Clinical impact of volume of disease and time of metastatic disease presentation on patients receiving enzalutamide or abiraterone acetate plus prednisone as first-line therapy for metastatic castration-resistant prostate cancer

Pier Vitale Nuzzo; Filippo Pederzoli; Calogero Saieva; Elisa Zanardi; Giuseppe Fotia; Andrea Malgeri; Sabrina Rossetti; Loana Valenca Bueno; Livia Maria Q S Andrade; Anna Patrikidou; Ricardo Pereira Mestre; Mikol Modesti; Sandro Pignata; Giuseppe Procopio; Giuseppe Fornarini; Ugo De Giorgi; Antonio Russo; Edoardo Francini; SPARTACUSS Investigators

doi:10.1186/s12967-022-03861-2

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Clinical impact of volume of disease and time of metastatic disease presentation on patients receiving enzalutamide or abiraterone acetate plus prednisone as first-line therapy for metastatic castration-resistant prostate cancer

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Clinical impact of volume of disease and time of metastatic disease presentation on patients receiving enzalutamide or abiraterone acetate plus prednisone as first-line therapy for metastatic castration-resistant prostate cancer

Pier Vitale Nuzzo, Filippo Pederzoli, Calogero Saieva, Elisa Zanardi, Giuseppe Fotia, Andrea Malgeri, Sabrina Rossetti, Loana Valenca Bueno, Livia Maria Q S Andrade, Anna Patrikidou, …

Journal of translational medicine, Vol.21(1), pp.75-7

02/03/2023

DOI: 10.1186/s12967-022-03861-2

PMCID: PMC9896712

PMID: 36737752

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Abstract

Metastatic castration-resistant prostate cancer remains a challenging condition to treat. Among the available therapeutic options, the androgen receptor signaling inhibitors abiraterone acetate plus prednisone (AA) and enzalutamide (Enza), are currently the most used first-line therapies in clinical practice. However, validated clinical indicators of prognosis in this setting are still lacking. In this study, we aimed to evaluate a prognostic model based on the time of metastatic disease presentation (after prior local therapy [PLT] or de-novo [DN]) and disease burden (low volume [LV] or high-volume [HV]) at AA/Enza onset for mCRPC patients receiving either AA or Enza as first-line. A cohort of consecutive patients who started AA or Enza as first-line treatment for mCRPC between January 1st, 2015, and April 1st, 2019 was identified from the clinical and electronic registries of the 9 American and European participating centers. Patients were classified into 4 cohorts by the time of metastatic disease presentation (PLT or DN) and volume of disease (LV or HV; per the E3805 trial, HV was defined as the presence of visceral metastases and/or at least 4 bone metastases of which at least 1 out the axial/pelvic skeleton) at AA/Enza onset. The endpoint was overall survival defined as the time from AA or Enza initiation, respectively, to death from any cause or censored at the last follow-up visit, whichever occurred first. Of the 417 eligible patients identified, 157 (37.6%) had LV/PLT, 87 (20.9%) LV/DN, 64 (15.3%) HV/PLT, and 109 (26.1%) HV/DN. LV cohorts showed improved median overall survival (59.0 months; 95% CI, 51.0-66.9 months) vs. HV cohorts (27.5 months; 95% CI, 22.8-32.2 months; P = 0.0001), regardless of the time of metastatic presentation. In multivariate analysis, HV cohorts were confirmed associated with worse prognosis compared to those with LV (HV/PLT, HR = 1.87; p = 0.029; HV/DN, HR = 2.19; P = 0.002). Our analysis suggests that the volume of disease could be a prognostic factor for patients starting AA or Enza as first-line treatment for metastatic castration-resistant prostate cancer, pending prospective clinical trial validation.

Abiraterone Acetate - therapeutic use

Antineoplastic Combined Chemotherapy Protocols - therapeutic use

Humans

Male

Nitriles

Prednisone - therapeutic use

Prospective Studies

Prostatic Neoplasms, Castration-Resistant - drug therapy

Prostatic Neoplasms, Castration-Resistant - pathology

Treatment Outcome

Details

Title: Subtitle: Clinical impact of volume of disease and time of metastatic disease presentation on patients receiving enzalutamide or abiraterone acetate plus prednisone as first-line therapy for metastatic castration-resistant prostate cancer
Creators: Pier Vitale Nuzzo - Cornell University
Filippo Pederzoli - Cornell University
Calogero Saieva - Piedmont Reference Center for Epidemiology and Cancer Prevention
Elisa Zanardi - Ospedale Policlinico San Martino
Giuseppe Fotia - Fondazione IRCCS Istituto Nazionale dei Tumori
Andrea Malgeri - Campus Bio Medico University Hospital
Sabrina Rossetti - Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale"
Loana Valenca Bueno - Hospital São Rafael
Livia Maria Q S Andrade - Hospital São Rafael
Anna Patrikidou - Institut Gustave Roussy
Ricardo Pereira Mestre - Università della Svizzera italiana
Mikol Modesti - Università della Svizzera italiana
Sandro Pignata - Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale"
Giuseppe Procopio - Istituti Ospitalieri di Cremona
Giuseppe Fornarini - Ospedale Policlinico San Martino
Ugo De Giorgi - Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori
Antonio Russo - University of Palermo
Edoardo Francini - University of Florence
SPARTACUSS Investigators
Resource Type: Journal article
Publication Details: Journal of translational medicine, Vol.21(1), pp.75-7
DOI: 10.1186/s12967-022-03861-2
PMID: 36737752
PMCID: PMC9896712
NLM abbreviation: J Transl Med
ISSN: 1479-5876
eISSN: 1479-5876
Grant note: P50 CA211024 / NCI NIH HHS
Language: English
Date published: 02/03/2023
Academic Unit: Internal Medicine
Record Identifier: 9985221243902771

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