Page 13 - CUA2019 Abstracts - Oncology-Prostate

Poster session 10: Prostate Cancer II

proportion of patients with a positive surgical margin (32% pre-report card patients with >10 bone metastases in the NLR <2.5 group. Our survival
vs. 39% post-report card; p=0.09). There was no difference in postopera- results demonstrate that higher NLR values corresponded to a poorer
tive erectile function (24% vs. 26%; p=0.69) and a decrease in continence overall survival and prostate-specific antigen (PSA) response to AA but
(76% vs. 63.2%; p=0.01). not placebo (Figs. 1A, C), which was confirmed in our adjusted regres-
Conclusions: A surgical report card program is feasible. With one year sion models. No significant differences were seen in time to radiographic
of surgical report cards, overall patient outcomes did not improve. We progression (Fig. 1B). In separate analyses, an increase or decrease NLR
believe that specific initiatives and longer duration of feedback are needed by two from treatment baseline did not clearly signal subsequent lack of
for positive change to occur. benefit with continued AA.
Conclusions: Our results suggest that baseline NLR may be able to predict
MP-10.4 response to AA in men with asymptomatic mCRPC, but that changes in
NLR during treatment are insufficient to guide treatment. Further valida-
Assessment of magnetic resonance imaging-fusion prostate tion studies are warranted.
biopsy with comparison to concurrent standard systematic This paper has a figure, which may be viewed online at:
ultrasound-guided biopsy https://2019.cua.events/webapp/lecture/240
Ryan Sun , Jeffery W. Saranchuk 1 This study, carried out under YODA Project # 2016-1103, used data
1
1 Urology, University of Manitoba, Winnipeg, MB, Canada obtained from the Yale University Open Data Access Project, which has
Introduction: The current standard for prostate cancer diagnosis involves an agreement with Janssen Research & Development, L.L.C. The interpre-
a systematic, ultrasound-guided prostate biopsy, which may be limited tation and reporting of research using this data are solely the responsibil-
by suboptimal detection rate. Recent development of magnetic reso- ity of the authors and does not necessarily represent the official views
nance imaging (MRI)-guided fusion biopsy has emerged as a promising of the Yale University Open Data Access Project or Janssen Research &
technique for cancer detection that potentially allows for more accurate Development, L.L.C.
sampling of suspicious lesions using real-time MR image registration. In
this study, we aim to assess the diagnostic accuracy and clinical impact
of MRI-fusion. MP-10.6
Methods: Patients with suspicious prostate lesions on MRI who under- Targeted ablation using ultrasound-guided irreversible
went MRI-fusion and concurrent systematic biopsy were included in this electroporation of index prostate tumours (TARGET Study): Pilot
retrospective study. The results of fusion biopsies were compared with development study evaluating patient-reported outcomes and
corresponding standard biopsies. The primary outcome was the sensitivity oncological efficacy
for clinically significant prostate cancer and whether the fusion biopsies Taehyoung Lee , Arjun Sivaraman , Emily Vertosick , Gregory Chesnut ,
1
1
1
1
led to clinically impactful changes in patient management. Jonathan Fainberg , Stephen B. Solomon , Samson W. Fine , James
1
1
2
Results: A total of 42 patients and 52 lesions were included; 76% of patients Eastham , Jonathan Coleman , Behfar Ehdaie 1
1
1
were found to have clinically significant prostate cancer. The sensitivity of 1 Memorial Sloan Kettering Cancer Center, New York, NY, United States;
systematic and fusion biopsies were 75% and 88%, respectively (p=0.057). 2 Department of Urology, New York-Presbyterian Weill Cornell Medical
Fusion biopsies alone missed 16% of clinically significant cancer, com- College of Cornell University, New York, NY, United States
pared to 22% in systematic biopsies. A potential change in clinical man- Introduction: We studied the patient-reported functional and sexual out-
agement of prostate cancer as a result of MRI-fusion biopsy was seen in comes, and oncological efficacy of focal irreversible electroporation (IRE)
10 (29%) cases compared to 16 (47%) from a repeat systematic biopsy. as a primary treatment for intermediate-risk prostate cancer (PCa).
