8 maart 2022: Bron: American Society of Clinical Oncology Genitourinary Cancers Symposium van 17 tot 19 februari 2022

Naast verschillende abstracten gepresenteerd op het American Society of Clinical Oncology Genitourinary Cancers Symposium 2022 die we al hebben geplaatst bij artikelen over studies gedaan bij patiënten met nierkanker kunt u ook alle abstracten bekijken in deze PDF. Het zijn wel 118 abstracten, maar staan best wel interessante tussen. Het lukt mij niet om deze er allemaal tussenuit te halen en te plaatsen. Dus kijk indien geinteresseerd zelf in deze PDF.

In deze PDF staan twee abstracten gerelateerd aan bijnierkanker die ook hieronder staan:

1 Oral Abstract Session
First randomized trial on adjuvant mitotane in adrenocortical carcinoma patients: The Adjuvo study. Alfredo Berruti, Martin Fassnacht, Rossella Libe, Andr  e Lacroix, Darko Kastelan, Harm Haak,  Weibke Arlt, Ben edict Decoudier, H el ene Lasolle, Irina Bancos, Markus Quinkler, Maria Candida  Barisson Villares Fragoso, Letizia Canu, Soraya Puglisi, Isabelle Bourdeau, Eric Baudin, Paola Berchialla, Felix Beuschlein, Jerome Bertherat, Massimo Terzolo; University of Brescia, Brescia, Italy; University Hospital Wuerzburg, Wuerzburg, Germany; Department of Endocrinology Cochin Hospital, Paris, France; Service d’Endocrinologie et Centre de Recherche du CHUM (CRCHUM), Montreal, QC, Canada; Department of Endocrinology, University Hospital Centre, Zagreb, Croatia; Maxima Medical Center, Internal Medicine, Eindhoven, Netherlands; University of Birmingham, Birmingham, United Kingdom; Service d’Endocrinologie, Hopital Robert Debr ^ e, Centre Hospitalier Universitaire Reims, Reims, France; Endocrinology Department, Reference Centre for Rare Pituitary Diseases HYPO, "Groupement Hospitalier Est" Hospices Civils de Lyon, Lyon, France; Mayo Clinic, Rochester, MN; Endocrinology in Charlottenburg, Berlin, Germany; Servic¸o de Endocrinologia da Clınica de Bases do Instituto do Cancer do Estado de S ^ ao Paulo, S ~ ao Paulo, Brazil; Department of Experimental and Clinical ~ Biomedical Sciences, University of Florence, Florence, Italy; Internal Medicine Unit, Clinical and Biological Sciences Department, University of Turin, San Luigi Gonzaga University Hospital, Orbassano, Italy; Division of Endocrinology, Department of Medicine and Research Center, Centre Hospitalier de l’Universite de Montr eal (CHUM), Montreal, QC, Canada; Department of Nuclear Medicine and Endo- crine Oncology, Gustave Roussy Cancer Campus, Villejuif, France; University of Turin, Torino, Italy; Endokrinologie, Diabetologie und Klinische Ernahrung, Zurich, Switzerland; Department of € Endocrinology, Hopital Cochin, Paris, France; Internal Medicine, Department of Clinical and Biological ^ Sciences, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy

Background: The ESE-ENSAT guidelines on ACC management suggest adjuvant mitotane for patients at high risk of recurrence. This indication has limited evidence base, lacking results from randomized controlled trials. No suggestion for or against adjuvant mitotane in low-risk patients was given, since studies did not stratify patients for prognosis. The randomized controlled study ADIUVO compared the efficacy of adjuvant mitotane treatment vs. observation in prolonging recurrence-free survival (RFS) in patients at low-intermediate risk of recurrence.

Methods:
The main inclusion criteria were: stage I-III ACC, R0 surgery, and Ki-67 ≤10%. Patients were randomly assigned 1:1 to adjuvant mitotane or observation. The primary endpoint of the study was RFS. Patients who refused randomization were eligible for the ADIUVO OBSERVATIONAL study. In this prospective, observational study, patients were managed as in ADIUVO except for randomization. A total of 91 patients were enrolled in ADIUVO, 45 in the mitotane and 46 in the observation arm. Baseline characteristics of patients were perfectly matched between the 2 arms: median age, 51 vs. 50.5 years; female, 73% vs. 67%; stage I, 20% vs. 26%; stage II, 67% vs. 63%, stage III, 13% vs. 11%; ACC secretion 44% vs. 36%; Weiss 5 vs. 5; respectively. In ADIUVO OBSERVATIONAL, 42 patients were treated with mitotane and 53 were untreated. Baseline characteristics of patients were matched between the 2 groups and with mitotane and observation groups in ADIUVO. Thus, the ADIUVO OBSERVATIONAL cohort was analyzed in parallel to deal with the lower than expected recruitment in ADIUVO.

