Genitourinary Cancer

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SU_30_2309 - Evaluation of Inflammatory Marker Levels in Patients Treated With Radiation Therapy for Prostate Cancer

Sunday, October 21
1:15 PM - 2:45 PM
Location: Innovation Hub, Exhibit Hall 3

Evaluation of Inflammatory Marker Levels in Patients Treated With Radiation Therapy for Prostate Cancer
F. Palorini1, N. Bedini2, B. Avuzzi2, M. Dispinzieri2, S. Morlino2, B. Noris Chiorda2, L. Andreoli2, E. Campi3, V. Doldi3, T. Di Florio1, F. Badenchini1, C. Marrone1, F. Zollo1, N. Zaffaroni3, T. Rancati1, and R. Valdagni4; 1Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, 2Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, 3Molecular Pharmacology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, 4Dept. of Oncology and Hemato-Oncology, Università  degli Studi di Milano, Milan, Italy

Purpose/Objective(s): To evaluate early variations of inflammatory marker levels in patients (pts) treated with high-dose radiation therapy (RT) for prostate cancer and to establish their possible association with urinary and gastrointestinal toxicities.

Materials/Methods: Pts were enrolled in a prospective observational trial in 2017 and treated with conventional (70 or 78Gy at 2 Gy/fr) or moderately hypofractionated (65 Gy at 2.6 Gy/fr) image-guided RT in 5 fr/week. Blood samples were collected at three time points: before RT (T0), between 16-24 Gy (T1) and at the end of RT (T2). Plasma levels of three cytokines and two receptors were evaluated: CCL2, TNF-α, TNFR1, TGF-β1 and PDGF-BB. Urinary and gastrointestinal symptoms were evaluated through the Common Toxcity Criteria for Adverse Events before RT and weekly during RT. Primary endpoint for toxicity was grade >= 2 at the end of RT. Inflammatory cytokine kinetics and plasma levels of pts with or without toxicity were evaluated with Kruskall-Wallis test by ranks and Wilcoxon signed-rank test, respectively. Descriptive results are expressed as median values and interquartile ranges in pg/ml units.

Results: 50 pts were included: 14/50 (28%) and 12/50 (24%) showed acute G2 urinary (GU2) and intestinal (GI2) toxicities, respectively. No G3 toxicities were registered. Considering the whole cohort, CCL2 levels had a peak at T1 (p=0.006) and PDGF-BB linearly decreased during RT (p=0.003); the other markers did not show significant variations during RT. Focusing on pts with GU2 toxicity, early CCL2 absolute concentrations (T1) were significantly higher than those of pts without symptoms: 103 (77-112) vs 78 (61-92), respectively (p=0.048). In addition, TGF-β1 values of pts with or without GU2 toxicity had an opposite behaviour during RT (i.e. decreasing values for pts with toxicity and viceversa): 30 (17-41) vs 19 (8-30) at T0 (p=0.048); and 17 (8-25) vs 25 (6-31) at T2, respectively (p=0.063). A similar trend was seen for TNF-α: 17 (7-20) vs 15 (5-24) at T0 (p=0.89), and 10 (5-21) vs 19 (10-28) at T2 (p=0.08). Finally, pts with GI2 toxicity showed a trend for significantly lower TNFR1 at baseline (T0): 100 (79-105) vs 134 (90 – 215) (p=0.06).

Conclusion: Plasma levels of five inflammatory markers were evaluated at three time points. Interestingly, patients with urinary toxicity showed significantly higher CCL2 values after 16-24 Gy, significantly lower TGF-β1 at baseline and decreasing TGF-β1 values during RT. Patients with intestinal toxicities showed a trend for lower TNFR1 values at baseline. These results, if confirmed in a larger cohort of patients, might allow timely identification of patients with increased risk of toxicity.

Author Disclosure: F. Palorini: None. N. Bedini: None. M. Dispinzieri: None. S. Morlino: None. B. Noris Chiorda: None. E. Campi: None. T. Di Florio: None. F. Badenchini: None. R. Valdagni: Advisory Board; Amgen Dompè, Bayer SpA.

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