Page 7 - CUA2018 Abstracts - Oncology-Other

Poster session 10: Other Oncology II

UP–10.4 Results: Among 5069 eligible respondents, 3606 (71.1%) men reported
Novel ex–vivo patient–derived 3D model as a powerful tool to trusting cancer information from their physician ‘a lot,’ 1186 (23.4%)
apply precision medicine ‘somewhat,’ 219 (4.3%) ‘a little,’ and 58 (1.1%) ‘not at all.’ A total of
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Kayla Simeone 1,2,3 , Robin Guay–Lord 2,3,4 , Benjamin Péant , Abdul 2655 (52.4%) men reported receiving PSA screening. The degree of
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Mohammed Lateef , Jennifer Kendall–Dupont , Adriana Orimoto , trust an individual had in their physician for cancer information was
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Euridice Carmona , Thomas Gervais 2,3,4 , Anne–Marie Mes–Masson 1,2,3 , strongly associated with their likelihood of having received PSA screen-
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Fred Saad 1,2,3 ing (p trend <0.0001) (54.9% ‘a lot’ vs. 27.6% ‘not at all’). These findings
1 Molecular Biology, Université de Montréal, Montreal, QC, Canada; persisted after multivariable regression. Similarly, men who had high levels
2 Oncology, Centre de Recherche du CHUM, Montreal, QC, Canada; of trust in their physician were more likely to have discussed PSA screen-
3 Oncology, Institut du Cancer de Montréal, Montreal, QC, Canada; ing with a strong trend across strata (p trend <0.0001).
4 Engineering, Polytechnique Montréal, Montreal, QC, Canada Conclusions: The level of trust an individual has in cancer information
Study Groups: Molecular Pathology Platform at CRCHUM. from their physician is strongly associated with their likelihood of discuss-
Introduction: Several therapeutic options are available to treat pros- ing and undergoing PSA screening. As rationale implementation of PSA
tate cancer (PCa). However, choosing the suitable option for individual screening requires shared decision–making, the level of trust an individual
patients remains a clinical challenge. We have developed an ex–vivo has in their physician has important implications for dissemination of PSA
patient–derived 3D model, using microfluidic technology, that identi- screening guidelines.
fies responders vs. non–responders in the presence of therapeutic agents.
We hypothesize that our ex–vivo model is an effective tool for implement- UP–10.6
ing a precision medicine approach. Comparison of perioperative and oncological outcomes in
Methods: Tumour specimens were sectioned to form microdissected tissue intermediate–risk (ISUP grade 3) vs. high–risk (ISUP grade 4/5)
(MDT) samples (~400 µm in diameter) and cultured in a microfluidic chip prostate cancer following robot–assisted radical prostatectomy
platform, capable of trapping 32 MDTs in four separate channels. MDTs Sabrina Harmouch , Thomas Martin , Côme Tholomier , Helen Davis
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derived from PCa cell line xenografts (DU145 and LnCaP) were exposed to Bondarenko , Cristina Negrean , Félix Couture , Mila Mansour , Khaled
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chemotherapeutics (docetaxel,10nM) for 12 hours and further analyzed after Ajib , Samer Traboulsi , Pierre Karakiewicz , Assaad El–Hakim , Kevin
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a 12–hour recovery period. Separately, MDTs were also treated with TNF–α Zorn 1
(10 ng/mL) for 30 minutes. Cell fate was measured using FACs (Annexin 1 Urology, Université de Montréal, Montreal, QC, Canada; Urology,
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V for apoptotic cells and DRAQ7 for dead cells) or by a technique based McGill University, Montreal, QC, Canada
on formalin fixed paraffin embedding of MDTs within microfluidic device Introduction: We aimed to compare perioperative and oncological out-
creating a high–density MDT–array (MDTA). The MDTA slides suitable for comes in International Society for Urological Pathology (ISUP) grade 3
histopathology (HP) monitor MDT viability (cleaved caspase–3), prolifera- (Gleason 4+3) vs. ISUP grade 4/5 cancer patients who underwent robotic–
tion (Ki–67), and epithelial components (CK 8/18). assisted radical prostatectomy (RARP).
