Page 6 - CUA2018 Abstracts - Oncology-Testis

Poster session 12: Other Oncology III

Methods: All patients between December 2009 and June 2017 who UP–12.1
underwent full bilateral RPLND for metastatic testicular malignancy in Consolidation radical cystectomy for metastatic bladder cancer:
London, Ontario were identified using ICD–9 coding and retrospectively Preliminary analysis from the University of Alberta
reviewed. All procedures were completed by a single uro–oncological Steven Tong , Jan Rudzinski , Niels Jacobsen , Sunita Ghosh , Benjamin
1
1
1
2
surgeon. Nerve–sparing was performed when feasible based on patient Beech , Dylan Hoare , Nick Dean , Ryan McLarty 1
1
1
1
and tumour factors. Data included clinical and pathological parameters 1 Urology, University of Alberta, Edmonton, AB, Canada; Oncology,
2
and patient–reported ejaculatory function. All patients with complete data University of Alberta, Edmonton, AB, Canada
were included. Statistical analysis included Chi–square tests. Introduction: Data supporting the use of high–intensity local treatment
Results: A total of 24 patients (median age 27 year, interquartile range (HILT) with radical cystectomy as a component of curative intent therapy
[IQR] 23–33) were included. Of the procedures, 13 involved NS and 11 for metastatic bladder cancer is lacking. The aim of the current study was
were non–nerve–sparing (NNS). Of the NS group, all 13 patients (100%) to examine the safety and efficacy of consolidation radical cystectomy in
reported antegrade ejaculation postoperatively, and only six (54.5%) patients with metastatic bladder cancer.
reported an episode of antegrade ejaculation in the NNS group, which Methods: A retrospective analysis of prospectively collected data from
was significantly different (p<0.01). the University of Alberta Radical Cystectomy Database was performed.
Conclusions: Our findings confirm the superiority of NS technique com- Between August 2013 and August 2017, 15 consecutive patients under-
pared to NNS in minimizing postoperative retrograde ejaculation in went curative intent induction chemotherapy followed by consolidation
Canadian men. This has significant impact on quality of life and fertility radical cystectomy for histologically proven lymph node metastatic uro-
potential. NS technique should be applied when possible for RPLND, thelial carcinoma of the bladder (cTanyN1–3M0) by a single urologic
and has implications for possible application to other surgeries in the oncologist. The main outcome measures were 30–day mortality, 90–day
infrarenal retroperitoneum. mortality, and overall survival. The Kaplan–Meier method and descriptive
statistics were used to analyze survival data.
MP–12.13 Results: Data were evaluable for all 15 patients. The median age was 51
Combination of PD–1 blockade and OX40 stimulation for years (range 47–70). Thirteen patients (87%) were male and four patients
bladder cancer treatment (27%) received an orthotopic bladder substitution. No patient died within
Fanny Gaignier , Marjorie Besançon , Alain Bergeron , Yves Fradet 1 90 days of surgery. The two–year overall survival rate was 52%.
1
1
1
1 Laboratoire d’Uro–Oncologie Expérimentale, CHU de Québec – Conclusions: These preliminary data suggest that HILT with consolida-
Université Laval, Quebec City, QC, Canada tion radical cystectomy may be a safe and efficacious treatment strategy
Introduction: To escape from immune system, tumours regulate the in selected patients with metastatic bladder cancer. Further study is
expression of immune cell surface receptors called immune checkpoints warranted.
