MP06-05 PRECYSTECTOMY EPITHELIAL TUMOR MARKER RESPONSE TO NEOADJUVANT CHEMOTHERAPY AND ITS EFFECT ON ONCOLOGICAL OUTCOMES IN UROTHELIAL BLADDER CANCER

Abstract

You have accessJournal of UrologyBladder Cancer: Epidemiology & Evaluation II1 Apr 2016MP06-05 PRECYSTECTOMY EPITHELIAL TUMOR MARKER RESPONSE TO NEOADJUVANT CHEMOTHERAPY AND ITS EFFECT ON ONCOLOGICAL OUTCOMES IN UROTHELIAL BLADDER CANCER Soroush T Bazargani, Thomas G. Clifford, Hooman Djaladat, Anne Schuckman, Sarmad Sadeghi, Tanya Dorff, David Quinn, and Siamak Daneshmand Soroush T BazarganiSoroush T Bazargani More articles by this author , Thomas G. CliffordThomas G. Clifford More articles by this author , Hooman DjaladatHooman Djaladat More articles by this author , Anne SchuckmanAnne Schuckman More articles by this author , Sarmad SadeghiSarmad Sadeghi More articles by this author , Tanya DorffTanya Dorff More articles by this author , David QuinnDavid Quinn More articles by this author , and Siamak DaneshmandSiamak Daneshmand More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2166AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We have previously reported that elevated pre-cystectomy serum levels of epithelial tumor markers predict worse oncological outcome in patients with invasive urothelial bladder cancer (UBC). Herein, we evaluated the effect of neoadjuvant chemotherapy (NAChT) on elevated tumor marker levels and their association with oncological outcomes. METHODS Under IRB approval, serum levels of Carbohydrate Antigen 125 (CA-125), Carbohydrate Antigen 19-9 (CA 19-9) and Carcinoembryonic Antigen (CEA) were prospectively measured in 368 patients with invasive UBC from August 2011 through August 2015. In the subgroup undergoing NAChT, markers were measured prior to the first and after the last cycle of chemotherapy (before cystectomy). RESULTS 93 (25%) patients underwent NAChT, of whom 51 had a complete tumor marker profile before and after therapy and 24 (47%) of them had one or more elevated pre-NAChT tumor markers (3 missing post NAChT markers). The mean age was 67 years (range: 33-82), with 12 (57%) males. After completion of chemotherapy, 9/21 (43%) patients normalized their tumor markers, while 12/21 (57%) had one or more persistently elevated markers (p=0.004). There was no difference in pathological stage between groups (p=0.16). Median serum level of CA19-9 was significantly different before and after NAChT (137 vs. 19.3. respectively; p=0.03), while CA125 and CEA were not (Figure 1). Further analysis showed that tumor marker response is strongly correlated with disease recurrence/progression (45% in responders vs. 91% in non-responders at a median time 111 vs. 71 days respectively; p=0.01). Two patients that died in the normalized tumor marker group had tumor marker relapse at recurrence prior to their death. CONCLUSIONS To our knowledge, this is the first pilot study showing tumor marker response to NAChT. The results of this cohort suggest that patients with persistently elevated markers following NAChT have a very poor prognosis following cystectomy. There may be a promising role for these markers in identifying patients whose tumor is resistant to chemotherapy. A larger, controlled study with longer follow up is needed to determine their role in predicting survival. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e68 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Soroush T Bazargani More articles by this author Thomas G. Clifford More articles by this author Hooman Djaladat More articles by this author Anne Schuckman More articles by this author Sarmad Sadeghi More articles by this author Tanya Dorff More articles by this author David Quinn More articles by this author Siamak Daneshmand More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...