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
27P - The prognostic value of neutrophil to lymphocyte ratio (NLR) and 18F-FDG PET SUV in breast cancer patients underwent neoadjuvant chemotherapy
Presenter: Soong June Bae
Session: Poster display session
Resources:
Abstract
28P - Accuracy of core biopsy in predicting pathologic complete response in the breast in patients with complete/near complete clinical and radiological response (Complete Responders in the Breast – CRBr): A feasibility study
Presenter: Nisha Hariharan
Session: Poster display session
Resources:
Abstract
29P - Tumour response to neoadjuvant chemotherapy in breast cancer: Routine pathologic markers improve the predictive power of a cell-loss metric based on release of thymidine kinase 1 into blood
Presenter: Bernhard Tribukait
Session: Poster display session
Resources:
Abstract
30P - Comparison of metabolic changes between neoadjuvant chemotherapy and neoadjuvant endocrine therapy in premenopausal women with ER positive, HER2 negative breast cancer
Presenter: Ho-hyun Ryu
Session: Poster display session
Resources:
Abstract
31P - Circulating miR-155 as a potential therapeutic monitoring marker in breast cancer
Presenter: Sumadi Lukman Anwar
Session: Poster display session
Resources:
Abstract
32P - Profile of breast cancer epidemiology in Sanglah General Hospital, Denpasar, Bali from 2012 to 2019
Presenter: Citra Aryanti
Session: Poster display session
Resources:
Abstract
33P - Contrast enhanced chest CT in patients with breast cancer: Comprehensive imaging analysis and correlation with biological markers
Presenter: Bo Hwa Choi
Session: Poster display session
Resources:
Abstract
34P - Verification of metabolic regulatory mechanisms in androgen receptor-positive triple negative breast cancer
Presenter: Yuka Asano
Session: Poster display session
Resources:
Abstract
35TiP - Ribociclib plus goserelin with hormonal therapy versus physician choice chemotherapy in pre-/perimenopausal patients with HR+, HER2– inoperable locally advanced breast cancer (ABC): RIGHT choice study
Presenter: Yen-Shen Lu
Session: Poster display session
Resources:
Abstract
36TiP - A prospective study to assess response to neoadjuvant hormonal therapy in postmenopausal women with hormone-receptor positive breast cancer at a regional cancer centre in South India
Presenter: Shina Goyal
Session: Poster display session
Resources:
Abstract