Conclusions: Preliminary data showed a trend toward improved over- Methods: Between February 2015 and April 2017, 20 consecutive patients
all prostate cancer detection rate with fusion biopsies, but traditional initiated IRE and underwent 22 treatments. All patients underwent mag-
systematic biopsies detected some significant cancer that would be oth- netic resonance imaging (MRI)-targeted and systematic transrectal (ST)
erwise missed or under-graded if only fusion biopsies were performed. biopsies. Eligibility criteria were Gleason grade group (GrdGrp) 2/3 PCa
Additional systematic sampling should still be performed for maximal in a maximum of two adjacent sextant prostate sectors in one hemigland
cancer detection. without extraprostatic extension on MRI. Ablation was performed with 5
mm cancer margin and any GrdGrp 1 cancer outside of mapped index
MP-10.5 lesion was untreated. Outcome measures were based on prostate quality
of life survey, Male Sexual Health Questionnaire, and MRI-targeted and
The neutrophil-to-lymphocyte ratio (NLR) as a predictive marker ST biopsies at three and 12 months.
of response to abiraterone acetate: A retrospective analysis of Results: Nineteen patients completed IRE. One patient had electrocardio-
the COU302 study gram (ECG) changes and IRE was aborted. Patient and disease character-
Thomas Loubersac , Molière Nguile Makao , Frédéric Pouliot , Vincent istics are listed in Table 1. The rate of no cancer at 12 months after initial
1
2
2,3
Fradet , Paul Toren 2,3 IRE was 72% (95% confidence interval [CI] 47%, 90%). GrdGrp 2/3 PCa
2,3
1 Urology, Centre Hospitalier Universitaire (CHU) Nantes, Nantes, France;
2 Division of Oncology, Centre de Recherche CHU de Québec-Université was identified in the treated area by biopsy at three months in 1/19 (5%)
patients and at 12 months in 2/18 (11%) patients. ST biopsy identified
Laval, Québec City, QC, Canada; Department of Surgery, Université GrdGrp 2/3 PCa in non-treated areas in 3/18 (17%) patients at 12 months.
3
Laval, Québec City, QC, Canada Three (16%) patients had repeat IRE and four (21%) underwent radical
Introduction: The neutrophil-to-lymphocyte ratio (NLR) is an inexpensive prostatectomy. At six months, no statistically significant deterioration was
and accessible prognostic marker for many cancers, including metastatic detected in urinary or sexual domains, or health-related quality of life
castration-resistant prostate cancer (mCRPC). In this study, we assess its index (Table 2). Ejaculation quality and bother worsened, while volume
role as a predictive biomarker through a retrospective analysis of the decreased at 12 months (Table 3). Complications are listed in Table 4.
pivotal COU302 study of abiraterone acetate (AA) as first-line therapy for All complications resolved by three months.
men with asymptomatic or minimally symptomatic mCRPC. Conclusions: Focal IRE as primary treatment of intermediate-risk PCa is
Methods: Descriptive statistics, as well as Kaplan-Meier and Cox survival safe and associated with high one-year treatment success. Urinary and
models, were used to assess the effect of baseline NLR and changes in sexual functions were well-maintained. Ejaculatory function was nega-
NLR on response to AA plus prednisone (P) vs. prednisone, with adjust- tively impacted by IRE. Patients should be counselled about the need for
ment for important covariates. possible re-treatment.
Results: Among the 1082 patients who received treatment, baseline NLR This paper has figures, which may be viewed online at:
values showed no significant differences according to baseline covariates https://2019.cua.events/webapp/lecture/241
except for albumin. Baseline variables were similar between dichoto-
mous groups, with a NLR cutoff of 2.5, except for a lower proportion of
CUAJ • June 2019 • Volume 13, Issue 6(Suppl5) S149