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Feasibility and acceptability of follow-up care for prostate cancer in primary care
S186
Abstracts
2064 POSTER Immunohistochemical expression of MAGE-A1, MAGE-A3/4 and NY-ESO-1 antigens in patients with non-small cell lung cancer: Is there any impact on the specific immunotherapy? D. Katalinic1 , J.J. Grah2 . 1 Faculty of Medicine- J. J. Strossmayer University of Osijek, Department of Internal Medicine, Osijek, Croatia; 2 University Hospital Centre Zagreb, Department of Oncology, Zagreb, Croatia Background: Non-small cell lung cancer (NSCLC) is one of the most common causes of cancer mortality in men and women, exceeding the combined mortality rates of breast, cervical and ovarian cancers in women, and prostate cancer in men, and is thus likely to present a significant public health problem for years to come. The aim of this study was to explore the expression of cancer/testicular tumour-associated antigens (C/T-TAAs) MAGE-A1, MAGE-A 3/4 and NY-ESO-1 in adenocarcinoma and squamous cell carcinoma of the lung, and to evaluate their association with the clinicalpathological features of surgically treated lung cancer patients. Material and Methods: The study included 80 patients (40 patients with adenocarcinoma and 40 patients with squamous cell carcinoma of the lung) who had undergone surgery. The MAGE-A1, MAGE-A3/4 antigen expression was determined by an immunohistochemical method using monoclonal antibodies (mAb) 57B and the NY-ESO-1 antigen expression was determined with the addition of the B9.8.1.1 antibody (mAb). Results: MAGE-A1, MAGE-A3/4 and NY-ESO-1 were expressed in 17.3%, 44.4% and 18.5% of NSCLC, respectively. A statistically higher immunohistological expression rate of MAGE-A3/4 was found in planocellular bronchial carcinoma (p < 0.001) and a significantly higher amount of tumour necrosis was observed in tumours with MAGE-A3/4 expression (p = 0.001), but no correlation with positive lymph nodes was found. There was a statistically significant correlation between the MAGE-A1 expression in adenocarcinoma and the presence of tumour necrosis (p = 0.050). Furthermore, there was a significant correlation between the NY-ESO-1 expression and positive lymph nodes in adenocarcinoma (p < 0.001), but not in squamous cell carcinoma. Conclusions: Our results demonstrate that the MAGE-A3/4 and NY-ESO-1 expression was significantly associated with prognostic factors of poor outcome of disease (presence of tumour necrosis and lymph node metastasis). As C/T-TAAs are important for inducing a specific immune reaction in lung cancer patients, there is an intention to form a subgroup of patients, whose treatment would be enhanced by specific immunotherapy. No conflict of interest. 2065 POSTER Analysis of clinical and research implications of updating next-generation sequencing (NGS) libraries in the treatment options of lung cancer in a large cancer center M. Gonzalez Velez1 , V. Mariotti1 , R. Parrondo1 , N. Duma2 , V. Jaramillo Restrepo3 , M. McKenna4 , M. Palascak4 , H. Harper5 , S. Kothadia1 , B. Boseski5 , M. Gutierrez5 . 1 Rutgers NJMS, Internal Medicine, Newark, USA; 2 Mayo Clinic, Hematology/Oncology, Rochester, USA; 3 CES University, Medellin- Colombia, Medical Student, Medellin, Colombia; 4 Saint George University, Medical student, Hackensack, USA; 5 Hackensack University Medical Center- JTCC, Hematology/Oncology, Hackensack, USA Background: The routine use of next-generation sequencing (NGS) in clinical practice has increased the therapeutic options for many cancers. Multiple NGS assays are now commercially used. The genomic libraries used by these assays are continuously being expanded, resulting in increased detections of genomic alterations (GAs) leading to potential new treatments. The aim of this study was to identify the clinical and research implications of a database expansion in the detection of GAs in patients with lung cancer at a large comprehensive cancer center. Materials and Methods: We retrospectively analyzed 72 consecutive patients with lung cancer that had NGS at the John Theurer Cancer Center between 01/2014 and 08/2016. GAs were identified using the FoundationOne assay (Foundation Medicine, Cambridge, MA). GAs, number of genomic-directed therapies and number of clinical trials were reviewed. Results: Period 1 (P1) comprised 01/2014−09/2014, period 2 (P2) comprised 10/2014−08/2016. The NGS assay interrogated 236 genes and introns of 19 genes during P1, and was expanded to 315 genes and introns of 28 genes during P2. The 12 samples analyzed during P1 harbored a total of 44 GAs with an average of 3.6 GAs/sample (range 1−6). The 60 samples analyzed during P2 harbored a total of 330 GAs with an average of 5.5 GAs/sample (range 0−16). This represented an increase of 52% in GAs from P1 to P2. 35 GAs in 27 genes were detected in P2 that were not
Proffered Papers, Saturday 28 January 2017 interrogated during P1. Based on new genetic findings, more clinical trials were made available for the patients on P2; an average of 10 vs 6 clinical trials (66% increase in available clinical trials). Conclusions: Periodical updates on NGS and the expansion of genomic libraries increase the detection of GAs, and available clinical trials for patients with lung cancer. Continued expansions of NGS are needed to improve genomic characterization, and increase in the personalized therapeutic options for our patients. No conflict of interest.
