Page 9 - CUA2018 Abstracts - Oncology-Bladder

Poster session 10: Other Oncology II

included in this cohort study. Baseline patient, tumour, and treatment MP–10.8
characteristics between IC and NIC were compared (Table 1; available Comparing laparoscopic cytoreductive nephrectomy to open
at https://cua.guide/). surgery: A large, multicentre, retrospective analysis
Results: During the study period, 110 of 5031 patients self–identified as Samir Ksara , Premal Patel , Darrel Drachenberg , Antonio Finelli , Ricardo
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Indigenous. These patients were significantly younger at the time of clini- Rendon , Simon Tanguay , Anil Kapoor , Jun Kawakami , Ronald Moore ,
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cal diagnosis (p=0.0002) and had a twofold greater prevalence of family Alan So , Luke Lavallee , Jean–Baptiste Lattouf , Frédéric Pouliot , Amy
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history of RCC (p=0.005). Clinical stage at diagnosis was similar between Liu , Olli Saarela 12
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groups (p=0.98). In total, 11 (10%) and 541 (11%) presented with meta- 1 Department of Urology, University of Manitoba, Winnipeg, MB, Canada;
static disease. IC more commonly had prevalent comorbid conditions that 2 Division of Urology, Department of Surgical Oncology, University of
may impact the management of RCC, including higher rates of obesity, Toronto, Toronto, ON, Canada; Department of Urology, Dalhousie
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hypertension, renal disease, diabetes mellitus, and smoking (p<0.05). University, Halifax, NS, Canada; Division of Urologic Oncology,
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IC received significantly fewer renal tumour biopsies and a lower rate Department of Surgery, McGill University , Montreal, QC, Canada;
of active surveillance (p<0.05). From the time of clinical diagnosis, IC 5 Department of Urology, McMaster University, Hamilton, ON, Canada;
had a longer median time to biopsy and surgery by 2.9 months and 0.5 6 Division of Urology, University of Calgary , Calgary, AB, Canada;
months, respectively. Surgical, ablative, and systemic treatments were 7 Division of Urology, University of Alberta, Edmonton, AB, Canada;
not different between groups. The five–year overall survival (OS) rate was 8 Department of Urology, University of British Columbia, Vancouver,
significantly greater in IC compared to NIC (p=0.025). Time to recurrence BC, Canada; Division of Urology, University of Ottawa, Ottawa, ON,
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and progression between groups was comparable. Canada; Department of Urology, University of Montreal Health Centre,
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Conclusions: IC with RCC are diagnosed at an earlier age and at a similar Montreal, QC, Canada; Division of Urology, Université Laval, Quebec,
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clinical stage to NIC. Despite higher baseline comorbid diseases and lon- QC, Canada; Cancer Care Ontario, University of Toronto, Toronto, ON,
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ger time to biopsy and surgery, IC experienced similar clinical outcomes Canada
to NIC. Although five–year OS was different between groups, this may Introduction: Laparoscopic surgery is known to minimize perioperative
be confounded by factors that may be clarified with further followup. morbidity and decrease length of hospital admission, however, its benefit
in cytoreductive nephrectomy (CN) continues to be a topic of debate.
MP–10.7 We performed a large, multicentre, retrospective analysis comparing
Identifying the spatio–functional origins of drug resistance with laparoscopic radical cytoreductive nephrectomy (LCN) to open cytore-
rapid tumour xenografts ductive radical nephrectomy (OCN). The objective of this study is to
Nicholas Power , Matthew Lowerison , Yaroslav Fedyshyn , Karla Williams , assess whether LCN minimizes the delay to systemic therapy and offers
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Ann Chambers , James Lacefield , Paul Boutros , Hon Leong 2 an overall survival benefit when compared to OCN.
