Correlation between time to PSA progression (TTPP), radiographic progression-free survival (rPFS) and overall survival (OS) in first-line abiraterone/enzalutamide (Abi/Enza) and docetaxel (Doc) treated patients in a prospective cohort study.

Authors

null

David Lorente

MEdical Oncology Department, Hospital Provincial de Castellón, Castellón De La Plana, Spain

David Lorente , Elena Castro , Rebeca Lozano , Javier Puente , Nuria Romero-Laorden , Rafael Morales-Barrera , Alejo Rodriguez Vida , M Isabel Sáez , Maria Jose Mendez-Vidal , Eva Fernandez , Elena Almagro , Amaia Hernandez , Susana Hernando Polo , Begoña Pérez-Valderrama , Fernando López-Campos , Casilda Llacer Perez , A. Montesa , Nuria Lainez , Josep M. Piulats , David Olmos

Organizations

MEdical Oncology Department, Hospital Provincial de Castellón, Castellón De La Plana, Spain, Spanish National Cancer Research Centre, Madrid, Spain, Hospital Universitario Clínico San Carlos, Madrid, Spain, Hospital Universitario La Princesa, Madrid, Spain, Vall d'Hebron Institute, Barcelona, Hospital del Mar, Barcelona, Spain, CRIS Cancer Foundation Prostate Cancer Research Group, Institute of Biomedical Research in Malaga/ CNIO-IBIMA Genitourinary Cancer Research Unit, H Universitarios Virgen de la Victoria y Regional de Málaga, Malaga, Spain, Reina Sofía University Hospital, Cordoba, Spain, Hospital de Valme, Sevilla, Spain, Hospital Quironsalud, Madrid, Spain, Hospital Onkologikoa, San Sebastián, Spain, Hospital Universitario Fundación de Alcorcón, Alcorcon, Spain, Instituto de Biomedicina de Sevilla, IBiS/Hospital Universitario Virgen del Rocio/CSIC/Universidad de Sevilla, Seville, Spain, Radiation Oncology Department, Ramon y Cajal University Hospital, Madrid, Spain, IBIMA-Hospital Regional Universitario y Virgen de la Victoria, Malaga, Spain, CNIO-IBIMA Genitorurinary Cancer Clinical Research Unit, Hospitales Universitarios Virgen de la Victoria and Regional de Málaga, Malaga, Spain, Complejo Hospitalario de Navarra, Pamplona, Spain, Catalan Cancer Institute, Barcelona, Spain, Prostate Cancer Clinical Research Unit, Spanish National Cancer Research Center, Madrid, Spain

Research Funding

Other Foundation

Background: Abiraterone, enzalutamide and docetaxel represent first-line (1L) treatment options in mCRPC. A significant correlation between rPFS and OS has been reported for patients treated with 1L abi and enza in mCRPC. It is however unclear whether TTPP or rPFS present a similar magnitude of correlation with OS in Doc-treated pts. Methods: We evaluated the association of TTPP and rPFS with OS in pts treated with 1L Abi/Enza or Doc in a prospective multicenter observational cohort study. TTPP and rPFS were defined as per PCWG2. Correlation between TTPP and rPFS with OS was evaluated with Spearman rho coefficients (r), and by calculating the concordance index (c-index) in Cox-regression models. Results: 406 out of 419 pts received 1L Abi/Enza or Doc. After a median follow-up of 40 months (m), 253 mCRPC-related deaths were observed, with a median OS of 31.3 m (95% CI: 27.6-35). Median rPFS and TTPP were 10.8 m (95% CI:9.7-11.9) and 7.2 m (95% CI:6.7-7.7), respectively. Significant correlations between rPFS/TTPP and OS were observed in all pts treated at 1L, as well as in Abi/Enza and Doc treated pts (Table). R and c-index were consistently higher in Abi/Enza treated pts than in Doc treated pts, with a higher difference in predictive accuracy of the Cox regression model observed when comparing the association between TTPP and OS (c-index 0.788 in Abi/Enza treated pts vs 0.627 in Doc treated pts). Conclusions: Differences in r and c-index were observed when evaluating the association between TTPP/rPFS and OS in Abi/Enza and Doc treated pts, suggesting rPFS and TTPP may better predict OS in Abi/Enza than in Doc-treated pts. Indirect comparisons of TTPP in Abi/Enza vs Doc pts may therefore not reflect their true impact on OS. Further insight on the exact significance of TTPP is needed. Clinical trial information: NCT03075735

Association of rPFS and TTPP with OS in Abi/Enza and Doc-treated pts.

OutcomeAll pts
(N=406)
Abi/Enza
(n=218)
Doc
(n=188)
rc-indexrc-indexrc-index
rPFS0.65*0.7550.74*0.7620.55*0.745
TTPP0.54*0.7260.65*0.7880.44*0.627

(*p<0.001)

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Abstract Details

Meeting

2019 Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Prostate Cancer

Track

Prostate Cancer,Prostate Cancer

Sub Track

Prostate Cancer - Advanced Disease

Clinical Trial Registration Number

NCT03075735

Citation

J Clin Oncol 37, 2019 (suppl 7S; abstr 267)

DOI

10.1200/JCO.2019.37.7_suppl.267

Abstract #

267

Poster Bd #

M2

Abstract Disclosures