Proffered Papers (Saturday 28 January 2017) Urology 2114 ORAL Feasibility and acceptability of follow-up care for prostate cancer in primary care M. Heins1 , J. Korevaar1 , S. Van Dulmen2 , G. Donker1 , F. Schellevis1 . 1 Netherlands Institute for Health services Research NIVEL, General Practice, Utrecht, Netherlands; 2 Netherlands Institute for Health services Research NIVEL, Communication in health care, Utrecht, Netherlands Background: The number of prostate cancer survivors is high and will increase further due to the ageing population. Follow-up care for prostate cancer patients will therefore put an increasing demand on health care capacity and costs. Increasing the role of the GP in follow-up care for prostate cancer patients may help to limit the increase in work load in secondary care and reduce health care costs. Before testing costeffectiveness in a large trial, feasibility and acceptability should first be tested in a smaller sample. Materials and Methods: We tested the feasibility and acceptability of a new clinical pathway for patients with prostate cancer in a stable phase aged 65 years and with comorbidity. Follow-up care for prostate cancer was transferred to the GP and patients were followed for one year. We aimed to include 20 patients. Participating GPs and urologists jointly developed a care protocol. Patient satisfaction regarding GP care was measured at 0 and 12 months after transfer of care from urologist to the GP with the subscale ‘personalized care’ of the Consumer Quality Index GP-care. Next, patients, GPs and urologists were interviewed about their experiences. We considered the clinical pathway successful if: no patients were referred back to the urologist except for an increase in PSA, and the majority of patients and participating urologists and GPs were satisfied. Results: Of the 20 patients included in the study, three were referred back to the urologist because of increasing PSA levels and one died (unrelated to prostate cancer). Most patients (73%) were satisfied with the transfer of care, indicated by a score of 3 or higher on the subscale ‘personalized care’. Participating GPs and urologists were confident in the ability of GPs to provide follow-up care and preferred to continue this. Conclusion: The new clinical pathway was successful. This warrants a larger study to provide evidence for the (cost-)effectiveness of GP-led prostate cancer follow-up care. No conflict of interest. 2115 ORAL Quality of life (QL) of muscle invasive bladder cancer (MIBC) patients (pts) receiving radiotherapy (RT) +/− chemotherapy (CT) in the BC2001 trial (CRUK/01/004) R. Huddart1 , E. Hall2 , M. Miranda2 , M. Crundwell3 , P. Jenkins4 , C. Rawlings5 , J. Tremlett6 , C. Hendron7 , R. Lewis2 , N. Porta2 , S. Hussain8 , N. James9 . 1 Institute of Cancer Research, Radiotherapy and Imaging, London, United Kingdom; 2 Institute of Cancer Research, Clinical Trials and Statistics Unit, London, United Kingdom; 3 Royal Devon and Exeter NHS Foundation Trust, Urology, Exeter, United Kingdom; 4 Cheltenham General Hospital, Clinical Oncology, Cheltenham, United Kingdom; 5 Torbay Hospital, Torbay Oncology Unit, Torquay, United Kingdom; 6 Brighton and Sussex University Hospitals NHS Trust, Radiotherapy, Brighton, United Kingdom; 7 Institute for Cancer StudiesUniversity of Birmingham, CRUK Clinical Trials Unit, Birmingham, United Kingdom; 8 Institute of Translational Medicine- University of Liverpool, Molecular and Clinical Cancer Medicine, Liverpool, United Kingdom; 9 University of Warwick, Cancer Research Unit, Warwick, United Kingdom Background: BC2001 showed that addition of chemotherapy (5FU+MMC; cRT) to RT (55 Gy/20f or 64 Gy/32f) significantly improved rates of MIBC locoregional disease free survival from 54% to 67% at 2 years (James et al 2012) & reduced high dose volume RT (RHDVRT) rather than standard RT (stRT) did not significantly reduce late side effects (Huddart et al 2013). Here we present pt reported QL outcomes.
