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The development of risk groups in men with metastatic castration-resistant prostate cancer based on risk factors for PSA decline and survival.

Publication ,  Journal Article
Armstrong, AJ; Tannock, IF; de Wit, R; George, DJ; Eisenberger, M; Halabi, S
Published in: Eur J Cancer
February 2010

AIMS OF THE STUDY: There are no known predictive factors of response in men receiving chemotherapy for metastatic castration-resistant prostate cancer (mCRPC). We investigated pre-treatment factors that predicted a 30% PSA decline (30% PSAD) within 3 months of starting chemotherapy, and assessed performance of a risk group classification in predicting PSA declines and overall survival (OS) in men with mCRPC. METHODS: In TAX327, 1006 men with mCRPC were randomized to receive docetaxel (D) in two schedules, or mitoxantrone (M), each with prednisone: 989 provided data on PSA decline within 3 months. Predictive factors for a 30% PSAD were identified using multivariable regression in D-treated men (n=656) and validated in M-treated men (n=333). RESULTS: Four independent risk factors predicted 30% PSAD: pain, visceral metastases, anaemia and bone scan progression. Risk groups (good: 0-1 factors, intermediate: 2 factors and poor: 3-4 factors) were developed with median OS of 25.7, 18.7 and 12.8 months (p<0.0001); 30% PSAD in 78%, 66% and 58% of men (p<0.001); and measurable disease response in 19%, 9% and 5% of men (p=0.018), respectively. In the validation cohort, similar predictive ability was noted for 30% PSAD, tumour response and OS. PCWG2 subtypes were also predictive but resulted in unequal grouping. C-indices were 0.59 and 0.62 for 30% PSAD and OS in the validation dataset, respectively. CONCLUSIONS: Risk groups have been identified and validated that predict PSAD and OS in men with mCRPC and may facilitate evaluation of new systemic regimens warranting definitive testing in comparison with docetaxel and prednisone. Prospective validation of this classification system is needed.

Duke Scholars

Published In

Eur J Cancer

DOI

EISSN

1879-0852

Publication Date

February 2010

Volume

46

Issue

3

Start / End Page

517 / 525

Location

England

Related Subject Headings

  • Treatment Outcome
  • Taxoids
  • Survival Analysis
  • Risk Factors
  • Prostatic Neoplasms
  • Prostate-Specific Antigen
  • Prognosis
  • Prednisone
  • Orchiectomy
  • Oncology & Carcinogenesis
 

Citation

APA
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ICMJE
MLA
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Armstrong, A. J., Tannock, I. F., de Wit, R., George, D. J., Eisenberger, M., & Halabi, S. (2010). The development of risk groups in men with metastatic castration-resistant prostate cancer based on risk factors for PSA decline and survival. Eur J Cancer, 46(3), 517–525. https://doi.org/10.1016/j.ejca.2009.11.007
Armstrong, Andrew J., Ian F. Tannock, Ronald de Wit, Daniel J. George, Mario Eisenberger, and Susan Halabi. “The development of risk groups in men with metastatic castration-resistant prostate cancer based on risk factors for PSA decline and survival.Eur J Cancer 46, no. 3 (February 2010): 517–25. https://doi.org/10.1016/j.ejca.2009.11.007.
Armstrong AJ, Tannock IF, de Wit R, George DJ, Eisenberger M, Halabi S. The development of risk groups in men with metastatic castration-resistant prostate cancer based on risk factors for PSA decline and survival. Eur J Cancer. 2010 Feb;46(3):517–25.
Armstrong, Andrew J., et al. “The development of risk groups in men with metastatic castration-resistant prostate cancer based on risk factors for PSA decline and survival.Eur J Cancer, vol. 46, no. 3, Feb. 2010, pp. 517–25. Pubmed, doi:10.1016/j.ejca.2009.11.007.
Armstrong AJ, Tannock IF, de Wit R, George DJ, Eisenberger M, Halabi S. The development of risk groups in men with metastatic castration-resistant prostate cancer based on risk factors for PSA decline and survival. Eur J Cancer. 2010 Feb;46(3):517–525.

Published In

Eur J Cancer

DOI

EISSN

1879-0852

Publication Date

February 2010

Volume

46

Issue

3

Start / End Page

517 / 525

Location

England

Related Subject Headings

  • Treatment Outcome
  • Taxoids
  • Survival Analysis
  • Risk Factors
  • Prostatic Neoplasms
  • Prostate-Specific Antigen
  • Prognosis
  • Prednisone
  • Orchiectomy
  • Oncology & Carcinogenesis