Results: We observed a viability of >85% by FACs and proliferative capac- Methods: A retrospective review of a prospectively maintained IRB–
ity of 60% by HP analysis in the MDTs during a culture period of 15 approved database of patients who underwent RARP between January
days (n=3 for LNCaP, n=2 for DU145). Response to docetaxel showed 2007 and April 2017 was performed. Risk stratification was made accord-
50% increase in caspase–3 activation by HP and 20% increase in cell ing to the ISUP Consensus on Gleason Grading of Prostatic Carcinoma.
death by FACs compared to control. We also show a nuclear translocation Preoperative characteristics, as well as perioperative, pathological, and
of p65 in 80% of MDTs treated with TNF–α. oncological outcomes at 24 months, were assessed. Kaplan–Meier
Conclusions: Our ex–vivo drug response model allows us to obtain treat- method was used to compare biochemical recurrence (BCR)–free survival.
ment response analysis in less than five days, appropriate for clinical deci- Results: A total of 156 intermediate–risk (ISUP 3) and 110 high–risk (ISUP
sion–making, Using our model and the precise techniques developed, we 4/5) prostate cancer (PCa) patients were identified; 61% of the ISUP 3
can characterize the molecular response of cancer cells in the presence group had pT3 compared to 48% of the ISUP 4/5 group. Median positive
of therapeutics, while conserving the natural tumour microenvironment. cores were four in both groups and positive surgical margins rates were
42% in ISUP 3 vs. 35% in ISUP 4/5 patients (p>0.05). Claven–Dindo
UP–10.5 complications were comparable between groups. BCR–free survival
The association between physician trust and prostate–specific rates at 24 months were 71% (n=121) and 61%(n=67) in ISUP 3 and
antigen screening: Implications for shared decision–making ISUP 4/5 groups, respectively (p<0.002) (Table 1; available at https://
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Zachary Klaassen , Christopher Wallis , Hanan Goldberg , Thenappan cua.guide/). Kaplan–Meier analysis showed higher BCR–free survival
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Chandrasekar , Neil Fleshner , Antonio Finelli , Girish Kulkarni , Raj rates at 24 months in the ISUP 3 group compared to their counterpart
Satkunasivam 2 (p log–rank=0.003). Salvage radiotherapy was administered in 27% of
1 Urologic Oncology, Princess Margaret Cancer Centre/University Health ISUP 3 patients compared to 32% of ISUP 4/5 patients (p<0.05). Salvage
Network, Toronto, ON, Canada; Urology, Houston Methodist Hospital, hormonotherapy was higher in the ISUP 4/5 than in the ISUP 3 group,
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Houston, TX, United States; Institute of Health Policy, Management, and but this difference was not statistically significant (15% vs. 9%). Rates of
Evaluation, Toronto, ON, Canada patients who received radiotherapy and hormonotherapy were similar in
Introduction: Shared decision–making is widely recommended when men the studies groups (Fig. 1; available at https://cua.guide/).
are considering prostate cancer screening with prostate–specific antigen Conclusions: While BCR–free survival benefits were observed at 24
(PSA). The role of a patient’s trust in cancer information from their physi- months favouring ISUP grade 3, RARP still offers potential cure and
cian in such decisions is unknown. favourable outcomes for men with ISUP grade 4/5. Nevertheless, the
Methods: We identified male respondents ≥18 years of age from the consideration of multimodal therapy should be discussed during patient
Health Information National Trends Survey, a population–based survey preoperative counselling.
of people living in the U.S. (2011–2014). We assessed the association
between degree of trust in cancer information from respondent’s physi-
cian with patient–reported receipt of PSA screening and patient–reported
discussion of PSA screening with their physician. A multivariable logistic
regression model assessed the association between cancer information
from patient’s physician and cancer information form the internet with
PSA–screening, adjusted for a priori covariates.
S122 CUAJ • June 2018 • Volume 12(6Suppl2)