PD10-02 TIME TO BIOCHEMICAL RECURRENCE (BCR) IN PATIENTS WITH LOCALIZED HIGH-RISK PROSTATE CANCER (PC) TREATED WITH NEOADJUVANT ANDROGEN BLOCKADE (NAB) PRIOR TO RADICAL PROSTATECTOMY (RP): RESULTS OF A POOLED ANALYSIS OF THREE PHASE 2 TRIALS

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy I1 Apr 2017PD10-02 TIME TO BIOCHEMICAL RECURRENCE (BCR) IN PATIENTS WITH LOCALIZED HIGH-RISK PROSTATE CANCER (PC) TREATED WITH NEOADJUVANT ANDROGEN BLOCKADE (NAB) PRIOR TO RADICAL PROSTATECTOMY (RP): RESULTS OF A POOLED ANALYSIS OF THREE PHASE 2 TRIALS Rana McKay, Bruce Montogomery, Wanling Xie, Zhenwei Zhang, Glenn Bubley, Daniel Lin, Mark Preston, Quoc-Dien Trinh, Andrew Wagner, Elahe Mostaghel, Philip Kantoff, Peter Nelson, Mary-Ellen Taplin, and Adam Kibel Rana McKayRana McKay More articles by this author , Bruce MontogomeryBruce Montogomery More articles by this author , Wanling XieWanling Xie More articles by this author , Zhenwei ZhangZhenwei Zhang More articles by this author , Glenn BubleyGlenn Bubley More articles by this author , Daniel LinDaniel Lin More articles by this author , Mark PrestonMark Preston More articles by this author , Quoc-Dien TrinhQuoc-Dien Trinh More articles by this author , Andrew WagnerAndrew Wagner More articles by this author , Elahe MostaghelElahe Mostaghel More articles by this author , Philip KantoffPhilip Kantoff More articles by this author , Peter NelsonPeter Nelson More articles by this author , Mary-Ellen TaplinMary-Ellen Taplin More articles by this author , and Adam KibelAdam Kibel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.565AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Despite local therapy, a significant portion of men with high-risk PC develop progressive disease. NAB prior to RP is an approach that can potentially maximize survival outcomes in a subset of patients with localized disease. The objective of this pooled analysis was to evaluate the time to BCR in patients treated with NHT pre-RP. METHODS This analysis included patients enrolled on three neoadjuvant trials at three institutions: Dana-Farber/Brigham and Women's Cancer Center, University of Washington, and Beth Israel Deaconess Medical Center. Study 08295 evaluated 3 months of either 1) a luteinizing hormone-releasing hormone agonist (LHRHa) + dutasteride, 2) LHRHa + dutasteride + bicalutamide, or 3) LHRHa + dutasteride + bicalutamide + ketoconazole. Study 09107 evaluated either 1) 12 weeks of abiraterone acetate (AA) and 24 weeks of a LHRHa or 2) 24 weeks of AA and 24 weeks of a LHRHa. Study 12089 evaluated 6 months of 1) enzalutamide or 2) enzalutamide + LHRHa + dutasteride. BCR is defined as a prostate specific antigen (PSA) >=0.2 ng/mL, which is confirmed, or need for salvage radiation therapy or androgen deprivation therapy. The distributions of time to BCR are estimated using the Kaplan Meier method. RESULTS This analysis included 72 patients (total patient cohort 133): 57% (n=41) enrolled on 09107, 38% (n=27) enrolled on 12089, and 6% (n=4) enrolled on 08295. Overall, median follow-up was 3.4 years from RP. Prior to initiation of NAB, 12 patients (17%) had clinical T3 disease and median PSA was 8.3 ng/mL. The majority of patients had Gleason 8-10 disease (n=46, 64%). Median age at RP was 59. Eleven patients (16%) had tumor measuring <= 0.5 cm at largest diameter at RP. Four patients (6%) had a pathologic complete response (pCR). Positive margins, extraprostatic, seminal vesicle or lymph node involvement was present in 9 (13%), 39 (56%), 43 (61%), and 8 (11%) patients, respectively. Twenty-three patients (32%) experienced a BCR and the 3-year BCR free rate was 70% (57%-80%). No patient with a pCR or tumor measuring <= 0.5 cm experienced a BCR. Five patients (7%) developed metastatic disease and there was one death related to PC. CONCLUSIONS NAB results in cases with little or no residual tumor. Metrics of efficacy other than survival are needed; in this subset analysis of patients with available PSA data, we demonstrate that patients with minimal residual tumor and pCR have not experienced BCR. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e199 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Rana McKay More articles by this author Bruce Montogomery More articles by this author Wanling Xie More articles by this author Zhenwei Zhang More articles by this author Glenn Bubley More articles by this author Daniel Lin More articles by this author Mark Preston More articles by this author Quoc-Dien Trinh More articles by this author Andrew Wagner More articles by this author Elahe Mostaghel More articles by this author Philip Kantoff More articles by this author Peter Nelson More articles by this author Mary-Ellen Taplin More articles by this author Adam Kibel More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...