Abstracts
2064 POSTER Immunohistochemical expression of MAGE-A1, MAGE-A3/4 and NY-ESO-1 antigens in patients with non-small cell lung cancer: Is there any impact on the specific immunotherapy? D. Katalinic1 , J.J. Grah2 . 1 Faculty of Medicine- J. J. Strossmayer University of Osijek, Department of Internal Medicine, Osijek, Croatia; 2 University Hospital Centre Zagreb, Department of Oncology, Zagreb, Croatia Background: Non-small cell lung cancer (NSCLC) is one of the most common causes of cancer mortality in men and women, exceeding the combined mortality rates of breast, cervical and ovarian cancers in women, and prostate cancer in men, and is thus likely to present a significant public health problem for years to come. The aim of this study was to explore the expression of cancer/testicular tumour-associated antigens (C/T-TAAs) MAGE-A1, MAGE-A 3/4 and NY-ESO-1 in adenocarcinoma and squamous cell carcinoma of the lung, and to evaluate their association with the clinicalpathological features of surgically treated lung cancer patients. Material and Methods: The study included 80 patients (40 patients with adenocarcinoma and 40 patients with squamous cell carcinoma of the lung) who had undergone surgery. The MAGE-A1, MAGE-A3/4 antigen expression was determined by an immunohistochemical method using monoclonal antibodies (mAb) 57B and the NY-ESO-1 antigen expression was determined with the addition of the B9.8.1.1 antibody (mAb). Results: MAGE-A1, MAGE-A3/4 and NY-ESO-1 were expressed in 17.3%, 44.4% and 18.5% of NSCLC, respectively. A statistically higher immunohistological expression rate of MAGE-A3/4 was found in planocellular bronchial carcinoma (p < 0.001) and a significantly higher amount of tumour necrosis was observed in tumours with MAGE-A3/4 expression (p = 0.001), but no correlation with positive lymph nodes was found. There was a statistically significant correlation between the MAGE-A1 expression in adenocarcinoma and the presence of tumour necrosis (p = 0.050). Furthermore, there was a significant correlation between the NY-ESO-1 expression and positive lymph nodes in adenocarcinoma (p < 0.001), but not in squamous cell carcinoma. Conclusions: Our results demonstrate that the MAGE-A3/4 and NY-ESO-1 expression was significantly associated with prognostic factors of poor outcome of disease (presence of tumour necrosis and lymph node metastasis). As C/T-TAAs are important for inducing a specific immune reaction in lung cancer patients, there is an intention to form a subgroup of patients, whose treatment would be enhanced by specific immunotherapy. No conflict of interest. 2065 POSTER Analysis of clinical and research implications of updating next-generation sequencing (NGS) libraries in the treatment options of lung cancer in a large cancer center M. Gonzalez Velez1 , V. Mariotti1 , R. Parrondo1 , N. Duma2 , V. Jaramillo Restrepo3 , M. McKenna4 , M. Palascak4 , H. Harper5 , S. Kothadia1 , B. Boseski5 , M. Gutierrez5 . 1 Rutgers NJMS, Internal Medicine, Newark, USA; 2 Mayo Clinic, Hematology/Oncology, Rochester, USA; 3 CES University, Medellin- Colombia, Medical Student, Medellin, Colombia; 4 Saint George University, Medical student, Hackensack, USA; 5 Hackensack University Medical Center- JTCC, Hematology/Oncology, Hackensack, USA Background: The routine use of next-generation sequencing (NGS) in clinical practice has increased the therapeutic options for many cancers. Multiple NGS assays are now commercially used. The genomic libraries used by these assays are continuously being expanded, resulting in increased detections of genomic alterations (GAs) leading to potential new treatments. The aim of this study was to identify the clinical and research implications of a database expansion in the detection of GAs in patients with lung cancer at a large comprehensive cancer center. Materials and Methods: We retrospectively analyzed 72 consecutive patients with lung cancer that had NGS at the John Theurer Cancer Center between 01/2014 and 08/2016. GAs were identified using the FoundationOne assay (Foundation Medicine, Cambridge, MA). GAs, number of genomic-directed therapies and number of clinical trials were reviewed. Results: Period 1 (P1) comprised 01/2014−09/2014, period 2 (P2) comprised 10/2014−08/2016. The NGS assay interrogated 236 genes and introns of 19 genes during P1, and was expanded to 315 genes and introns of 28 genes during P2. The 12 samples analyzed during P1 harbored a total of 44 GAs with an average of 3.6 GAs/sample (range 1−6). The 60 samples analyzed during P2 harbored a total of 330 GAs with an average of 5.5 GAs/sample (range 0−16). This represented an increase of 52% in GAs from P1 to P2. 35 GAs in 27 genes were detected in P2 that were not
Proffered Papers, Saturday 28 January 2017 interrogated during P1. Based on new genetic findings, more clinical trials were made available for the patients on P2; an average of 10 vs 6 clinical trials (66% increase in available clinical trials). Conclusions: Periodical updates on NGS and the expansion of genomic libraries increase the detection of GAs, and available clinical trials for patients with lung cancer. Continued expansions of NGS are needed to improve genomic characterization, and increase in the personalized therapeutic options for our patients. No conflict of interest.
