Page 7 - CUA2018 Abstracts - Oncology-Prostate

Poster session 1: Prostate Cancer I

4. Epstein JI, Allsbrook WC Jr, Amin MB, et al. The 2005 Methods: At a median followup of 33.8 months, 264 patients were
International Society of Urological Pathology (ISUP) consen- enrolled from 39 sites. Their Functional Assessment of Cancer Therapy–
sus conference on Gleason grading of prostatic carcinoma. Prostate (FACT–P) and Montreal Cognitive Assessment (MoCA) were evalu-
Am J Surg Pathol 2005;29:1228–42.https://doi.org/10.1097/01. ated at baseline then at weeks 12, 24, 48, and 72 after AA+P initiation. A
pas.0000173646.99337.b1 10–point drop denotes clinically significant degradation in FACT–P and a
5. Epstein JI, Egevad L, Amin MB, et al. The 2014 International Society total MoCA score of ≥26 is considered normal. Descriptive analysis was
of Urological Pathology (ISUP) consensus conference on Gleason used with continuous variables. Changes from baseline were summarized
grading of prostatic carcinoma: Definition of grading patterns and using mean (standard deviation [SD]).
proposal for a new grading system. Am J Surg Pathol 2016;40:244– Results: At a median age of 77 years among 264 patients, their mean
52. baseline FACT–P total score was 111.2 (19.44), with a <3–point absolute
6. Epstein JI, Zelefsky MJ, Sjoberg DD, et al. A contemporary pros- change from baseline at subsequent assessments, denoting no clinically
tate cancer grading system: A validated alternative to the Gleason significant change in functional status over time. Their mean baseline
score. Eur Urol 2016;69:428–35. https://doi.org/10.1016/j. MoCA score was 25.2 (4.50), yet all subsequent assessments scored above
eururo.2015.06.046 26 and a mean absolute change from baseline of <1, showing an absence
7. Spratt DE, Cole AI, Palapattu GS, et al. Independent surgical vali- of cognitive decline over time. Prostate–specific antigen (PSA) value was
dation of the new prostate cancer grade grouping system. BJU Int available for 221 patients; 64.3% (142/221) and 34.4% (76/221) achieved
2016;118:763–9. https://doi.org/10.1111/bju.13488 a PSA decline of >50% and 90%, respectively. All–grade treatment–related
8. Berney DM, Beltran L, Fisher G, et al. Validation of a contempo- adverse events were reported in 63 patients, with 11% who have had
rary prostate cancer grading system using prostate cancer death as AA+P discontinuation/interruption.
outcome. Br J Cancer 2016;114:1078–83. https://doi.org/10.1038/ Conclusions: COSMiC represents the largest Canadian mCRPC cohort
bjc.2016.86 treated with AA+P with real–world prospective evaluation of PROs. This
9. D’Amico AV, Whittington R, Malkowicz SB, et al. The combination of data demonstrated the maintenance in quality of life and cognitive status
preoperative prostate–specific antigen and postoperative pathologi- over the course of the study, and underscores the importance of PRO use
cal findings to predict prostate specific antigen outcome in clinically in this complex patient population.
localized prostate cancer. J Urol 1998;160:2096–101. https://doi.
org/10.1097/00005392–199812010–00041 MP–1.10
10. He J, Albertsen PC, Moore D, et al. Validation of a contemporary
five–tiered Gleason grade grouping using population–based data. Eur Outcomes of surgical management of localized high–risk prostate
Urol 2017;71:760–3. https://doi.org/10.1016/j.eururo.2016.11.031 cancer: Results from the Prostate Cancer Canadian Collaboration
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11. Loeb S, Folkvaljon Y, Robinson D, et al. Evaluation of the 2015 Gleason Jesse Ory , Rodney Breau , Fred Saad , Wassim (Wes) Kassouf , Bobby
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grade groups in a nationwide population–based cohort. Eur Urol Shayegan , Jon Duplisea , Tarek Lawen , Christopher Morash , Armen
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2016;69:1135–41. https://doi.org/10.1016/j.eururo.2015.11.036 1 Aprikian , Ricardo Rendon 2
12. Spratt DE, Jackson WC, Abugharib A, Tomlins SA, Dess RT, Soni Urology, Dalhousie University, Halifax, NS, Canada; Urology, University
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PD, et al. Independent validation of the prognostic capacity of the of Ottawa, Ottawa, ON, Canada; Urology, Université de Montréal,
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ISUP prostate cancer grade grouping system for radiation treated Montreal, QC, Canada; Urology, McGill University, Montreal, QC,
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patients with long–term followup. Prostate Cancer Prostatic Dis Canada; Urology, McMaster University, Hamilton, ON, Canada
2016;19(3):292–7. https://doi.org/10.1038/pcan.2016.18 Introduction: Men with localized high–risk prostate cancer (HRPCa) rep-
13. Tsao CK, Gray KP, Nakabayashi M, et al. Patients with biopsy resent those at highest risk of experiencing disease–specific morbidity
Gleason 9 and 10 prostate cancer have significantly worse outcomes and mortality. There is limited data on the outcomes of men with HRPCa
compared to patients with Gleason 8 disease. J Urol 2015;194:91–7. undergoing radical prostatectomy (RP). We describe the results of the
https://doi.org/10.1016/j.juro.2015.01.078 Prostate Cancer Canadian Collaboration.