Results:
In the ADIUVO study, recurrences were 8 in the MIT and 11 in the OBS arm, while deaths were 2 and 5, respectively. RFS and overall survival (OS) did not significantly differ between the 2 arms. In the OBS arm, the HR for recurrence was 1.321 (95%CI, 0.55-3.32, p = 0.54) and HR for death 2.171 (95%CI, 0.52-12.12, p = 0.29). The survival analysis in the ADIUVO OBSERVATIONAL study confirmed that of ADIUVO. Given the outcome of both studies, the NNT is 55. Conclusions: ACC patients at low-intermediate risk of recurrence after surgery are a minority; however, they show a far better prognosis than expected (5-yr RFS is 75%) and do not benefit significantly from adjuvant mitotane. The results of the ADIUVO study do not support routine use of adjuvant mitotane in this subset of patients, who may thus avoid a potentially toxic treatment. This is an important step toward personalization of ACC care. Clinical trial information: NCT00777244. Research Sponsor: Italian Agency of Medicine, Pharmaceutical/Biotech Company.

Abstract no. 2:
Longitudinal trends of "manels" and gender representation at the ASCO Genitourinary Cancers Symposium. Melissa Jessica Huynh, Anushka Ghosh, Beow Y. Yeap, Anthony L. Zietman, Neha Vapiwala, Sophia C. Kamran; Division of Urology, Department of Surgery, Western University, London, ON, Canada; Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Massachusetts General Hospital and Harvard Medical School, Boston, MA; University of Pennsylvania, Philadelphia, PA; Massachusetts General Hospital, Boston, MA Background: Gender disparity in academic medicine has been a longstanding issue. Efforts have been made to recognize this imbalance and increase inclusivity. Despite this, a recent study examining the prevalence of all-male panels (“manels”) found that female faculty are significantly underrepresented at urology meetings, and nearly two-thirds of the sessions were manels. Therefore, we aimed to investigate the prevalence and longitudinal trends of manels and gender representation across genitourinary oncology disciplines at the ASCO Genitourinary Cancers Symposium (GU ASCO).

Methods: GU ASCO online programs from 2018-2021 were used to obtain faculty information. Data collected included perceived gender, medical specialty, and panel role (chair/moderator vs. non-chair/non-moderator). For year 2021, additional data about the panelists, including the number of publications, H-index, citations, and academic rank, was collected. The primary outcomes were the percentage of manels and proportion of female panelists over time. Additionally, female representation among chair/moderators and specialties were evaluated. Results: Among 83 sessions involving 317 faculty members, 227 (71.6%) were males (p<0.001), and 28 panel sessions (33.7%) were manels. Between 2018 and 2020, there was a decrease in the prevalence of manels from 45% to 21.7%, but in 2021, it rose to 32.0%. The proportion of female panel members increased over time from 17.1% in 2018 to 35.7% in 2021 (p=0.012). The role of chair/moderator was predominantly represented by males (67.2%, p<0.001). The proportion of male panelists was particularly high in urology (91.2%, p<0.001) and radiation oncology (81.8%, p=0.002) compared to medical oncology (54.6%). In 2021, male speakers held higher academic rank (i.e. professor, associate, assistant) (p=0.020) and had a greater number of publications (p=0.003), H-index (p=0.009), citations (p=0.014) than females (Table).

Conclusions: Over time, the number of female panelists increased with a corresponding decrease in proportion of manels, with the exception of 2021. Future studies that include data on meeting participant demographics will provide insight on whether panelists are over/under-represented in proportion to the audience. While improvements in male and female representation have been made over the years, meeting organizers should strive for representation that reflects a diversity of expertise and perspectives. Research Sponsor: None. ASCO Genitourinary Cancers Symposium 2021 by gender. Males (N=54) Females (N=30) p-value (two-sided) Full Professor 30 (69.8%) 13 (30.2%) 0.02 Associate Professor 10 (66.7%) 5 (33.3%) Assistant Professor 2 (22.2%) 7 (77.8%) Non-faculty rank 12 (70.6%) 5 (29.4%) Publications, median (range) 194 (11-847) 92.5 (7-394) <0.01 H-index, median (range) 43 (6-121) 24 (2-83) <0.01 Citations, median (range) 7741 (70-58052) 2951.5 (52-51660) 0.01 ADRENAL CANCER © 2022 by American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

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