Time of metastatic disease presentation and volume of disease are prognostic for metastatic hormone sensitive prostate cancer (mHSPC)
Background Currently, there is no universally accepted prognostic classification for patients (pts) with metastatic hormone sensitive prostate cancer (mHSPC) treated with androgen deprivation therapy (ADT). Subgroup analyses demonstrated that pts with low volume (LV), per CHAARTED trial definition,...
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| Veröffentlicht in: | The Prostate Jg. 78; H. 12; S. 889 - 895 |
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| Hauptverfasser: | , , , , , , , , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
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United States
Wiley Subscription Services, Inc
01.09.2018
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| ISSN: | 0270-4137, 1097-0045, 1097-0045 |
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| Abstract | Background
Currently, there is no universally accepted prognostic classification for patients (pts) with metastatic hormone sensitive prostate cancer (mHSPC) treated with androgen deprivation therapy (ADT). Subgroup analyses demonstrated that pts with low volume (LV), per CHAARTED trial definition, mHSPC, and those who relapse after prior local therapy (PLT) have longer overall survival (OS) compared to high volume (HV) and de‐novo (DN), respectively. Using a hospital‐based registry, we aimed to assess whether a classification based on time of metastatic disease (PLT vs DN) and disease volume (LV vs HV) are prognostic for mHSPC pts treated with ADT.
Methods
A retrospective cohort of consecutive patients with mHSPC treated with ADT between 1990 and 2013 was selected from the prospectively collected Dana‐Farber Cancer Institute database and categorized as DN or PLT and HV or LV, at time of ADT start. Primary and secondary endpoints were OS and time to castration‐resistant prostate cancer (CRPC), respectively, which were measured from date of ADT start using Kaplan‐Meier method. Multivariable Cox proportional hazards models using known prognostic factors was used.
Results
The analytical cohort consisted of 436 patients. The median OS and time to CRPC for PLT/LV were 92.4 (95%CI: 80.4‐127.2) and 25.6 (95%CI: 21‐35.7) months and 43.2 (95%CI: 37.2‐56.4) and 12.2 (95%CI: 9.8‐14.8) months for DN/HV, respectively, whereas intermediate values were observed for PLT/HV and DN/LV. A robust gradient for both outcomes was observed (Trend test P < 0.0001) in the four groups. In a multivariable analysis, DN presentation, HV, and cancer‐related pain were independent prognostic factors.
Conclusions
In our hospital‐based registry, time of metastatic presentation and disease volume were prognostic for mHSPC pts treated with ADT. This simple prognostic classification system can aid patient counseling and future trial design. |
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| AbstractList | Background
Currently, there is no universally accepted prognostic classification for patients (pts) with metastatic hormone sensitive prostate cancer (mHSPC) treated with androgen deprivation therapy (ADT). Subgroup analyses demonstrated that pts with low volume (LV), per CHAARTED trial definition, mHSPC, and those who relapse after prior local therapy (PLT) have longer overall survival (OS) compared to high volume (HV) and de‐novo (DN), respectively. Using a hospital‐based registry, we aimed to assess whether a classification based on time of metastatic disease (PLT vs DN) and disease volume (LV vs HV) are prognostic for mHSPC pts treated with ADT.
Methods
A retrospective cohort of consecutive patients with mHSPC treated with ADT between 1990 and 2013 was selected from the prospectively collected Dana‐Farber Cancer Institute database and categorized as DN or PLT and HV or LV, at time of ADT start. Primary and secondary endpoints were OS and time to castration‐resistant prostate cancer (CRPC), respectively, which were measured from date of ADT start using Kaplan‐Meier method. Multivariable Cox proportional hazards models using known prognostic factors was used.
Results
The analytical cohort consisted of 436 patients. The median OS and time to CRPC for PLT/LV were 92.4 (95%CI: 80.4‐127.2) and 25.6 (95%CI: 21‐35.7) months and 43.2 (95%CI: 37.2‐56.4) and 12.2 (95%CI: 9.8‐14.8) months for DN/HV, respectively, whereas intermediate values were observed for PLT/HV and DN/LV. A robust gradient for both outcomes was observed (Trend test P < 0.0001) in the four groups. In a multivariable analysis, DN presentation, HV, and cancer‐related pain were independent prognostic factors.
