimed that pain affected their daily living (86%), and concentration and focus (87%). Furthermore, 78% of respondents were unemployed with 42% discon- tinuing work due to cancer pain. Among employed patients, 70% reported that pain affected work. Interpretation: Cancer pain is a debilitating condition creating sig- nificant social and economic burden for Asian patients. In general, Abstracts / 51 (2015) e1–e36 e33