Abstract 204P
Background
Ra-223 radioisotope has been reported to increase median survival in bone metastatic prostate carcinoma. The addition of Ra-223 to abiraterone was associated with an increased risk of bone fractures. There is no comprehensive data for using Ra-223 in veteran population.
Methods
We present a retrospective study of patients (pts) with bone metastatic CRPC who received standard doses of Ra-223 and other sequential therapies at VAPHS from 2014 to 2018. Pts were divided into agent orange exposure (AO) and no exposure (Non-AO). Time to study was calculated from the initiation of Ra-223. Time to skeletal related events (SRE), progression of PSA, bone metastasis and alkaline phosphatase (ALP) were calculated in months (mos) using unpaired T-test with two-tailed p value. Median survival was calculated by Kaplan Meier R log rank test.
Results
There were 34 pts with bone metastatic CRPC. 17 pts (50%) were AO, 17 pts (50%) Non-AO. The mean age of diagnosis of AO was 62 y/o and Non-AO was 69 y/o (p 0.005). The mean Gleason score for AO was 8.12 and Non-AO was 8.00 (p 0.7048). The median number of Ra-223 cycles was 6 (60%). 10 pts received Ra-223 as first line (29%) and 24 pts received Ra-223 later (71%). There were 12 SRE with median survival of 15 mos. There was no difference in mean time to SRE between AO (8 pts, 10.63 mos) and Non-AO (4 pts, 10.25 mos) with p 0.9306. The mean time to PSA progression for AO was 5.40 mos and Non-AO was 6.79 mos (p 0.2808). Mean time to bone progression for AO was 7.56 mos and Non-AO was 10.14 mos (p 0.1574). Mean time to ALP progression for AO and Non-AO was 6.25 mos and 8.71 mos respectively (p 0.0512). 20 patients (58%) had died. Median survival for Ra-223 first was 32 mos and for Ra-223 later was 15 mos with p 0.14 and HR 0.48 (95% CI, 0.17 to 1.3). Median survival between AO and Non-AO was 12 mos and 18 mos respectively with p 0.15 and HR 2.0 (95% CI, 0.77 to 5).
Conclusions
There is no statistical difference between AO and Non-AO in terms of time to SRE, PSA, bone and ALP progression even though there is a trend of shorter duration in AO veterans. There is no median survival difference between Ra-223 first versus Ra-223 later as well as between AO and Non-AO but there is a trend of worse survival in AO veterans.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
340TiP - A multicenter, randomized, controlled, phase II trial exploring adjuvant combined therapy of apatinib and SHR-1210 (anti-PD-1), in patients with hepatocellular carcinoma at high risk of recurrence after radical resection
Presenter: Shida Yan
Session: Poster display session
Resources:
Abstract
347P - Relationship between modified surgical margin and prognosis of cutaneous squamous cell carcinoma
Presenter: Yukiko Teramoto
Session: Poster display session
Resources:
Abstract
348P - Malignant melanoma: A study of clinical profiles and treatment outcomes in Indian patients
Presenter: Sorun Shishak
Session: Poster display session
Resources:
Abstract
349P - Flavonoids from ethanol extracts of euphorbia hirta inhibit melanoma growth and metastatic potential
Presenter: Shubhra Mishra
Session: Poster display session
Resources:
Abstract
350P - Low-dose cisplatin and 5-fluorouracil combined concurrent chemoradiotherapy for unresectable cutaneous squamous cell carcinoma: Analysis of 23 cases
Presenter: Azusa Hiura
Session: Poster display session
Resources:
Abstract
353P - A prediction model for the intents regarding life-sustaining treatment decisions in patients with terminal cancer
Presenter: Yoonsun Kim
Session: Poster display session
Resources:
Abstract
354P - Predictive factors and survival outcomes with stereotactic body radiation therapy in treatment of oligometastases in colorectal cancer
Presenter: Vibhay Pareek
Session: Poster display session
Resources:
Abstract
355P - Cost analysis and overview of single versus multiple fraction palliative radiotherapy for painful bone metastasis
Presenter: Vinodhkumar Selvaraj
Session: Poster display session
Resources:
Abstract
356P - Observational study on role of crude cannabis in pain control and quality of life in terminally ill cancer patients: An Indian perspective
Presenter: Vidyasagar Dusi
Session: Poster display session
Resources:
Abstract
357P - Application of multi-modal approach to palliation in end of life head and neck cancer pain
Presenter: Srujana Joga
Session: Poster display session
Resources:
Abstract