Mp11-12 development of a risk model for time to second progression in patients with high-risk metastatic castration-sensitive prostate cancer treated with abiraterone acetate and androgen deprivation therapy

You have accessJournal of UrologyCME1 Apr 2023MP11-12 DEVELOPMENT OF A RISK MODEL FOR TIME TO SECOND PROGRESSION IN PATIENTS WITH HIGH-RISK METASTATIC CASTRATION-SENSITIVE PROSTATE CANCER TREATED WITH ABIRATERONE ACETATE AND ANDROGEN DEPRIVATION THERAPY Shintaro Narita, Takafumi Yanagisawa, Shingo Hatakeyama, Kenichi Hata, Hiromi Sato, Ryuichiro Sagehashi, Yuya Sekine, Mizuki Kobayashi, Taketoshi Nara, Kazuyuki Numakura, Mitsuru Saito, Chikara Ohyama, Takahiro Kimura, and Tomonori Habuchi Shintaro NaritaShintaro Narita More articles by this author , Takafumi YanagisawaTakafumi Yanagisawa More articles by this author , Shingo HatakeyamaShingo Hatakeyama More articles by this author , Kenichi HataKenichi Hata More articles by this author , Hiromi SatoHiromi Sato More articles by this author , Ryuichiro SagehashiRyuichiro Sagehashi More articles by this author , Yuya SekineYuya Sekine More articles by this author , Mizuki KobayashiMizuki Kobayashi More articles by this author , Taketoshi NaraTaketoshi Nara More articles by this author , Kazuyuki NumakuraKazuyuki Numakura More articles by this author , Mitsuru SaitoMitsuru Saito More articles by this author , Chikara OhyamaChikara Ohyama More articles by this author , Takahiro KimuraTakahiro Kimura More articles by this author , and Tomonori HabuchiTomonori Habuchi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003226.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Evidence on risk stratification in patients treated with doublet therapy with abiraterone acetate is limited. In this study, we developed a risk stratification model in patients with de novo high-risk mCSPC who received abiraterone acetate plus androgen deprivation therapy based on clinical risk factors. METHODS: Medical records of 224 high-risk patients with de novo mCSPC treated with abiraterone acetate plus androgen deprivation therapy at 11 centers between 2015 and 2022 were retrospectively reviewed. Castration-resistant prostate cancer (CRPC)-free, progression-free survival 2 (PFS2), and overall survival (OS) were estimated using the Kaplan–Meier method. The association of pretreatment clinical risk factors with PFS2 was evaluated by Cox proportional hazard models and survival outcomes were classified according to the number of risk factors. RESULTS: Median PFS2 was 43 months; second-progression occurred in 76 (34.2%) patients. On multivariable analysis, the following four risk factors were identified as independent predictors of PFS2: primary Gleason pattern 5 (HR 1.97, 95% CI 1.20–3.22), presence of liver metastasis (HR 2.05, 95% CI 1.02–4.13), extent of disease score ≥3 (HR 2.25, 95% CI 1.16–4.34), and abnormal hemoglobin (HR 1.73, 95% CI 1.02–2.92). Significant differences in PFS2 were observed among the three risk groups (low vs. intermediate; p=0.006, intermediate vs. high; p<0.001). Median PFS2 and OS of high-risk patients were significantly worse in the low- and intermediate-risk groups. The median PFS2 of low-risk patients with no or one factor was not reached, whereas that of intermediate-risk patients with two or three factors and high-risk patients with four factors were 42 months and 16 months, respectively. Median OS was 24 months in high-risk patients, whereas it was not reached in low- and intermediate-risk patients. CONCLUSIONS: We successfully classified patients with high-risk mCSPC treated with abiraterone acetate based on four clinical risk factors. Risk-adapted treatment may be beneficial for selected patients with mCSPC in this triplet therapy era. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e128 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shintaro Narita More articles by this author Takafumi Yanagisawa More articles by this author Shingo Hatakeyama More articles by this author Kenichi Hata More articles by this author Hiromi Sato More articles by this author Ryuichiro Sagehashi More articles by this author Yuya Sekine More articles by this author Mizuki Kobayashi More articles by this author Taketoshi Nara More articles by this author Kazuyuki Numakura More articles by this author Mitsuru Saito More articles by this author Chikara Ohyama More articles by this author Takahiro Kimura More articles by this author Tomonori Habuchi More articles by this author Expand All Advertisement PDF downloadLoading ...