Presented by: Thomas Williams MD
The Smith Institute for Urology - Northwell Health

Introduction

As prostate cancer remains the most frequently diagnosed cancer in men, there has been a strong impetus to offer men less invasive treatments for localized disease while not compromising oncologic outcomes or quality of life metrics. One such focal treatment modality is Nanospectra Biosciences’ Aurolase Therapy ablation system. Patients are infused with gold nanoparticles the day prior to the ablative procedure allowing time for the nanoparticles to preferentially accumulate within the tumor. Utilizing a transperineal approach, near infrared lasers are inserted into the lesion with magnetic resonance/ultrasound (MR/US) fusion guidance. We aimed to determine the feasibility of this focal technology, as well to define its oncologic & safety outcomes.

Materials

A prospective, open-label, single dose study of AuroLase Therapy was conducted at 10 tertiary-care centers. Men ≥ 45 years with organ-confined prostate cancer with Gleason Score ≤ 7 & ≤ 2 lesions were included. Success was defined as no evidence of Gleason ≥7 or ≥3mm of Gleason 6 at biopsy. All treatments utilized the UroNav MR/US fusion biopsy & the Nanospectra’s Aurolase Therapy ablation systems. Descriptive & inferential statistics were calculated as indicated.

Results

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Of the 100 patients included, mean baseline PSA was 8.4 ng/dL (± 3.9), & the baseline incidence of Gleason Grade Groups 1, 2, & 3 were 24%, 63%, & 13%, respectively. Patients were biopsied at 6-months & 1-year post-ablation (Table 1). Overall success rate at 1-year, accounting for 7 failures that withdrew for salvage therapy, was 71% (65 successful of 92 evaluated). Marginal differences were seen in baseline & 1-year Sexual Health Inventory for Men & International Prostate Symptom Scores, & no change was seen in baseline to 1-year Quality of Life scores, though the sample size of the reported functional outcomes was not sufficient for significance to be evaluated. No serious adverse events were reported.

Conclusion

Focal therapy is an important treatment option for men with clinically significant prostate cancer in which whole gland therapy, & the side effects that often accompany it, seem too radical. This study shows that gold nanoparticle focal laser ablation is a safe & effective treatment modality in men with low-to intermediate risk prostate cancer. Source of Funding: Nanospectra Bioscience Inc

Funding

: Nanospectra Bioscience Inc

Lead Authors

Thomas Williams, MD
The Smith Institute for Urology - Northwell Health

Co-Authors

Cynthia Knauer, RN, MS, AOCN
The Smith Institute for Urology - Northwell Health

Michael Schwartz, MD
The Smith Institute for Urology - Northwell Health

Alejandro Sanchez, MD
University of Utah

Lance Mynderse, MD
Mayo Clinic

William Ellis, MD
University of Washington

Arjun Sivaraman, MD
Washington Univerity

Christopher Weight, MD
Cleveland Clinic

Eric Klein, MD
Cleveland Clinic

Thomas Polascik, MD
Duke University

Arvin George, MD
University of Michigan

Steven Canfield, MD
University of Texas - Houston

Ardeshir Rastinehad, DO
The Smith Institute for Urology - Northwell Health