Proffered Papers (Saturday 28 January 2017) Urology 2114 ORAL Feasibility and acceptability of follow-up care for prostate cancer in primary care M. Heins1 , J. Korevaar1 , S. Van Dulmen2 , G. Donker1 , F. Schellevis1 . 1 Netherlands Institute for Health services Research NIVEL, General Practice, Utrecht, Netherlands; 2 Netherlands Institute for Health services Research NIVEL, Communication in health care, Utrecht, Netherlands Background: The number of prostate cancer survivors is high and will increase further due to the ageing population. Follow-up care for prostate cancer patients will therefore put an increasing demand on health care capacity and costs. Increasing the role of the GP in follow-up care for prostate cancer patients may help to limit the increase in work load in secondary care and reduce health care costs. Before testing costeffectiveness in a large trial, feasibility and acceptability should first be tested in a smaller sample. Materials and Methods: We tested the feasibility and acceptability of a new clinical pathway for patients with prostate cancer in a stable phase aged 65 years and with comorbidity. Follow-up care for prostate cancer was transferred to the GP and patients were followed for one year. We aimed to include 20 patients. Participating GPs and urologists jointly developed a care protocol. Patient satisfaction regarding GP care was measured at 0 and 12 months after transfer of care from urologist to the GP with the subscale ‘personalized care’ of the Consumer Quality Index GP-care. Next, patients, GPs and urologists were interviewed about their experiences. We considered the clinical pathway successful if: no patients were referred back to the urologist except for an increase in PSA, and the majority of patients and participating urologists and GPs were satisfied. Results: Of the 20 patients included in the study, three were referred back to the urologist because of increasing PSA levels and one died (unrelated to prostate cancer). Most patients (73%) were satisfied with the transfer of care, indicated by a score of 3 or higher on the subscale ‘personalized care’. Participating GPs and urologists were confident in the ability of GPs to provide follow-up care and preferred to continue this. Conclusion: The new clinical pathway was successful. This warrants a larger study to provide evidence for the (cost-)effectiveness of GP-led prostate cancer follow-up care. No conflict of interest. 2115 ORAL Quality of life (QL) of muscle invasive bladder cancer (MIBC) patients (pts) receiving radiotherapy (RT) +/− chemotherapy (CT) in the BC2001 trial (CRUK/01/004) R. Huddart1 , E. Hall2 , M. Miranda2 , M. Crundwell3 , P. Jenkins4 , C. Rawlings5 , J. Tremlett6 , C. Hendron7 , R. Lewis2 , N. Porta2 , S. Hussain8 , N. James9 . 1 Institute of Cancer Research, Radiotherapy and Imaging, London, United Kingdom; 2 Institute of Cancer Research, Clinical Trials and Statistics Unit, London, United Kingdom; 3 Royal Devon and Exeter NHS Foundation Trust, Urology, Exeter, United Kingdom; 4 Cheltenham General Hospital, Clinical Oncology, Cheltenham, United Kingdom; 5 Torbay Hospital, Torbay Oncology Unit, Torquay, United Kingdom; 6 Brighton and Sussex University Hospitals NHS Trust, Radiotherapy, Brighton, United Kingdom; 7 Institute for Cancer StudiesUniversity of Birmingham, CRUK Clinical Trials Unit, Birmingham, United Kingdom; 8 Institute of Translational Medicine- University of Liverpool, Molecular and Clinical Cancer Medicine, Liverpool, United Kingdom; 9 University of Warwick, Cancer Research Unit, Warwick, United Kingdom Background: BC2001 showed that addition of chemotherapy (5FU+MMC; cRT) to RT (55 Gy/20f or 64 Gy/32f) significantly improved rates of MIBC locoregional disease free survival from 54% to 67% at 2 years (James et al 2012) & reduced high dose volume RT (RHDVRT) rather than standard RT (stRT) did not significantly reduce late side effects (Huddart et al 2013). Here we present pt reported QL outcomes.