Abstract
Introduction: Recently, a prognostic index including six risk factors (RFs) (unfavourable ECOG performance status [PS], presence of liver metastases, short response to luteinizing hormone-releasing hormone [LHRH] agonists/antagonists, low albumin, increased alkaline phosphatase [ALP] and lactate dehydrogenase [LDH]) was developed from the COU-AA-301 trial in post-chemotherapy metastatic castration-resistant prostate cancer (mCRPC) patients treated with abiraterone acetate. Our primary objective was to evaluate this model in a cohort of chemotherapy-naive mCRPC patients receiving abiraterone. Methods: We identified 197 chemotherapy-naive patients who received abiraterone at six BC Cancer Agency centres and who had complete information on all six RFs. Study endpoints were prostate-specific antigen (PSA) response rate (RR), time to PSA progression, time on treatment, and overall survival (OS). PSA RR and survival outcomes were compared using ?2 test and log-rank test. Multivariable Cox proportional hazard analysis was performed to identify RFs independently associated with OS. Results: Patients were classified into good (0?1 RFs), intermediate (2?3 RFs), and poor (4?6 RFs) prognostic groups (33%, 52%, and 15%, respectively). For good, intermediate, and poor risk patients, PSA RR (≥50% decline) was 60% vs. 42% vs. 40% (p=0.05); median time to PSA progression was 7.3 vs. 5.3 vs. 5.0 months (p=0.02); and median OS was 29.4 vs. 13.8 vs. 8.7 months (p<0.0001). Conclusions: The six-factor prognostic index model stratifies clinical outcomes in chemotherapy-naive mCRPC patients treated with abiraterone. Identifying patients at risk of poor outcomes is important for informing clinical practice and clinical trial design.
| Original language | English |
|---|---|
| Pages (from-to) | E47-E52 |
| Number of pages | 6 |
| Journal | Canadian Urological Association |
| Volume | 12 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 1 Feb 2018 |
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A prognostic model for stratifying clinical outcomes in chemotherapy-naive metastatic castration-resistant prostate cancer patients treated with abiraterone acetate. / Khalaf, D. J.; Avilés, C. M.; Azad, A. A.; Sunderland, K.; Todenhöfer, T.; Eigl, B. J.; Finch, D.; Le, L.; Atwell, A.; Keith, B.; Kollmannsberger, C.; Chi, K. N.
In: Canadian Urological Association, Vol. 12, No. 2, 01.02.2018, p. E47-E52.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - A prognostic model for stratifying clinical outcomes in chemotherapy-naive metastatic castration-resistant prostate cancer patients treated with abiraterone acetate
AU - Khalaf, D. J.
AU - Avilés, C. M.
AU - Azad, A. A.
AU - Sunderland, K.
AU - Todenhöfer, T.
AU - Eigl, B. J.
AU - Finch, D.
AU - Le, L.
AU - Atwell, A.
AU - Keith, B.
AU - Kollmannsberger, C.
AU - Chi, K. N.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - Introduction: Recently, a prognostic index including six risk factors (RFs) (unfavourable ECOG performance status [PS], presence of liver metastases, short response to luteinizing hormone-releasing hormone [LHRH] agonists/antagonists, low albumin, increased alkaline phosphatase [ALP] and lactate dehydrogenase [LDH]) was developed from the COU-AA-301 trial in post-chemotherapy metastatic castration-resistant prostate cancer (mCRPC) patients treated with abiraterone acetate. Our primary objective was to evaluate this model in a cohort of chemotherapy-naive mCRPC patients receiving abiraterone. Methods: We identified 197 chemotherapy-naive patients who received abiraterone at six BC Cancer Agency centres and who had complete information on all six RFs. Study endpoints were prostate-specific antigen (PSA) response rate (RR), time to PSA progression, time on treatment, and overall survival (OS). PSA RR and survival outcomes were compared using ?2 test and log-rank test. Multivariable Cox proportional hazard analysis was performed to identify RFs independently associated with OS. Results: Patients were classified into good (0?1 RFs), intermediate (2?3 RFs), and poor (4?6 RFs) prognostic groups (33%, 52%, and 15%, respectively). For good, intermediate, and poor risk patients, PSA RR (≥50% decline) was 60% vs. 42% vs. 40% (p=0.05); median time to PSA progression was 7.3 vs. 5.3 vs. 5.0 months (p=0.02); and median OS was 29.4 vs. 13.8 vs. 8.7 months (p<0.0001). Conclusions: The six-factor prognostic index model stratifies clinical outcomes in chemotherapy-naive mCRPC patients treated with abiraterone. Identifying patients at risk of poor outcomes is important for informing clinical practice and clinical trial design.
AB - Introduction: Recently, a prognostic index including six risk factors (RFs) (unfavourable ECOG performance status [PS], presence of liver metastases, short response to luteinizing hormone-releasing hormone [LHRH] agonists/antagonists, low albumin, increased alkaline phosphatase [ALP] and lactate dehydrogenase [LDH]) was developed from the COU-AA-301 trial in post-chemotherapy metastatic castration-resistant prostate cancer (mCRPC) patients treated with abiraterone acetate. Our primary objective was to evaluate this model in a cohort of chemotherapy-naive mCRPC patients receiving abiraterone. Methods: We identified 197 chemotherapy-naive patients who received abiraterone at six BC Cancer Agency centres and who had complete information on all six RFs. Study endpoints were prostate-specific antigen (PSA) response rate (RR), time to PSA progression, time on treatment, and overall survival (OS). PSA RR and survival outcomes were compared using ?2 test and log-rank test. Multivariable Cox proportional hazard analysis was performed to identify RFs independently associated with OS. Results: Patients were classified into good (0?1 RFs), intermediate (2?3 RFs), and poor (4?6 RFs) prognostic groups (33%, 52%, and 15%, respectively). For good, intermediate, and poor risk patients, PSA RR (≥50% decline) was 60% vs. 42% vs. 40% (p=0.05); median time to PSA progression was 7.3 vs. 5.3 vs. 5.0 months (p=0.02); and median OS was 29.4 vs. 13.8 vs. 8.7 months (p<0.0001). Conclusions: The six-factor prognostic index model stratifies clinical outcomes in chemotherapy-naive mCRPC patients treated with abiraterone. Identifying patients at risk of poor outcomes is important for informing clinical practice and clinical trial design.
UR - http://www.scopus.com/inward/record.url?scp=85040340324&partnerID=8YFLogxK
U2 - 10.5489/cuaj.4600
DO - 10.5489/cuaj.4600
M3 - Article
AN - SCOPUS:85040340324
VL - 12
SP - E47-E52
JO - Canadian Urological Association
JF - Canadian Urological Association
SN - 1920-1214
IS - 2
ER -