Clinicopathologic factors that influence prognosis and survival outcomes in men with metastatic castration‐resistant prostate cancer treated with Radium‐223

Abstract

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Real-world effectiveness, long-term safety and treatment pathway integration of radium-223 therapy in patients with metastatic castration-resistant prostate cancer

“…Several studies have reported composite prognostic scoring methods aimed at identifying patients that may benefit most from 223 Ra therapy (59)(60)(61)64). A composite score derived from combining baseline Hb ≥ 120 g/L, total ALP ≤ 110 U/L and ECOG PS 0-1 identified patients with a low-, intermediate-or high-risk of death (composite score 2, 3-4 and 5-6, respectively; median OS 23, 8, and 5 months) (60).…”

“…Multivariate analyses have found various factors to be associated with survival outcomes. Baseline Hb was found to be prognostic of OS ( 59 ) and elevated baseline Hb (≥ 120 g/L) was associated with increased OS ( 60 ), whereas low baseline albumin (< 35 g/L) ( 61 ) and elevated PSA (> 80 μg/L) ( 61 ) were associated with poor OS. Similarly, other factors prognostic of OS include baseline neutrophil-to-lymphocyte ratio ( 28 ), baseline lactose dehydrogenase ( 62 ) [with elevated lactose dehydrogenase associated with shorter OS ( 41 )] and higher baseline ALP ( 28 ) [with ALP > 150 U/L associated with poor OS ( 61 )].…”

“…Baseline Hb was found to be prognostic of OS ( 59 ) and elevated baseline Hb (≥ 120 g/L) was associated with increased OS ( 60 ), whereas low baseline albumin (< 35 g/L) ( 61 ) and elevated PSA (> 80 μg/L) ( 61 ) were associated with poor OS. Similarly, other factors prognostic of OS include baseline neutrophil-to-lymphocyte ratio ( 28 ), baseline lactose dehydrogenase ( 62 ) [with elevated lactose dehydrogenase associated with shorter OS ( 41 )] and higher baseline ALP ( 28 ) [with ALP > 150 U/L associated with poor OS ( 61 )]. Elevated baseline ALP without a subsequent ALP decline of ≥ 10% following the first 223 Ra dose was also prognostic of shorter OS ( 62 ).…”

“…With regard to disease characteristics, visceral metastases ( 63 ) and prior SSEs ( 63 ) reduced OS, whereas bone-only metastases were associated with longer OS ( 41 ). Eastern Cooperative Oncology Group performance status (ECOG PS) was also prognostic of OS ( 59 , 62 ), with ECOG PS 2–3 ( 61 ) and ECOG PS 2–4 ( 63 ) associated with worse OS and ECOG PS 0–1 associated with increased OS ( 60 ). Another clinical parameter prognostic of OS was number of prior systemic therapies ( 62 ).…”

Prognostic Value of the BIO-Ra Score in Metastatic Castration-Resistant Prostate Cancer Patients Treated with Radium-223 after the European Medicines Agency Restricted Use: Secondary Investigations of the Multicentric BIO-Ra Study

“…Several studies previously investigated many parameters potentially able to improve patient’s selection since baseline [ 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. However, most of them remained inconclusive since none of the identified clinical or biochemical biomarkers has been validated as a unique and reliable selection tool.…”