Journal article
A novel prognostic model predicting overall survival in patients with metastatic castration‐resistant prostate cancer receiving standard chemotherapy: A multi‐trial cohort analysis
The Prostate, Vol.82(13), pp.1293-1303
09/01/2022
DOI: 10.1002/pros.24403
PMID: 35790016
Abstract
Purpose
Generalizable, updated, and easy‐to‐use prognostic models for patients with metastatic castration‐resistant prostate cancer (mCRPC) are lacking. We developed a nomogram predicting the overall survival (OS) of mCRPC patients receiving standard chemotherapy using data from five randomized clinical trials (RCTs).
Methods
Patients enrolled in the control arm of five RCTs (ASCENT 2, VENICE, CELGENE/MAINSAIL, ENTHUSE 14, and ENTHUSE 33) were randomly split between training (n = 1636, 70%) and validation cohorts (n = 700, 30%). In the training cohort, Cox regression tested the prognostic significance of all available variables as a predictor of OS. Independent predictors of OS on multivariable analysis were used to construct a novel multivariable model (nomogram). The accuracy of this model was tested in the validation cohort using time‐dependent area under the curve (tAUC) and calibration curves.
Results
Most of the patients were aged 65–74 years (44.5%) and the median (interquartile range) follow‐up time was 13.9 (8.9–20.2) months. At multivariable analysis, the following were independent predictors of OS in mCRPC patients: sites of metastasis (visceral vs. bone metastasis, hazard ratio [HR]: 1.24), prostate‐specific antigen (HR: 1.00), aspartate transaminase (HR: 1.01), alkaline phosphatase (HR: 1.00), body mass index (HR: 0.97), and hemoglobin (≥13 g/dl vs. <11 g/dl, HR: 0.41; all p < 0.05). A nomogram based on these variables was developed and showed favorable discrimination (tAUC at 12 and 24 months: 73% and 72%, respectively) and calibration characteristics on external validation.
Conclusion
A new prognostic model to predict OS of patients with mCRPC undergoing first line chemotherapy was developed. This can help urologists/oncologists in counseling patients and might be useful to better stratify patients for future clinical trials.
Details
- Title: Subtitle
- A novel prognostic model predicting overall survival in patients with metastatic castration‐resistant prostate cancer receiving standard chemotherapy: A multi‐trial cohort analysis
- Creators
- Daniele Modonutti - Henry Ford Health SystemSami E. Majdalany - Henry Ford Health SystemNicholas Corsi - Henry Ford Health SystemPin Li - Henry Ford Health SystemAkshay Sood - Henry Ford Health SystemDeepansh Dalela - Henry Ford Health SystemMarcus L. Jamil - Henry Ford Health SystemClara Hwang - Henry Ford Health SystemMani Menon - Henry Ford Health SystemCraig G. Rogers - Henry Ford Health SystemQuoc‐Dien Trinh - Brigham and Women's HospitalGiacomo Novara - University of PaduaFiras Abdollah - Henry Ford Health System
- Resource Type
- Journal article
- Publication Details
- The Prostate, Vol.82(13), pp.1293-1303
- DOI
- 10.1002/pros.24403
- PMID
- 35790016
- NLM abbreviation
- Prostate
- ISSN
- 0270-4137
- eISSN
- 1097-0045
- Number of pages
- 11
- Language
- English
- Date published
- 09/01/2022
- Academic Unit
- Urology
- Record Identifier
- 9984949203502771
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