You have accessJournal of UrologyInfertility: Epidemiology & Evaluation I (MP26)1 Apr 2020MP26-19 TESTICULAR HISTOPATHOLOGY AFTER IMMUNOTHERAPY WITH IMMUNE CHECKPOINT INHIBITORS - A RETROSPECTIVE COHORT STUDY Taylor P Kohn*, Jason Scovell, Iryna Samarska, Mahir Maruf, Eleonora Duregon, Jody Hooper, Shamlal Mangrav, Andres Matoso, and Amin S Herati Taylor P Kohn*Taylor P Kohn* More articles by this author , Jason ScovellJason Scovell More articles by this author , Iryna SamarskaIryna Samarska More articles by this author , Mahir MarufMahir Maruf More articles by this author , Eleonora DuregonEleonora Duregon More articles by this author , Jody HooperJody Hooper More articles by this author , Shamlal MangravShamlal Mangrav More articles by this author , Andres MatosoAndres Matoso More articles by this author , and Amin S HeratiAmin S Herati More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000865.019AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Immune checkpoint inhibitors (ICIs) are frequently used in the treatment of metastatic melanoma, clear cell renal cell carcinoma, and an increasing number of other cancers. Approximately 5% of these cancers will be diagnosed in adults of reproductive age. While chemotherapy is known to be gonadotoxic, no study has assessed the impact of ICI on spermatogenesis and the majority of preclinical data was performed on animals that were not yet sexually mature. The objective of this study is to assess the histologic impact of ICI on human spermatogenesis using autopsy specimens comparing testicular histology. METHODS: Men with a history of melanoma who had undergone immunotherapy for > 1 month with ipilimumab, nivolumab, and pembrolizumab between the years of 2013 and 2016 were included. A 1:1 proportioned control cohort was created and matched for age at biopsy. Men with a history of systemic chemotherapy or radiation were excluded. Tissue specimens were retrospectively examined from both living patients with testicular biopsies and deceased patients with testicular autopsies. For each testis specimen Johnsen score, seminiferous tubule density, Leydig cell density, and seminiferous tubule diameter were assessed. Medians were compared using Mann-Whitney U test using R 3.4.1. RESULTS: A total of seven men were included in the immunotherapy group with a median age at time of tissue biopsy of 58 years (range 23-66). Nine men were included in the control group with a median age at time of biopsy of 57 years (range 23-83). For patients undergoing autopsy, median time to autopsy was 7 hours in the ICI group and 6 hours in the control group. No difference was seen in Johnsen score when comparing ICI cohort and the control group, 8 (range: 2-10) and 9 (range: 2-10), respectively (p=0.55). No significant difference was seen between the ICI group and controls when assessing the number of seminiferous tubules per 200 um (11 vs 12), Leydig cells per 100 um (30 vs 26), or seminiferous tubular diameter (142 vs 171 um), respectively (p>0.05). CONCLUSIONS: In this retrospective cohort study assessing the impact of ICI, we found no significant difference in testicular histology between those receiving ICI and those who had never received ICI. This null finding suggests that ICI agents may not be spermatotoxic, unlike chemotherapy counterparts, and may be a valuable treatment when fertility preservation is desired. Large multicenter registries are needed to further track potential side-effects associated with ICI. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e408-e408 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Taylor P Kohn* More articles by this author Jason Scovell More articles by this author Iryna Samarska More articles by this author Mahir Maruf More articles by this author Eleonora Duregon More articles by this author Jody Hooper More articles by this author Shamlal Mangrav More articles by this author Andres Matoso More articles by this author Amin S Herati More articles by this author Expand All Advertisement PDF downloadLoading ...