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1 Surgery, Western University, London, ON, Canada; Surgery, Mayo Clinic, Methods: Data was collected from The Canadian Kidney Cancer
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Rochester, MN, United States; OICR, OICR, Toronto, ON, Canada; Information System, a prospectively maintained database from 14
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4 Pharmaceutical Sciences, UBC, Vancouver, BC, Canada Canadian centres. Patients who underwent CN from January 1, 2011 to
Introduction: Treatment of patients with advanced cancers increasingly June 1, 2016 were included. Cox proportional hazard model was used to
relies on expensive agents targeting specific molecular or cellular aber- adjust for age, gender, pathological stage, size of largest tumour, grade,
rations. Pre–existing and acquired drug resistance typically renders these and whether patient received neoadjuvent systemic therapy.
therapies ineffective, leading to lethal disease. The genome and microen- Results: Two hundred twenty–four patients met the inclusion criteria, 93
vironment of cancers vary spatially, allowing drug resistance to emerge patients underwent laparoscopic surgery, and 131 patients underwent
in any tumour region. To quantify this spatio–functional heterogeneity in open surgery. One–year survival estimate was 85.5% for the open group
response to therapy, we developed an approach based on tumour–implan- and 83.3% for the lap group. No statistical significant in survival differ-
tation into the chorioallantoic membrane of chick embryos (PDXovo). ence was found for those who underwent laparoscopic or open cytore-
Methods: Various cores were obtained from the primary tumour and ductive nephrectomy (p=0.13).
metastases from patients with metastatic renal cell carcinoma at the time Conclusions: LCN does not lead to earlier delivery of systemic therapy
of nephrectomy (n=6). Each of these cores (5–6 for the primary tumour and shows no benefit in overall survival when compared to OCN.
and 1–3 for metastases) were subdivided into 3 mm sized fragments and
were implanted into the chorioallantoic membrane of chick embryos at UP–10.1
Day 9 of embryonic development. Two days later, PDXs were treated Comparing outcomes of second–line axitinib or everolimus
topically with vehicle or sunitinib (10 uM final in dimethyl sulfoxide in metastatic renal cell carcinoma patients: Results from the
[DMSO]) every day until Day 17 of embryonic development. At endpoint Canadian Kidney Cancer information system
(Day 19), all PDXs were submitted to high–frequency ultrasound imaging Naveen Basappa , Georg Bjarnason , Aaron Hansen , Daniel Heng ,
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to quantitate differences in tumour blood perfusion and tumour volume Anil Kapoor , Christian Kollmannsberger , Eric Lévesque , Austin Kalirai ,
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between treatment groups. After imaging, PDXs were individually submit- Haocheng Li , Ranjena Maloni , Neil Reaume , Denis Soulières ,
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ted to total exome sequencing. Lori Wood 13
Results: We apply this approach to 1548 tumour regions from six renal 1 Department of Oncology, University of Alberta, Edmonton, AB, Canada;
cell carcinoma patients, achieving a 93.6% engraftment rate. We quantify 2 Division of Medical Oncology/Hematology, Sunnybrook Odette Cancer
the spatial heterogeneity in response of these models to sunitinib, an Centre, University of Toronto, Toronto, ON, Canada; Division of Medical
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anti–angiogenic therapy, and predict clinical resistance using ultrasound Oncology, Princess Margaret Cancer Centre, University of Toronto,
imaging. Combining functional and somatic genomics of the primary Toronto, ON, Canada; Department of Oncology, University of Calgary,
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tumour and metastases revealed some mutational features associated with Tom Baker Cancer Centre, Calgary, AB, Canada; Division of Urology,
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sunitinib resistance both at baseline and after treatment. McMaster University, Hamilton, ON, Canada; Division of Medical
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Conclusions: This phenotype–based readout was superior to various prog- Oncology, University of British Columbia, British Columbia Cancer
nostic scoring criteria systems and point towards PDX–based methods Agency–Vancouver Cancer Centre, Vancouver, BC, Canada; University of
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to predict de novo drug resistance in patients with metastatic renal cell Laval, CHUQ Hôtel–Dieu de Québec, Quebec, QC, Canada; University
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carcinoma. of Alberta, Edmonton, AB, Canada; Department of Mathematics and
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Statistics, University of Calgary, Calgary, Canada; Department Surgical
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Oncology (Urology), Princess Margaret Cancer Centre, University Health
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Network, Toronto, ON, Canada; Division of Medical Oncology, The
Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, ON,
Canada; Division of Medical Oncology/ Hematology , Centre Hospitalier
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S120 CUAJ • June 2018 • Volume 12(6Suppl2)