Survival outcome and prognostic factors in patients with chemotherapy-naive metastatic castration-resistant prostate cancer treated with abiraterone acetate – real-world experience in Vietnam
DOI:
https://doi.org/10.15584/ejcem.2024.2.18Keywords:
abiraterone acetate, metastatic castration-resistant prostate cancer, overall survival, real-world evidenceAbstract
Introduction and aim. In real life, metastatic castration-resistant prostate cancer patients (mCRPC) had more complex clinical presentation than patients in the COU-AA-302 trial. This study primarily aimed to describe the overall survival of chemotherapy-naive mCRPC treated with abiraterone acetate plus prednisone (AAP). Other relevant outcomes and baseline characteristics of these patients were also evaluated.
Material and methods. This retrospective, observational study collected data from chemotherapy-naive mCRPC patients treated with AAP in Vietnam. Kaplan-Meier curves were used to estimate time to treatment failure (TTF), and overall survival (OS). The impact of baseline characteristics on OS was explored using univariate and multivariate Cox proportional hazard models.
Results. Data from 65 eligible patients were analyzed. The rate of PSA response was 73.8%, median PSA PFS was 10.5 months (95% CI: 7.4–13.6), median TTF was 15 months (95% CI: 11.1–18.9), and median OS was 24.9 months (95% CI: 18.9–30.9). Shorter OS was significantly associated with a higher Gleason score (≥8), shorter time from ADT start to mCRPC (<12 months), visceral metastases, and <50% PSA decline (p<0.05).
Conclusion. Abiraterone acetate plus prednisone is well tolerated and effective for chemotherapy-naive mCRPC patients in clinical practice. Moreover, Gleason score, visceral metastasis, time from ADT start to mCRPC, and PSA response are the independent indicators for predicting the OS of mCRPC patients in both univariate and multivariate analyses.
Downloads
References
Gandaglia G, Leni R, Bray F, et al. Epidemiology and Prevention of Prostate Cancer. Eur Urol Oncol. 2021;4(6):877-892. doi: 10.1016/j.euo.2021.09.006
Cancer of the Prostate - Cancer Stat Facts. SEER. https://seer.cancer.gov/statfacts/html/prost.html. Accessed February 5, 2024.
Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer Statistics, 2021. CA Cancer J Clin. 2021;71(1):7-33. doi: 10.3322/caac.21654
Ryan CJ, Smith MR, de Bono JS, et al. Abiraterone in metastatic prostate cancer without previous chemotherapy. N Engl J Med. 2013;368(2):138-148. doi: 10.1056/NEJMoa1209096
Scher HI, Morris MJ, Stadler WM, et al. Trial Design and Objectives for Castration-Resistant Prostate Cancer: Updated Recommendations From the Prostate Cancer Clinical Trials Working Group 3. J Clin Oncol. 2016;34(12):1402-1418. doi: 10.1200/JCO.2015.64.2702
Rao A, Scher HI, De Porre P, et al. Impact of clinical versus radiographic progression on clinical outcomes in metastatic castration-resistant prostate cancer. ESMO Open. 2020;5(6):000943. doi: 10.1136/esmoopen-2020-000943
Pilon D, Behl AS, Ellis LA, Emond B, Lefebvre P, Dawson NA. Duration of Treatment in Prostate Cancer Patients Treated with Abiraterone Acetate or Enzalutamide. J Manag Care Spec Pharm. 2017;23(2):225-235. doi: 10.18553/jmcp.2016.16233
Boegemann M, Khaksar S, Bera G, et al. Abiraterone acetate plus prednisone for the Management of Metastatic Castration-Resistant Prostate Cancer (mCRPC) without prior use of chemotherapy: report from a large, international, real-world retrospective cohort study. BMC Cancer. 2019;19(1):60. doi: 10.1186/s12885-019-5280-6
Bjartell A, Lumen N, Maroto P, et al. Real-World Safety and Efficacy Outcomes with Abiraterone Acetate Plus Prednisone or Prednisolone as the First- or Second-Line Treatment for Metastatic Castration-Resistant Prostate Cancer: Data from the Prostate Cancer Registry. Target Oncol. 2021;16(3):357-367. doi: 10.1007/s11523-021-00807-4