(ICs). Inhibitory ICs, such as PD–1, curtail immune response and prevent
automimmunity, whereas stimulatory ICs, such as OX40, regulate immune UP–12.2
cell activation. Treatment with antagonistic or agonistic antibodies tar- Clinical outcomes of metastatic renal cell carcinoma patients
geting ICs can rescue anti–tumour immune response. In advanced blad- undergoing complete or incomplete metastasectomy
der cancer (BCa) patients, PD–1/PD–L1 inhibition resulted in 20–30% Sara Nazha , Alice Dragomir , Antonio Finelli , Aaron Hansen , Lori Wood ,
1
3
2
1
2
objective response rates. We hypothesize that the combination of PD–1 Ricardo Rendon , Alan So , Christian Kollmannsberger , Frédéric Pouliot ,
4
3
5
4
inhibition with OX40 stimulation could be more effective in rescuing the Naveen Basappa , Daniel Heng , Denis Soulières , Anil Kapoor , Simon
9
8
7
6
anti–tumour immune response. The aims of this study were to characterize Tanguay 1
PD–1 and OX40 expression in murine MBT–2 bladder tumours and to 1 McGill University Health Centre, McGill University, Montreal, QC,
assess the effect of their modulation on tumour growth. Canada; Princess Margaret Cancer Centre, University of Toronto, Toronto,
2
Methods: MBT–2 tumours, grown s.c. into C3H female mice, were dis- ON, Canada; Queen Elizabeth II Health Sciences Centre, Halifax, NS,
3
sociated and analyzed by multicolour flow cytometry for PD–1/PD–L1 Canada; BC Cancer Agency Vancouver Cancer Centre, BC Cancer
4
and OX40/OX40L expression on tumour–infiltrating immune cell and Agency, Vancouver , BC, Canada; Centre Hospitalier Universitaire de
5
tumour cell populations. IC blockade and/or stimulation were performed Québec, Université Laval, Quebec City, QC, Canada; Cross Cancer
6
by 4 i.p. injections of anti–PD–1 and/or anti–OX40 antibodies. After 80 Institute, University of Alberta, Edmonton, AB, Canada; Tom Baker Cancer
7
days, tumour–free mice were rechallenged to assess memory response. Centre, University of Calgary, Calgary, AB, Canada; Centre Hospitalier
8
Results: Among tumour infiltrating T lymphocytes, around 50% of CD8+ de l’Université de Montréal, Montreal, QC, Canada; Juravinski Cancer
9
and 40% of CD4+ cells co–expressed PD–1 and OX40. Moreover, 30% of Centre, McMaster University, Hamilton, ON, Canada
CD4+ cells were only OX40+ while 35% of CD8+ cells were only PD–1+. Introduction: Surgical resection of metastasis plays an important role
Treatments showed that PD–1 blockade induced a complete response in the management of metastatic renal cell carcinoma (mRCC) patients
rate (CRR) of 30%, whereas OX40 stimulation induced a CRR of 40%. when aiming for complete remission. Complete and incomplete metas-
However, when both therapies were combined, the CRR increased to tasectomy can potentially offer prolonged cancer control or symptoms
100%. All the latter mice survived rechallenge, indicating that the com- palliation. The objective of this study is to evaluate the overall survival
bined treatment induced a long–term memory response. (OS) and progression–free survival (PFS) in patients undergoing complete
Conclusions: MBT–2 tumours are frequently infiltrated by PD–1+ and and incomplete metastasectomy.
OX40+ T lymphocytes and PD–1/OX40 combined therapies resulted in Methods: The Canadian Kidney Cancer information system (CKCis)
a better response rate than those obtained with single–agent therapies. database was used to select patients who were diagnosed with mRCC
These results warrant further studies of this promising combination in between January 2011 and December 2016. Study cohort includes
clinical settings. patients diagnosed with mRCC and having received complete or incom-
plete metastasectomy during the study period. OS was calculated from
time of metastasectomy until death from any cause using Kaplan–Meier
(KM) curves. PFS was measured as time from metastasectomy until clinical
progression, defined as diagnosis of new metastasis. A Cox proportional
hazards model was used to identify the potential predictors of survival
while adjusting for confounding variables.
Results: Overall, 252 patients were included in the analysis, with 68%
(n=173) having received complete metastasectomy. Median time of fol-
lowup since the date of the first metastasectomy was 19 months (interquar-
tile range [IQR] 7–35). Patients undergoing incomplete metastasectomy
CUAJ • June 2018 • Volume 12(6Suppl2) S135