Page 11 - CUA 2020_Sexual Dysfunction and Transplant

Unmoderated Posters 2: Uro-Oncology, Pediatrics, Sexual Dysfunction, Transplant

the ENZA group (log-rank p=0.822). On multivariable analysis, the haz- Conclusions: Our study suggests that there is a statistically significant dif-
ard ratio (HR) for ABI vs. ENZA was 1.08 (95% confidence interval [CI] ference between the T levels of patients treated with abiraterone compared
0.79–1.38; p=0.721). Age greater than 75 (HR 1.41; 95% CI 1.18–1.70; to those treated with enzalutamide. Abiraterone appears to suppress T to
p<0.001), Charlson comorbidity scores greater than 4 (HR 1.33; 95% CI lower levels than enzalutamide. There is not a clinical significance due
1.08–1.63; p=0.008), presence of symptoms (HR 1.69; 95% CI 1.40–2.04; to the drugs still having very similar effects as a treatment of PCa, there-
p<0.001), time from prostate cancer diagnosis <3 years (HR 1.65; 95% CI fore, measuring T levels of patients on these drugs may not be required.
1.31–2.09; p<0.001), and time from last chemotherapy <6 months (HR
1.30; 95% CI 1.40–2.04; p<0.001) were associated with worse survival. UP-2.27
Conclusions: In our study population, there was no difference in overall
survival between ABI and ENZA as second-line treatments in the post- The bacterial DNA content of normal and prostate human tumor
chemotherapy setting in mCRPC. Further evaluation of both drugs using tissues and its modulation by a single nutrient 1 1
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real-world data is necessary to assess differences in other health outcomes, Gabriel Lachance , Karine Robitaille , Hélène Hovington , Alain Bergeron ,
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such treatment-related complications and use of health services. Yves Fradet , Vincent Fradet
CHU de Québec, Unversité Laval Research Center, Quebec City, QC,
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Canada
UP-2.24 Introduction: Cancer immunotherapy success was recently shown to be
Comparing testosterone levels in prostate cancer patients treated dependent on microbiota. Since few prostate cancer patients respond to
with enzalutamide or abiraterone immunotherapy, we used metagenomic sequencing to identify microbe-
Zoe Glase , Mohamad Baker Berjaou , Karen Hersey , Heidi Wagner , associated molecular patterns (MAMP) that could be linked to prostate
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Miran Kenk , Yazan Qaoud , Saranya Kulendran , Susan Nguyen , Alisha tumor.
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Bhimani , Neil E. Fleshner 2 Methods: A double-blind, phase 2b, randomized controlled trial was
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1 Carelton University, Ottawa, ON, Canada; Urological Oncology, conducted in our team to test the effects of monoacylglyceride-conjugated
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University Health Network - Princess Margaret Cancer Centre, Toronto, eicosapentaenoic acid (MAG-EPA)-rich fish oil in men with prostate can-
ON, Canada cer treated by radical prostatectomy (NCT02333435). In that study, par-
Introduction: Enzalutamide (Xtandi ) and abiraterone acetate (Zytiga ) ticipants were randomized to take either 3 g/day of MAG-EPA or placebo
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are second-generation hormone therapy drugs used for the treatment of for 4–10 weeks before surgery. Several biological samples were collected
advanced prostate cancer (PCa). Serial serum prostate specific antigen at baseline and surgery, including blood, stool, and prostate tissue. We
(PSA) and testosterone (T) testing is commonly used to monitor thera- analyzed the bacterial composition of prostate tissue at surgery from 30
peutic response to most PCa therapies. There has been recent interest in patients using 16srRNA metagenomic.
interpreting and understanding how T levels are affected by exposure to Results: Phylogenetic analysis showed that the vast majority of bac-
this class of drugs. The purpose of this study was to determine if there is a terial sequences found in all tissues and controls were associated
significant difference between T levels of patients treated with abiraterone with Proteobacteria phylum, which inhabit several ecological niches.
compared to patients treated with enzalutamide. However, sequences associated with Firmicutes phylum, which is natu-
Methods: Data from the electronic patient records (EPR) and the GU rally enriched in humans, were significantly higher in prostatic tissues
BioBank of University Health Network (UHN) (Princess Margaret Cancer compared to controls (p=0.031). Oscillibacter genus was the only sig-
Centre) was used. We examined the EPR charts of men diagnosed with nal to be significantly different between normal and tumor samples. We
advanced PCa who had been exposed to either abiraterone or enzalu- also observed that sequences from Clostridia were significantly reduced
tamide. A total of 150 patients were identified to be on one of the two in patients who received MAG-EPA compared to placebo. In contrast,
drugs: 75 patients on abiraterone and 75 patients on enzalutamide. The sequences associated with Corynebacterium genus were enriched in
T levels of patients, measured at both UHN and external laboratories, MAG-EPA group with a stronger trend in tumor compared to normal
were then analyzed and compared. samples. Interestingly, Bacteroides and Phascolarctobacterium genus
Results: The median T levels were 0.74 (<0.1–11.5) and 0.23 (<0.1–11) showed a trend to be specifically depleted in tumor samples from the
nmol/L for enzalutamide and abiraterone, respectively. A total of 830 T placebo group.
levels were recorded for patients using enzalutamide, while 726 were Conclusions: Taken together, our results support the idea that MAMPs can
recorded for patients on abiraterone. One hundred forty patients were be modulated at the tumor site by a targeted dietary intervention. This
being treated concurrently with a luteinizing hormone-releasing hormone approach could be used to provide immune cofactors and beneficially
(LHRH) agonist or antagonist; 10 patients showed no record of being on modulate the anti-tumor response in prostate cancer.
a concurrent LHRH therapy. There was a statistically significant difference
in the T levels between the two drugs using the t-Test (p=1.19x10–34).

CUAJ • June 2020 • Volume 14, Issue 6(Suppl2) S67