Conclusions
In our hospital‐based registry, time of metastatic presentation and disease volume were prognostic for mHSPC pts treated with ADT. This simple prognostic classification system can aid patient counseling and future trial design. BackgroundCurrently, there is no universally accepted prognostic classification for patients (pts) with metastatic hormone sensitive prostate cancer (mHSPC) treated with androgen deprivation therapy (ADT). Subgroup analyses demonstrated that pts with low volume (LV), per CHAARTED trial definition, mHSPC, and those who relapse after prior local therapy (PLT) have longer overall survival (OS) compared to high volume (HV) and de‐novo (DN), respectively. Using a hospital‐based registry, we aimed to assess whether a classification based on time of metastatic disease (PLT vs DN) and disease volume (LV vs HV) are prognostic for mHSPC pts treated with ADT.MethodsA retrospective cohort of consecutive patients with mHSPC treated with ADT between 1990 and 2013 was selected from the prospectively collected Dana‐Farber Cancer Institute database and categorized as DN or PLT and HV or LV, at time of ADT start. Primary and secondary endpoints were OS and time to castration‐resistant prostate cancer (CRPC), respectively, which were measured from date of ADT start using Kaplan‐Meier method. Multivariable Cox proportional hazards models using known prognostic factors was used.ResultsThe analytical cohort consisted of 436 patients. The median OS and time to CRPC for PLT/LV were 92.4 (95%CI: 80.4‐127.2) and 25.6 (95%CI: 21‐35.7) months and 43.2 (95%CI: 37.2‐56.4) and 12.2 (95%CI: 9.8‐14.8) months for DN/HV, respectively, whereas intermediate values were observed for PLT/HV and DN/LV. A robust gradient for both outcomes was observed (Trend test P < 0.0001) in the four groups. In a multivariable analysis, DN presentation, HV, and cancer‐related pain were independent prognostic factors.ConclusionsIn our hospital‐based registry, time of metastatic presentation and disease volume were prognostic for mHSPC pts treated with ADT. This simple prognostic classification system can aid patient counseling and future trial design. Currently, there is no universally accepted prognostic classification for patients (pts) with metastatic hormone sensitive prostate cancer (mHSPC) treated with androgen deprivation therapy (ADT). Subgroup analyses demonstrated that pts with low volume (LV), per CHAARTED trial definition, mHSPC, and those who relapse after prior local therapy (PLT) have longer overall survival (OS) compared to high volume (HV) and de-novo (DN), respectively. Using a hospital-based registry, we aimed to assess whether a classification based on time of metastatic disease (PLT vs DN) and disease volume (LV vs HV) are prognostic for mHSPC pts treated with ADT.BACKGROUNDCurrently, there is no universally accepted prognostic classification for patients (pts) with metastatic hormone sensitive prostate cancer (mHSPC) treated with androgen deprivation therapy (ADT). Subgroup analyses demonstrated that pts with low volume (LV), per CHAARTED trial definition, mHSPC, and those who relapse after prior local therapy (PLT) have longer overall survival (OS) compared to high volume (HV) and de-novo (DN), respectively. Using a hospital-based registry, we aimed to assess whether a classification based on time of metastatic disease (PLT vs DN) and disease volume (LV vs HV) are prognostic for mHSPC pts treated with ADT.A retrospective cohort of consecutive patients with mHSPC treated with ADT between 1990 and 2013 was selected from the prospectively collected Dana-Farber Cancer Institute database and categorized as DN or PLT and HV or LV, at time of ADT start. Primary and secondary endpoints were OS and time to castration-resistant prostate cancer (CRPC), respectively, which were measured from date of ADT start using Kaplan-Meier method. Multivariable Cox proportional hazards models using known prognostic factors was used.METHODSA retrospective cohort of consecutive patients with mHSPC treated with ADT between 1990 and 2013 was selected from the prospectively collected Dana-Farber Cancer Institute database and categorized as DN or PLT and HV or LV, at time of ADT start. Primary and secondary endpoints were OS and time to castration-resistant prostate cancer (CRPC), respectively, which were measured from date of ADT start using Kaplan-Meier method. Multivariable Cox proportional hazards models using known prognostic factors was used.The analytical cohort consisted of 436 patients. The median OS and time to CRPC for PLT/LV were 92.4 (95%CI: 80.4-127.2) and 25.6 (95%CI: 21-35.7) months and 43.2 (95%CI: 37.2-56.4) and 12.2 (95%CI: 9.8-14.8) months for DN/HV, respectively, whereas intermediate values were observed for PLT/HV and DN/LV. A robust gradient for both outcomes was observed (Trend test P < 0.0001) in the four groups. In a multivariable analysis, DN presentation, HV, and cancer-related pain were independent prognostic factors.RESULTSThe analytical cohort consisted of 436 patients. The median OS and time to CRPC for PLT/LV were 92.4 (95%CI: 80.4-127.2) and 25.6 (95%CI: 21-35.7) months and 43.2 (95%CI: 37.2-56.4) and 12.2 (95%CI: 9.8-14.8) months for DN/HV, respectively, whereas intermediate values were observed for PLT/HV and DN/LV. A robust gradient for both outcomes was observed (Trend test P < 0.0001) in the four groups. In a multivariable analysis, DN presentation, HV, and cancer-related pain were independent prognostic factors.In our hospital-based registry, time of metastatic presentation and disease volume were prognostic for mHSPC pts treated with ADT. This simple prognostic classification system can aid patient counseling and future trial design.CONCLUSIONSIn our hospital-based registry, time of metastatic presentation and disease volume were prognostic for mHSPC pts treated with ADT. This simple prognostic classification system can aid patient counseling and future trial design. Currently, there is no universally accepted prognostic classification for patients (pts) with metastatic hormone sensitive prostate cancer (mHSPC) treated with androgen deprivation therapy (ADT). Subgroup analyses demonstrated that pts with low volume (LV), per CHAARTED trial definition, mHSPC, and those who relapse after prior local therapy (PLT) have longer overall survival (OS) compared to high volume (HV) and de-novo (DN), respectively. Using a hospital-based registry, we aimed to assess whether a classification based on time of metastatic disease (PLT vs DN) and disease volume (LV vs HV) are prognostic for mHSPC pts treated with ADT. A retrospective cohort of consecutive patients with mHSPC treated with ADT between 1990 and 2013 was selected from the prospectively collected Dana-Farber Cancer Institute database and categorized as DN or PLT and HV or LV, at time of ADT start. Primary and secondary endpoints were OS and time to castration-resistant prostate cancer (CRPC), respectively, which were measured from date of ADT start using Kaplan-Meier method. Multivariable Cox proportional hazards models using known prognostic factors was used. The analytical cohort consisted of 436 patients. The median OS and time to CRPC for PLT/LV were 92.4 (95%CI: 80.4-127.2) and 25.6 (95%CI: 21-35.7) months and 43.2 (95%CI: 37.2-56.4) and 12.2 (95%CI: 9.8-14.8) months for DN/HV, respectively, whereas intermediate values were observed for PLT/HV and DN/LV. A robust gradient for both outcomes was observed (Trend test P < 0.0001) in the four groups. In a multivariable analysis, DN presentation, HV, and cancer-related pain were independent prognostic factors. In our hospital-based registry, time of metastatic presentation and disease volume were prognostic for mHSPC pts treated with ADT. This simple prognostic classification system can aid patient counseling and future trial design. |
| Author | Sweeney, Cristopher J. Bernard, Brandon Taplin, Mary‐Ellen Francini, Edoardo Xie, Wanling Kantoff, Philip W. Shaw, Grace K. Valença, Loana Harshman, Lauren C. Gray, Kathryn P. Albiges, Laurence |
| AuthorAffiliation | 6 Memorial Sloan Kettering Cancer Center, New York, NY, USA 3 Hospital Santa Izabel, Salvador, Bahia, Brazil 5 Institut Gustave Roussy, Villejuif, France 2 Policlinico Umberto I Hospital, Rome, Italy 4 University of Colorado Cancer Center, Aurora, CO, USA 1 Dana-Farber Cancer Institute, Lank Center for Genitourinary Oncology, Boston, MA, 02215, USA |
| AuthorAffiliation_xml | – name: 3 Hospital Santa Izabel, Salvador, Bahia, Brazil – name: 6 Memorial Sloan Kettering Cancer Center, New York, NY, USA – name: 1 Dana-Farber Cancer Institute, Lank Center for Genitourinary Oncology, Boston, MA, 02215, USA – name: 2 Policlinico Umberto I Hospital, Rome, Italy – name: 4 University of Colorado Cancer Center, Aurora, CO, USA – name: 5 Institut Gustave Roussy, Villejuif, France |
| Author_xml | – sequence: 1 givenname: Edoardo orcidid: 0000-0003-4270-7023 surname: Francini fullname: Francini, Edoardo organization: Sapienza University of Rome – sequence: 2 givenname: Kathryn P. surname: Gray fullname: Gray, Kathryn P. organization: Lank Center for Genitourinary Oncology – sequence: 3 givenname: Wanling surname: Xie fullname: Xie, Wanling organization: Lank Center for Genitourinary Oncology – sequence: 4 givenname: Grace K. surname: Shaw fullname: Shaw, Grace K. organization: Lank Center for Genitourinary Oncology – sequence: 5 givenname: Loana surname: Valença fullname: Valença, Loana organization: Hospital Santa Izabel – sequence: 6 givenname: Brandon surname: Bernard fullname: Bernard, Brandon organization: University of Colorado Cancer Center – sequence: 7 givenname: Laurence surname: Albiges fullname: Albiges, Laurence organization: Institut Gustave Roussy – sequence: 8 givenname: Lauren C. orcidid: 0000-0002-7636-1588 surname: Harshman fullname: Harshman, Lauren C. organization: Lank Center for Genitourinary Oncology – sequence: 9 givenname: Philip W. surname: Kantoff fullname: Kantoff, Philip W. organization: Memorial Sloan Kettering Cancer Center – sequence: 10 givenname: Mary‐Ellen surname: Taplin fullname: Taplin, Mary‐Ellen organization: Lank Center for Genitourinary Oncology – sequence: 11 givenname: Cristopher J. surname: Sweeney fullname: Sweeney, Cristopher J. email: christopher_sweeney@dfci.harvard.edu organization: Lank Center for Genitourinary Oncology |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/29707790$$D View this record in MEDLINE/PubMed |
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| References | 2015; 68 2016; 5 2015; 56 2012; 188 2013; 32 2002; 168 2017; 35 1941; 43 2015; 373 2014; 15 2016; 387 1978; 38 1988; 61 2009; 6 2016; 70 2003; 169 2017; 377 2016; 27 1971; 4 2016; 34 e_1_2_7_5_1 e_1_2_7_4_1 e_1_2_7_3_1 e_1_2_7_9_1 e_1_2_7_8_1 e_1_2_7_7_1 e_1_2_7_19_1 e_1_2_7_18_1 e_1_2_7_17_1 e_1_2_7_16_1 e_1_2_7_2_1 e_1_2_7_15_1 e_1_2_7_14_1 Gustafsson JA (e_1_2_7_6_1) 1978; 38 e_1_2_7_13_1 e_1_2_7_12_1 e_1_2_7_11_1 e_1_2_7_22_1 e_1_2_7_10_1 e_1_2_7_21_1 e_1_2_7_20_1 |
| References_xml | – volume: 34 start-page: 1402 year: 2016 end-page: 1418 article-title: Trial design and objectives for castration‐resistant prostate cancer: updated recommendations from the prostate cancer clinical trials working group 3 publication-title: J Clin Oncol – volume: 188 start-page: 1164 year: 2012 end-page: 1169 article-title: Improved overall survival trends of men with newly diagnosed M1 prostate cancer: a SWOG phase III trial experience (S8494, S8894 and S9346) publication-title: J Urol – volume: 377 start-page: 352 year: 2017 end-page: 360 article-title: Abiraterone plus prednisone in metastatic, castration‐sensitive prostate cancer publication-title: N Engl J Med – volume: 61 start-page: 195 year: 1988 end-page: 202 article-title: Stratification of patients with metastatic prostate cancer based on extent of disease on initial bone scan publication-title: Cancer – volume: 43 start-page: 209 year: 1941 end-page: 223 article-title: Studies on prostatic cancer: II. The effects of castration on advanced carcinoma of the prostate gland publication-title: Arch Surg – volume: 4 start-page: 391 year: 1971 end-page: 394 article-title: Effect of hormonal therapy on plasma testosterone levels in prostatic carcinoma publication-title: Br Med J – volume: 5 start-page: 407 year: 2016 end-page: 414 article-title: The Scandinavian Prostate Cancer Group (SPCG) Trial No. 5. 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Currently, there is no universally accepted prognostic classification for patients (pts) with metastatic hormone sensitive prostate cancer (mHSPC)... Currently, there is no universally accepted prognostic classification for patients (pts) with metastatic hormone sensitive prostate cancer (mHSPC) treated with... BackgroundCurrently, there is no universally accepted prognostic classification for patients (pts) with metastatic hormone sensitive prostate cancer (mHSPC)... |
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| SubjectTerms | ADT Aged Androgen Antagonists - administration & dosage Androgen Antagonists - therapeutic use Antineoplastic Agents Castration Classification Docetaxel - therapeutic use Humans Male Medical prognosis Metastases Metastasis mHSPC Middle Aged Neoplasm Metastasis - pathology Pain Prognosis prognostic classification Proportional Hazards Models Prostate cancer Prostate-Specific Antigen - analysis Prostatic Neoplasms - mortality Prostatic Neoplasms - pathology Prostatic Neoplasms - therapy Prostatic Neoplasms, Castration-Resistant Registries Retrospective Studies Survival Rate Time Factors time of metastatic disease volume of disease |
| Title | Time of metastatic disease presentation and volume of disease are prognostic for metastatic hormone sensitive prostate cancer (mHSPC) |
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