PD65-04 MR/US FUSION GUIDED ULTRA-FOCAL GOLD NANOPARTICLE DIRECTED LASER ABLATION OF PROSTATE TUMORS: RESULTS IN THE FIRST 11 PATIENTS (PHASE I/II TRIAL)

Abstract

You have accessJournal of UrologyProstate Cancer: Basic Research & Pathophysiology IV1 Apr 2018PD65-04 MR/US FUSION GUIDED ULTRA-FOCAL GOLD NANOPARTICLE DIRECTED LASER ABLATION OF PROSTATE TUMORS: RESULTS IN THE FIRST 11 PATIENTS (PHASE I/II TRIAL) Harry Anastos, Jared Winoker, Pratik Shukla, Shivaram Cumarasamy, John Sfakianos, Michael Carrick, Bodhi Rastinehad, Cynthia Knauer, Bachir Taouli, Sara Lewis, Jon Schwartz, and Ardeshir Rastinehad Harry AnastosHarry Anastos More articles by this author , Jared WinokerJared Winoker More articles by this author , Pratik ShuklaPratik Shukla More articles by this author , Shivaram CumarasamyShivaram Cumarasamy More articles by this author , John SfakianosJohn Sfakianos More articles by this author , Michael CarrickMichael Carrick More articles by this author , Bodhi RastinehadBodhi Rastinehad More articles by this author , Cynthia KnauerCynthia Knauer More articles by this author , Bachir TaouliBachir Taouli More articles by this author , Sara LewisSara Lewis More articles by this author , Jon SchwartzJon Schwartz More articles by this author , and Ardeshir RastinehadArdeshir Rastinehad More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2988AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Gold Nanoparticles (GNP) mediated laser ablation has been shown to be biocompatible and safe for the treatment of focal cancer. Herein, we report the first 11 cases in the world using GNP-directed focal laser ablation of prostate tumors using ultrasound (US) and MR/US fusion technology (NCT NCT02680535). METHODS All patients were diagnosed with Gleason 7 or less prostate cancer with biopsy proven MR visible lesions and no disease other than appreciated on the MRI. Patients underwent ultra-focal laser ablation of the tumors using GNP with MR/US fusion guidance. Following infusion of intravenous GNP on Day 0, trans-perineal laser catheters were placed into the prostate lesions for GNP excitation/tumor ablation under MR/US fusion guidance using an electromagnetic-tracked MR/US fusion device (UroNav, Invivo Gainesville FL). At 48 hours post-ablation, the patient is imaged, followed by re-imaging and MR/US fusion guided biopsy (FBx) at 3 months. All patient demographics, clinical variables, and complications were recorded. RESULTS To date, 11 patients (mean age: 69.6 yrs; range 58-79 yrs) have been enrolled in the trial. All patients were diagnosed with Gleason < 7. All patients had a solitary lesion with mean tumor volume 0.73 mL (range 0.6-1.87 cc). A single patient did not tolerate the cold IV infusion of the gold nano particles and was not able to undergo ablation the following day. 8 of 10 patients have completed the 3 month follow-up targeted biopsy as primary endpoint. Mean pre-treatment PSA was 7.84 ng/mL (range 5.5-12.3 ng/mL). Mean post-treatment PSA was 3.9 ng/mL (range 1.5-6.1 ng/mL; 50% reduction). Five out of eight patients (62.5%) did not have any cancer detected on follow up biopsy. Only 1 out of 8 patients had clinically significant cancer as per Delphi consensus criteria (Gleason score >6 or cancer > 3mm at Gleason score 6). CONCLUSIONS Recent trends toward less invasive image guided therapies have been seen as investigators pursue focal targeted therapies. This report is the first in-man demonstration of MR/US guided ultra-focal laser ablation of prostate tumors using GNP. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1226 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Harry Anastos More articles by this author Jared Winoker More articles by this author Pratik Shukla More articles by this author Shivaram Cumarasamy More articles by this author John Sfakianos More articles by this author Michael Carrick More articles by this author Bodhi Rastinehad More articles by this author Cynthia Knauer More articles by this author Bachir Taouli More articles by this author Sara Lewis More articles by this author Jon Schwartz More articles by this author Ardeshir Rastinehad More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...