Best paper

“oncologia” 2015

Elena Verzoni

Oncologia Medica

Fondazione IRCCS

Istituto Nazionale Tumori Milano

OS by extent of metastatic disease at start of ADT

High volume Low volume

ADT alone

Median 32.2 mo

ADT + DOC

Not reachedADT alone

Not reached

ADT + DOC

Median 49.2 mo

HR = 0.60

(95% CI 0.45-0.81)

P=0.0006

HR = 0.63

(95% CI 0.34-1.17)

P=0.1398

• 17-month benefit in median OS (from 32.2 to 49.2 months) for high-volume disease

P=0.0006 P=0.1398

Sweeney C et al. NEJM; August 5, 2015, pp 1-10.

• A multi-institutional integrative clinical sequencing of mCRPC

Integrative Clinical Genomics of Advanced

Prostate Cancer

• N=150 with complete integrative clinical sequencing (whole exome, matched germline, and transcriptome data)

• Approximately 90% of mCRPC harbor clinically actionable molecular alterations

• 8% harbor germline findings• 8% harbor germline findings

Robinson D et al Cell. 2015 May 21;161(5):1215-28.

�71%: AR pathway alterations (AR/SPOP/NCOR1-

2)

- multiple AR mutations in the same biopsy- multiple AR mutations in the same biopsy

� non AR mutations:

- 49% PI3K pathway alterations (pTEN)

- 19% DNA-repair pathway (BRCA2, BRCA1, ATM)- 19% DNA-repair pathway (BRCA2, BRCA1, ATM)

• Phase II trial, 50 pts

• Fresh biopsy-> genomic aberrations that interfere with DNA repair ->

biomarkers POSITIVE/NEGATIVE (33%/66%)

Abiraterone

Saad, Eur Urol 2015, Bellmunt Eur Urol 2015,

Abiraterone

Enzalutamide

Loriot, Lancet Oncology 2015, Ann Oncol 2015

Cabazitaxel

Grazie per l’attenzioneGrazie per l’attenzione

elena.verzoni@istitutotumori.mi.it