Abstract 4438
Background
Choline Positron Emission Tomography – Computed Tomography (Choline PET/CT) allows for the diagnosis of oligometastatic (OM) Prostate Cancer (PCa) recurrence that could be treated with a curative intent. The aim of the study was to evaluate the different therapeutic approaches and outcomes for first OM recurrence.
Methods
This multi-institutional, retrospective study included patients with a hormone-sensitive biochemical PCa recurrence after an initial curative local treatment, and with at least 1 to 5 Choline PET/CT-diagnosed metastatic lesions. Primary endpoint was Biochemical Recurrence Free Survival (BRFS). Secondary endpoints were Metastatic Recurrence-Free Survival (MRFS) and Androgen Deprivation Therapy-Free Survival (ADT-FS).
Results
Between October 2012 and December 2016, 177 patients were included. Sixty-eight patients (38.4%) received an ADT alone, 72 (40.7%) received an External Beam Radiation Therapy (EBRT) – ADT association, 28 (15.8%) received an EBRT, 6 (3.4%) received a surgery, and 2 (1.1%) received a surgery with ADT. Median follow-up was 49 months [95%CI, 44.3-53.4]. Among patients who received non-standard treatment, 55% avoided long-term ADT. Grade 3 acute and late toxicities were rare (0.8% and 2.5% respectively). The median BRFS, MRFS and ADT-FS were 42 [95%CI, 37-51], 61 [95%CI, 45-81], and 53 [95%CI, 45-60] months, respectively. In multivariate analysis, concomitant ADT with MDT and "regional" EBRT combined with MDT significantly improved BRFS (p < 0.0001 and p = 0.0113 respectively) and MRFS (p = 0.0005 and p = 0.0013 respectively). In multivariate analysis, a PSA-doubling time of > 3 months had a statistically significant positive impact on MRFS (p = 0.0496) and ADT-FS (p = 0.0007). The overall and disease specific survivals were 87% and 97% respectively at 5 years. The median incidence of castration resistant PCa was 80 months.
Conclusions
In patients with hormone-sensitive OM PCa recurrence after initial local treatment, BRFS and MRFS were significantly improved when concomitant ADT and "regional" EBRT were combined with MDT.
Clinical trial identification
OMPPC-IPC 2018-059.
Editorial acknowledgement
Legal entity responsible for the study
Institute Paoli-Calmettes.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
4543 - Long-term real-world (RW) outcomes in patients with advanced melanoma (MEL) treated with ipilimumab (IPI) and non-IPI therapies: IMAGE study
Presenter: Stéphane Dalle
Session: Poster Display session 3
Resources:
Abstract
4523 - Prognostic Factors for efficacy of Ipilimumab used after AntiPD1 and/or BRAF+MEK inhibitors in Melanoma Patients: an Italian Melanoma Intergroup study
Presenter: Riccardo Marconcini
Session: Poster Display session 3
Resources:
Abstract
3632 - Rechallenge with combination ipilimumab and anti-PD-1 (IPI+PD1) in metastatic melanoma after acquired resistance to IPI+PD1 immunotherapy
Presenter: Adriana Hepner
Session: Poster Display session 3
Resources:
Abstract
3732 - Clinicopathologic characteristics of immune colitis in melanoma patients treated with combination ipilimumab and anti-PD1 (IPI+PD1) and PD1 monotherapy.
Presenter: Kazi Nahar
Session: Poster Display session 3
Resources:
Abstract
5005 - Real-world outcomes of ipilimumab plus nivolumab for advanced melanoma in the Netherlands
Presenter: Michiel van Zeijl
Session: Poster Display session 3
Resources:
Abstract
5524 - Utilization of Real-World Data to Assess the Effectiveness of Immune Checkpoint Inhibitors (ICIs) in Elderly Patients with Metastatic Melanoma
Presenter: D Scott Ernst
Session: Poster Display session 3
Resources:
Abstract
5884 - Tumor mutational burden and response to PD-1 inhibitors: an analysis of 89 cases of metastatic melanoma.
Presenter: Léa Dousset
Session: Poster Display session 3
Resources:
Abstract
3120 - Increase in S100B and LDH as early outcome predictors for non-responsiveness to anti-PD-1 monotherapy in advanced melanoma.
Presenter: Elisa Rozeman
Session: Poster Display session 3
Resources:
Abstract
2157 - Immune status defined by molecular information layers predicts response to pembrolizumab treatment in advanced melanoma
Presenter: Guillermo Prado-Vázquez
Session: Poster Display session 3
Resources:
Abstract
2553 - Interim analysis of a phase Ib study of cobimetinib plus atezolizumab in patients with advanced BRAFV600 wild type melanoma progressing on prior anti-PD-L1 therapy
Presenter: Shahneen Sandhu
Session: Poster Display session 3
Resources:
Abstract