Development and Validation of Prognostic Model for Metastatic Castration-Resistant Prostate Cancer Patients Treated With First-Line Abiraterone or Enzalutamide

IF 2.3 3区医学 Q3 ONCOLOGY

Clinical genitourinary cancer Pub Date : 2025-02-01 DOI:10.1016/j.clgc.2024.102265

Orazio Caffo , Umberto Basso , Carlo Cattrini , Paola Ermacora , Marco Maruzzo , Martina Alberti , Cecilia Anesi , Davide Bimbatti , Massimiliano Cani , Veronica Crespi , Giovanni Farinea , Dzenete Kadrija , Stefania Kinspergher , Eleonora Lai , Ludovica Lay , Francesca Maines , Alessia Mennitto , Francesco Pierantoni , Alessandro Samuelly , Susanna Urban , Antonello Veccia

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引用次数: 0

Abstract

Introduction

Over the years, several prognostic models were developed in patients receiving chemotherapy for metastatic castration resistant prostate cancer (mCRPC), while data on androgen-receptor signaling inhibitors (ARSI) in a real-world setting are limited.

Patients and methods

We compared a consecutive series of 565 mCRPC patients receiving first-line ARSI at 4 high-volume Italian Centers (development set) to an external series of 180 patients receiving the same treatment at another Italian high-volume Center (training set), between 2011 and 2022.

Sixteen clinical and baseline laboratory variables were selected to develop a prognostic model. Patients were categorized into risk groups according to the number of independent factors positively associated with overall survival (OS).

Results

In the development cohort, after a median follow-up of 21.1 months, the median OS was 30.4 months (95% CI 27.5-33.4). At the multivariate analysis, 7 variables [age, prostate specific antigen (PSA) doubling time, baseline levels of hemoglobin, PSA, time to castration resistance, ECOG PS and bone metastases number) were included into the final model.

The median OS was 13.4, 25.7 and 46.4 months in poor (0-2 factors), intermediate (3-4 factors) and good (≥ 5 factors) prognosis group, respectively.

The application of the model to the validation set confirmed its ability to prognosticate for OS. The model c-indexes were 0.68 (95% CI 0.64-0.72) and 0.75 (95% CI 0.68-0.81) in the development and validation cohort, respectively.

Conclusions

Our model, based on clinical and laboratory variables readily assessable in clinical practice, might prognosticate the OS of mCRPC patients receiving first-line ARSI.

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一线阿比特龙或恩杂鲁胺治疗转移性去势抵抗性前列腺癌患者预后模型的建立和验证。

多年来，在接受转移性去势抵抗性前列腺癌（mCRPC）化疗的患者中建立了几种预后模型，而在现实环境中，雄激素受体信号抑制剂（ARSI）的数据有限。患者和方法：我们比较了2011年至2022年间在4个意大利大容量中心（开发组）接受一线ARSI治疗的565名mCRPC患者连续系列和在另一个意大利大容量中心（训练组）接受相同治疗的180名患者的外部系列。选择16个临床和基线实验室变量来建立预后模型。根据与总生存期（OS）呈正相关的独立因素数量将患者分为危险组。结果：在开发队列中，中位随访21.1个月后，中位OS为30.4个月（95% CI 27.5-33.4）。在多因素分析中，将年龄、前列腺特异性抗原（PSA）翻倍时间、基线血红蛋白水平、PSA、去势抵抗时间、ECOG PS和骨转移数等7个变量纳入最终模型。预后不良组（0-2个因素）、中预后组（3-4个因素）和预后良好组（≥5个因素）的中位OS分别为13.4、25.7和46.4个月。该模型在验证集上的应用证实了其预测OS的能力。在开发和验证队列中，模型c指数分别为0.68 （95% CI 0.64-0.72）和0.75 （95% CI 0.68-0.81）。结论：我们的模型基于临床实践中易于评估的临床和实验室变量，可以预测接受一线ARSI的mCRPC患者的OS。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical genitourinary cancer 医学-泌尿学与肾脏学

CiteScore

5.20

自引率

6.20%

发文量

201

审稿时长

54 days

期刊介绍： Clinical Genitourinary Cancer is a peer-reviewed journal that publishes original articles describing various aspects of clinical and translational research in genitourinary cancers. Clinical Genitourinary Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of genitourinary cancers. The main emphasis is on recent scientific developments in all areas related to genitourinary malignancies. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.