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A prognostic index model for predicting overall survival in patients with metastatic castration-resistant prostate cancer treated with abiraterone acetate after docetaxel

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Chi, K. N., Kheoh, T., Ryan, C. J., Molina, A., Bellmunt, J., Vogelzang, N. J., Rathkopf, D. E., Fizazi, K., Kantoff, P. W., Li, J., Azad, A. A., Eigl, B. J., Heng, D. Y. C., Joshua, A. M., de Bono, J. S., Scher, H. I. (2016) A prognostic index model for predicting overall survival in patients with metastatic castration-resistant prostate cancer treated with abiraterone acetate after docetaxel. ANNALS OF ONCOLOGY, 27 (3). pp. 454-460. ISSN 0923-7534

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Official URL: http://annonc.oxfordjournals.org/content/27/3/454....

Abstract

Few prognostic models for overall survival (OS) are available for patients with metastatic castration-resistant prostate cancer (mCRPC) treated with recently approved agents. We developed a prognostic index model using readily available clinical and laboratory factors from a phase III trial of abiraterone acetate (hereafter abiraterone) in combination with prednisone in post-docetaxel mCRPC. Baseline data were available from 762 patients treated with abiraterone-prednisone. Factors were assessed for association with OS through a univariate Cox model and used in a multivariate Cox model with a stepwise procedure to identify those of significance. Data were validated using an independent, external, population-based cohort. Six risk factors individually associated with poor prognosis were included in the final model: lactate dehydrogenase > upper limit of normal (ULN) [hazard ratio (HR) = 2.31], Eastern Cooperative Oncology Group performance status of 2 (HR = 2.19), presence of liver metastases (HR = 2.00), albumin a parts per thousand currency sign4 g/dl (HR = 1.54), alkaline phosphatase > ULN (HR = 1.38) and time from start of initial androgen-deprivation therapy to start of treatment a parts per thousand currency sign36 months (HR = 1.30). Patients were categorized into good (n = 369, 46%), intermediate (n = 321, 40%) and poor (n = 107, 13%) prognosis groups based on the number of risk factors and relative HRs. The C-index was 0.70 +/- 0.014. The model was validated by the external dataset (n = 286). This analysis identified six factors used to model survival in mCRPC and categorized patients into three distinct risk groups. Prognostic stratification with this model could assist clinical practice decisions for follow-up and monitoring, and may aid in clinical trial design. NCT00638690.

Item Type: Article
Authors (ICR Faculty only): De Bono, Johann
All Authors: Chi, K. N., Kheoh, T., Ryan, C. J., Molina, A., Bellmunt, J., Vogelzang, N. J., Rathkopf, D. E., Fizazi, K., Kantoff, P. W., Li, J., Azad, A. A., Eigl, B. J., Heng, D. Y. C., Joshua, A. M., de Bono, J. S., Scher, H. I.
Additional Information: ISI Document Delivery No.: DF9OU Times Cited: 0 Cited Reference Count: 34 Chi, K. N. Kheoh, T. Ryan, C. J. Molina, A. Bellmunt, J. Vogelzang, N. J. Rathkopf, D. E. Fizazi, K. Kantoff, P. W. Li, J. Azad, A. A. Eigl, B. J. Heng, D. Y. C. Joshua, A. M. de Bono, J. S. Scher, H. I. Janssen Research Development This work was supported by Ortho Biotech Oncology Research & Development, unit of Cougar Biotechnology (now Janssen Research & Development). No grant number is applicable. 0 OXFORD UNIV PRESS OXFORD ANN ONCOL
Uncontrolled Keywords: castration-resistant prostate cancer abiraterone acetate prognostic risk survival PLACEBO-CONTROLLED PHASE-3 1ST-LINE CHEMOTHERAPY PLUS PREDNISONE DOUBLE-BLIND MEN ENZALUTAMIDE MITOXANTRONE MANAGEMENT CARCINOMA LYMPHOMA
Research teams: ICR divisions > Cancer Therapeutics > Cancer Biomarkers
ICR divisions > Clinical Studies > Cancer Biomarkers

ICR divisions > Clinical Studies > Prostate Cancer Targeted Therapy Group
Depositing User: Barry Jenkins
Date Deposited: 06 Apr 2016 13:30
Last Modified: 07 Jul 2017 15:42
URI: http://publications.icr.ac.uk/id/eprint/14931

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