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Phase II Evaluation of Stereotactic Ablative Radiotherapy (SABR) and Immunity in 11C-Choline-PET/CT-Identified Oligometastatic Castration-Resistant Prostate Cancer.


ABSTRACT:

Purpose

Outcomes for resistant metastatic castration-resistant prostate cancer (CRPC) are poor. Stereotactic ablative radiotherapy (SABR) induces antitumor immunity in clinical and preclinical studies, but immunologic biomarkers are lacking.

Patients and methods

Eighty-nine patients with oligometastatic CRPC were identified by 11C-Choline-PET (Choline-PET) from August 2016 to December 2019 and treated with SABR. Prespecified coprimary endpoints were 2-year overall survival (OS) and PSA progression. Secondary endpoints included 2-year SABR-treated local failure and 6-month adverse events. Correlative studies included peripheral blood T-cell subpopulations before and after SABR.

Results

128 lesions in 89 patients were included in this analysis. Median OS was 29.3 months, and 1- and 2-year OS were 96% and 80%, respectively. PSA PFS was 40% at 1 year and 21% at 2 years. Local PFS was 84.4% and 75.3% at 1 and 2 years, respectively, and no grade ≥3 AEs were observed. Baseline high levels of tumor-reactive T cells (TTR; CD8+CD11ahigh) predicted superior local, PSA, and distant PFS. Baseline high levels of effector memory T cells (TEM; CCR7-CD45RA-) were associated with improved PSA PFS. An increase in TTR at day 14 from baseline was associated with superior OS.

Conclusions

This is the first comprehensive effector T-cell immunophenotype analysis in a phase II trial before and after SABR in CRPC. Results are favorable and support the incorporation of immune-based markers in the design of future randomized trials in patients with oligometastatic CRPC treated with SABR.

SUBMITTER: Zhang H 

PROVIDER: S-EPMC8639778 | biostudies-literature | 2021 Dec

REPOSITORIES: biostudies-literature

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Publications

Phase II Evaluation of Stereotactic Ablative Radiotherapy (SABR) and Immunity in <sup>11</sup>C-Choline-PET/CT-Identified Oligometastatic Castration-Resistant Prostate Cancer.

Zhang Henan H   Orme Jacob J JJ   Abraha Feven F   Stish B J BJ   Lowe Val J VJ   Lucien Fabrice F   Tryggestad Erik J EJ   Bold Michael S MS   Pagliaro Lance C LC   Choo C Richard CR   Brinkmann Debra H DH   Iott Matthew J MJ   Davis Brian J BJ   Quevedo J Fernando JF   Harmsen William S WS   Costello Brian A BA   Johnson Geoffrey B GB   Nathan Mark A MA   Olivier Kenneth R KR   Pisansky Thomas M TM   Kwon Eugene D ED   Dong Haidong H   Park Sean S SS  

Clinical cancer research : an official journal of the American Association for Cancer Research 20210930 23


<h4>Purpose</h4>Outcomes for resistant metastatic castration-resistant prostate cancer (CRPC) are poor. Stereotactic ablative radiotherapy (SABR) induces antitumor immunity in clinical and preclinical studies, but immunologic biomarkers are lacking.<h4>Patients and methods</h4>Eighty-nine patients with oligometastatic CRPC were identified by <sup>11</sup>C-Choline-PET (Choline-PET) from August 2016 to December 2019 and treated with SABR. Prespecified coprimary endpoints were 2-year overall survi  ...[more]

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