George DJ, Sartor O, Miller K, et al. Treatment Patterns and Outcomes in Patients With Metastatic Castration-resistant Prostate Cancer in a Real-world Clinical Practice Setting in the United States. Clin Genitourin Cancer. 2020;18(4):284-294. doi: 10.1016/j.clgc.2019.12.019
Chen WJ, Kong DM, Li L. Prognostic value of ECOG performance status and Gleason score in the survival of castration-resistant prostate cancer: a systematic review. Asian J Androl. 2021;23(2):163-169. doi: 10.4103/aja.aja_53_20
Valero J, Peleteiro P, Henríquez I, et al. Age, Gleason Score, and PSA are important prognostic factors for survival in metastatic castration-resistant prostate cancer. Results of The Uroncor Group (Uro-Oncological Tumors) of the Spanish Society of Radiation Oncology (SEOR). Clin Transl Oncol Off Publ Fed Span Oncol Soc Natl Cancer Inst Mex. 2020;22(8):1378-1389. doi: 10.1007/s12094-019-02274-w
Humphreys MR, Fernandes KA, Sridhar SS. Impact of Age at Diagnosis on Outcomes in Men with Castrate-Resistant Prostate Cancer (CRPC). J Cancer. 2013;4(4):304-314. doi: 10.7150/jca.4192
Fizazi K, Massard C, Smith M, et al. Bone-related Parameters are the Main Prognostic Factors for Overall Survival in Men with Bone Metastases from Castration-resistant Prostate Cancer. Eur Urol. 2015;68(1):42-50. doi: 10.1016/j.eururo.2014.10.001
Mazzone E, Preisser F, Nazzani S, et al. Location of Metastases in Contemporary Prostate Cancer Patients Affects Cancer-Specific Mortality. Clin Genitourin Cancer. 2018;16(5):376-384. doi: 10.1016/j.clgc.2018.05.016
Wenzel M, Preisser F, Hoeh B, et al. Impact of Time to Castration Resistance on Survival in Metastatic Hormone Sensitive Prostate Cancer Patients in the Era of Combination Therapies. Front Oncol. 2021;11:659135. doi: 10.3389/fonc.2021.659135
Sweeney CJ, Chen YH, Carducci M, et al. Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer. N Engl J Med. 2015;373(8):737-746. doi: 10.1056/NEJMoa1503747
Gravis G, Fizazi K, Joly F, et al. Androgen-deprivation therapy alone or with docetaxel in non-castrate metastatic prostate cancer (GETUG-AFU 15): a randomised, open-label, phase 3 trial. Lancet Oncol. 2013;14(2):149-158. doi: 10.1016/S1470-2045(12)70560-0
Koura M, Shiota M, Ueda S, et al. Prognostic impact of prior local therapy in castration-resistant prostate cancer. Jpn J Clin Oncol. 2021;51(7):1142-1148. doi: 10.1093/jjco/hyab019
Alvim CM, Mansinho A, Paiva RS, et al. Prognostic factors for patients treated with abiraterone. Future Sci OA. 6(2):FSO436. doi: 10.2144/fsoa-2019-0079
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 European Journal of Clinical and Experimental Medicine
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our open access policy is in accordance with the Budapest Open Access Initiative (BOAI) definition: this means that articles have free availability on the public Internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from having access to the Internet itself.
All articles are published with free open access under the CC-BY Creative Commons attribution license (the current version is CC-BY, version 4.0). If you submit your paper for publication by the Eur J Clin Exp Med, you agree to have the CC-BY license applied to your work. Under this Open Access license, you, as the author, agree that anyone may download and read the paper for free. In addition, the article may be reused and quoted provided that the original published version is cited. This facilitates freedom in re-use and also ensures that Eur J Clin Exp Med content can be mined without barriers for the research needs.
