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A model for predicting overall survival in men with metastatic castrate-resistant prostate cancer (CRPC) for whom first-line chemotherapy failed.

Publication ,  Journal Article
Lin, CY; Small, EJ; Armstrong, AJ; Kaplan, EB; Petrylak, DP; Sternberg, CN; Shen, L; Oudard, S; De Bono, JS; Sartor, AO
Published in: J Clin Oncol
February 20, 2013

24 Background: Several prognostic models for overall survival (OS) have been developed and validated in men with chemotherapy naïve mCRPC. The primary objective was to develop and validate a prognostic model that can be used to predict OS in men who have failed first-line chemotherapy. METHODS: Data was used from a phase III trial of 755 mCRPC men who had developed progressive disease following first-line chemotherapy and were randomized to cabazitaxel plus prednisone or mitoxantrone plus prednisone (TROPIC trial). The data was randomly split into training (n=507) and testing (n=248) sets. A separate data, consisting of 488 men previously treated with docetaxel who were randomly assigned to either satraplatin and prednisone or placebo and prednisone, was used as the validation set (SPARC trial). Penalized regression method was used to identify important prognostic factors. Adaptive Lasso selected nine variables of OS. A predictive score was computed from the estimated regression coefficients and used to classify patients into low (<-1.29) and high (>= -1.29) risk groups in the testing datasets. The model was assessed for its predictive accuracy using time dependent area under the curve (AUC) on the testing sets (TROPIC and SPARC trials). RESULTS: The final selected model included: ECOG performance status, time since last docetaxel use, measurable disease, presence of visceral disease, pain, duration of prior hormonal use, hemoglobin, prostate specific antigen and alkaline phosphatase. In the TROPIC testing set, the median OS in high and low risk groups were 11 and 17 months, respectively, with a hazard ratio (HR)=2.47 (p-value<0.0001). Using the SPARC set, the median OS were 11 and 20 months in the high and low risk groups, respectively, with a HR=1.94 (p<0.0001). The time dependent AUC were 0.73 and 0.70 on the testing sets. CONCLUSIONS: A prognostic model of OS in the post-docetaxel mCRPC setting was developed and validated and risk groups were identified. This model can be used to select patients based on their prognosis to participate in clinical trials. Prospective validation is needed.

Duke Scholars

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

February 20, 2013

Volume

31

Issue

6_suppl

Start / End Page

24

Location

United States

Related Subject Headings

  • Oncology & Carcinogenesis
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences
 

Citation

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Chicago
ICMJE
MLA
NLM
Lin, C. Y., Small, E. J., Armstrong, A. J., Kaplan, E. B., Petrylak, D. P., Sternberg, C. N., … Sartor, A. O. (2013). A model for predicting overall survival in men with metastatic castrate-resistant prostate cancer (CRPC) for whom first-line chemotherapy failed. J Clin Oncol, 31(6_suppl), 24. https://doi.org/10.1200/jco.2013.31.6_suppl.24
Lin, C. Y., E. J. Small, A. J. Armstrong, E. B. Kaplan, D. P. Petrylak, C. N. Sternberg, L. Shen, S. Oudard, J. S. De Bono, and A. O. Sartor. “A model for predicting overall survival in men with metastatic castrate-resistant prostate cancer (CRPC) for whom first-line chemotherapy failed.J Clin Oncol 31, no. 6_suppl (February 20, 2013): 24. https://doi.org/10.1200/jco.2013.31.6_suppl.24.
Lin CY, Small EJ, Armstrong AJ, Kaplan EB, Petrylak DP, Sternberg CN, et al. A model for predicting overall survival in men with metastatic castrate-resistant prostate cancer (CRPC) for whom first-line chemotherapy failed. J Clin Oncol. 2013 Feb 20;31(6_suppl):24.
Lin, C. Y., et al. “A model for predicting overall survival in men with metastatic castrate-resistant prostate cancer (CRPC) for whom first-line chemotherapy failed.J Clin Oncol, vol. 31, no. 6_suppl, Feb. 2013, p. 24. Pubmed, doi:10.1200/jco.2013.31.6_suppl.24.
Lin CY, Small EJ, Armstrong AJ, Kaplan EB, Petrylak DP, Sternberg CN, Shen L, Oudard S, De Bono JS, Sartor AO. A model for predicting overall survival in men with metastatic castrate-resistant prostate cancer (CRPC) for whom first-line chemotherapy failed. J Clin Oncol. 2013 Feb 20;31(6_suppl):24.

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

February 20, 2013

Volume

31

Issue

6_suppl

Start / End Page

24

Location

United States

Related Subject Headings

  • Oncology & Carcinogenesis
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences