Does Gleason score at initial diagnosis predict efficacy of abiraterone acetate therapy in patients with metastatic castration-resistant prostate cancer? An analysis of abiraterone acetate phase III trials

Fizazi, Karim; Flaig, Thomas W.; Stöckle, Michael; Scher, Howard I.; Bono, Johann S. de; Rathkopf, Dana E.; Ryan, Charles J.; Kheoh, Thian; Li, J.; Todd, Mary B.; Griffin, Thomas W.; Molina, Arturo; Ohlmann, Carsten

doi:10.1093/annonc/mdv545

Cited by 39 publications

(25 citation statements)

References 22 publications

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“…In our present study, a time of 16 months to mCRPC significantly predicted a 50% PSA response. Other factors, including the Gleason score and the TMPRSS2-ERG translocation, did not appear to estimate the response to abiraterone acetate (21,22). The baseline testosterone level was reported to be significantly prognostic of OS, but did not predict the response to treatment (23).…”

Section: Discussionmentioning

confidence: 92%

Consequences of an Early PSA Response to Enzalutamide Treatment for Japanese Patients with Metastatic Castration-resistant Prostate Cancer

Kato

Furuya

Miyazawa

et al. 2016

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Section: Discussionmentioning

confidence: 92%

Consequences of an Early PSA Response to Enzalutamide Treatment for Japanese Patients with Metastatic Castration-resistant Prostate Cancer

Kato

Furuya

Miyazawa

et al. 2016

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“…This association, however, has been documented in other studies, where high Gleason score was found to be predictive of sustained treatment response in docetaxel trials [10, 11] but not in the “new hormonal compounds” trials. In a recent retrospective analysis of the COU-AA-301 and COU-AA-302 trials by Fizazi et al [12], initial Gleason score was not predictive of response to abiraterone in either chemotherapy naïve or post-docetaxel patients, as no significant difference in treatment benefits was found between patients with a Gleason score of < 8 versus ≥ 8.…”

Section: Discussionmentioning

confidence: 99%

Predictors of long-term response to abiraterone in patients with metastastic castration-resistant prostate cancer: a retrospective cohort study

Verzoni

Giorgi

Derosa³

et al. 2016

Oncotarget

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We aimed to identify clinical predictors of long-term response to abiraterone (defined as >12 months drug exposure) in a retrospective cohort of metastatic castration-resistant prostate cancer patients treated in post-docetaxel setting at 24 Italian centers. The Cox proportional hazards model was used to analyze the association between clinical features and the duration of drug exposure. Results were expressed as hazard ratios (HR) with associated 95% confidence intervals (CI). A total of 143 patients met the inclusion criteria. Their median age was 73 years, median Gleason score 8 and median abiraterone exposure 20 months. At the univariate analysis, a significant correlation with the duration of abiraterone exposure was found for Gleason score (HR 0.82, 95% CI 0.71-0.96; p=0.012), PSA (HR 1.10, 95% CI 1.03-1.18; p=0.08) and lactic dehydrogenase levels (HR 1.22, 95% CI 1.02-1.46; p=0.027), while the association between lower alkaline phosphatase levels and treatment duration was marginally significant (HR 1.07, 95% CI 0.99-1.16; p=0.074). Only PSA and Gleason score were predictive of long-term treatment duration in the multivariate analysis. No other clinical factors resulted to be predictive of sustained response to abiraterone, including metastatic disease at diagnosis and visceral disease, suggesting that all subgroups of patients may derive a substantial clinical benefit from abiraterone treatment. These findings need to be validated in prospective, larger studies.

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“…(62) Likewise, a retrospective analysis including all patients of the pivotal studies involving abiraterone (COU-AA 301 and COU-AA 302) showed that patients with Gleason score ≥ 8 also had improvement in OS (p < 0.0001). (63) Undifferentiated tumors or tumors with small cell components are rare, aggressive, more common in young patients, and usually with low PSA regardless of the volume of metastatic disease. (64) In this situation, hormone therapy has limited action and chemotherapy is preferentially used.…”

Section: Sequencingmentioning

confidence: 99%

Tratamento do câncer avançado de próstata: Onde estamos em 2019?

Monteiro¹,

Soares²,

Oliveira³

et al. 2019

BJOncology

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In the last decade, important advances have been made in the treatment of metastatic prostate cancer, resulting in a better understanding of the biology underlying the disease, and in the approval of several therapeutic agents such as immunotherapy, new generation antiandrogens, cytotoxic chemotherapies, and radiopharmaceuticals. All these recent advances have been incorporated in clinical guidelines and a critical analysis of the data available should be important to help the decision-making process. In addition, the incorporation of well established therapies in early disease stages have demonstrated a robust overall survival gain for patients with castration-sensitive metastatic prostate cancer. However, no predictive biomarkers of response are available and the selection of the best therapeutic option is still challenging depending on clinical and pathological factors. Many questions related to the optimal sequencing of agents, or comparison of its efficacy remain unanswered.

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Does Gleason score at initial diagnosis predict efficacy of abiraterone acetate therapy in patients with metastatic castration-resistant prostate cancer? An analysis of abiraterone acetate phase III trials

Abstract: COU-AA-301 (NCT00638690); COU-AA-302 (NCT00887198).

Cited by 39 publications

References 22 publications

Consequences of an Early PSA Response to Enzalutamide Treatment for Japanese Patients with Metastatic Castration-resistant Prostate Cancer

Consequences of an Early PSA Response to Enzalutamide Treatment for Japanese Patients with Metastatic Castration-resistant Prostate Cancer

Predictors of long-term response to abiraterone in patients with metastastic castration-resistant prostate cancer: a retrospective cohort study

Tratamento do câncer avançado de próstata: Onde estamos em 2019?

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