Methods: We identified 702 men with cN0M0 HRPCa treated with RP at
five Canadian tertiary referral centres between 2005 and 2017. D’Amico
MP–1.9 criteria was used to define high–risk disease. Data were collected retro-
Real–world evidence in patient–related outcomes of metastatic spectively. Logistic regression was used to determine predictors of: adverse
castrate–resistant prostate cancer patients treated with surgical pathology, biochemical failure (BCF) (prostate–specific antigen
abiraterone acetate plus prednisone [PSA] >0.19 at first postoperative PSA) and biochemical recurrence (BCR).
Geoffrey Gotto , Vincent Fradet , Darrel Drachenberg , Robert Sabbagh , Results: The median age was 64 years. Median preoperative PSA was 9
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Ricardo Rendon , Bobby Shayegan , Brita Danielson , Richard Casey , ng/mL (interquartile range [IQR] 6.0–18.25). Seventy–four percent had
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Katherine Chan , Fernando Camacho , Anousheh Zardan , Huong Hew , Grade Group 4 or 5 on biopsy and 23% had ≥cT2C; 53%, 42%, and
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Andrew H. Feifer 11 4% of men underwent open, robotic, and laparoscopic surgery, respec-
1 Division of Urology, University of Calgary, Calgary, AB, Canada; tively. Histology showed ≥pT3 disease in 71% of men and 39% had
2 Department of Surgery, Université Laval, Quebec City, QC, Canada; positive margins. Nineteen percent received an extended lymph node
3 Division of Urology, University of Manitoba, Winnipeg, MB, Canada; dissection, with 14% having pN1 disease. Thirty–one percent and 21%
4 Department of Surgery, Centre Hospitalier Universitaire de Sherbrooke, received adjuvant and salvage therapies, respectively. Sixteen percent of
Sherbrooke, QC, Canada; Queen Elizabeth II Health Science Centre, men experienced BCF and 36% of men experienced BCR. At a median
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Dalhousie University, Halifax, NS, Canada; Division of Urology, followup of 49 months, 64% remained disease free. Table 1 (available at
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McMaster University, Hamilton, ON, Canada; Division of Radiation https://cua.guide/) depicts predictors of poor outcomes.
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Oncology, University of Alberta, Edmonton, AB, Canada; The Male Conclusions: With a median followup of over four years, close to two–
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Health Centre, Oakville, ON, Canada; Medical Affairs – Oncology, thirds of men who underwent surgery for HRPCa remain disease–free.
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Janssen Inc., Toronto, ON, Canada; Damos, North York, ON, Canada; These findings confirm that surgery remains an excellent option for this
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11 Department of Surgery, University of Toronto, Toronto, ON, Canada population. Of interest, prior treatment with active surveillance predicted
Introduction: Oral androgen biosynthesis inhibitor, abiraterone acetate BCF, which may have implications for patient counselling. Receiving open
plus prednisone (AA+P), has shown to improve survival and patient– surgery was a determinant of positive margins and positive nodal disease
related outcomes (PROs) in clinical trials. The COSMiC study (Canadian when compared to a robotic approach. In the absence of prospective
Observational Study in Metastatic Cancer of the Prostate; ClinicalTrials.gov: data, this large, multi–institutional analysis may help guide practitioners
NCT02364531) set out to prospectively amass real–world data on meta- in their approach to men with HRPCa.
static castrate–resistent prostate cancer (mCRPC) patients managed with
AA+P within Canada. Here, we report the interim analysis of their PROs.
CUAJ • June 2018 • Volume 12(6Suppl2) S65