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Prognostic and predictive value of plasma testosterone levels in patients receiving first-line chemotherapy for metastatic castrate-resistant prostate cancer.

de Liaño AG, Reig O, Mellado B, Martin C, Rull EU, Maroto JP - Br. J. Cancer (2014)

Bottom Line: The presence of anaemia was an unfavourable prognostic factor (median OS: 20.6 vs 28.4 months; P=0.0025, HR=1.88 (CI95%: 1.01-3.48)).High vs Low TL was associated with PSA response rate (55.6% vs 21.7%) in 41 patients receiving SHT.The PSA response to SHT differed depending on TLs.

View Article: PubMed Central - PubMed

Affiliation: Medical Oncology and Biochemistry Departments, Hospital de la Santa Creu i Sant Pau, Mas Casanovas s/n, 08025 Barcelona, Spain.

ABSTRACT

Background: Biomarkers for metastatic castration-resistant prostatic cancer (mCRPC) are an unmet medical need.

Methods: The prognostic and predictive value for survival and response to salvage hormonal therapy (SHT) of baseline testosterone level (TL) was analysed in a cohort of 101 mCRPC patients participating in 9 non-hormonal first-line chemotherapy phase II-III trials. Inclusion criteria in all trials required a TL of <50 ng dl(-1).

Results: Median age: 70 years; visceral metastases: 19.8%; median prostate-specific antigen (PSA): 50.7 ng ml(-1); median TL: 11.5 ng dl(-1). Median overall survival (OS; 24.5 months) was significantly longer if baseline TL was above (High TL; n=52) than under (Low TL; n=49) the TL median value (32.7 vs 22.4 months, respectively; P=0.0162, hazard ratio (HR)=0.6). The presence of anaemia was an unfavourable prognostic factor (median OS: 20.6 vs 28.4 months; P=0.0025, HR=1.88 (CI95%: 1.01-3.48)). Patients presenting both anaemia and low testosterone had a worse outcome compared to those with one or none of them (median OS: 17.9 vs 22.4 vs 38.1 months; P=0.0024). High vs Low TL was associated with PSA response rate (55.6% vs 21.7%) in 41 patients receiving SHT.

Conclusion: Testosterone level under castration range was a prognostic factor for survival mCRPC patients. The PSA response to SHT differed depending on TLs. Testosterone levels might help in treatment decision.

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Related in: MedlinePlus

Disease-free survival (A) and overall survival (B) according to testosterone baseline levels.
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fig2: Disease-free survival (A) and overall survival (B) according to testosterone baseline levels.

Mentions: Kaplan–Meier analysis stratified by TLs showed a median DFS higher in those patients with High TL than with Low TL (5.7 vs 4.9 months, respectively; P=0.001). Median OS was also longer in those patients with High TL compared with Low TL (32.7 vs 22.4 months, respectively, P=0.0162) (Figures 2a and b). When stratified by haemoglobin levels, OS was 28.4 vs 20.6 months (No anaemia vs Yes, respectively; P=0.0025, Figure 3a), and OS was 35.9 vs 22.8 months when age was analysed (<65 vs ⩾65 years old; P=0.0259; Figure 3b).


Prognostic and predictive value of plasma testosterone levels in patients receiving first-line chemotherapy for metastatic castrate-resistant prostate cancer.

de Liaño AG, Reig O, Mellado B, Martin C, Rull EU, Maroto JP - Br. J. Cancer (2014)

Disease-free survival (A) and overall survival (B) according to testosterone baseline levels.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4007243&req=5

fig2: Disease-free survival (A) and overall survival (B) according to testosterone baseline levels.
Mentions: Kaplan–Meier analysis stratified by TLs showed a median DFS higher in those patients with High TL than with Low TL (5.7 vs 4.9 months, respectively; P=0.001). Median OS was also longer in those patients with High TL compared with Low TL (32.7 vs 22.4 months, respectively, P=0.0162) (Figures 2a and b). When stratified by haemoglobin levels, OS was 28.4 vs 20.6 months (No anaemia vs Yes, respectively; P=0.0025, Figure 3a), and OS was 35.9 vs 22.8 months when age was analysed (<65 vs ⩾65 years old; P=0.0259; Figure 3b).

Bottom Line: The presence of anaemia was an unfavourable prognostic factor (median OS: 20.6 vs 28.4 months; P=0.0025, HR=1.88 (CI95%: 1.01-3.48)).High vs Low TL was associated with PSA response rate (55.6% vs 21.7%) in 41 patients receiving SHT.The PSA response to SHT differed depending on TLs.

View Article: PubMed Central - PubMed

Affiliation: Medical Oncology and Biochemistry Departments, Hospital de la Santa Creu i Sant Pau, Mas Casanovas s/n, 08025 Barcelona, Spain.

ABSTRACT

Background: Biomarkers for metastatic castration-resistant prostatic cancer (mCRPC) are an unmet medical need.

Methods: The prognostic and predictive value for survival and response to salvage hormonal therapy (SHT) of baseline testosterone level (TL) was analysed in a cohort of 101 mCRPC patients participating in 9 non-hormonal first-line chemotherapy phase II-III trials. Inclusion criteria in all trials required a TL of <50 ng dl(-1).

Results: Median age: 70 years; visceral metastases: 19.8%; median prostate-specific antigen (PSA): 50.7 ng ml(-1); median TL: 11.5 ng dl(-1). Median overall survival (OS; 24.5 months) was significantly longer if baseline TL was above (High TL; n=52) than under (Low TL; n=49) the TL median value (32.7 vs 22.4 months, respectively; P=0.0162, hazard ratio (HR)=0.6). The presence of anaemia was an unfavourable prognostic factor (median OS: 20.6 vs 28.4 months; P=0.0025, HR=1.88 (CI95%: 1.01-3.48)). Patients presenting both anaemia and low testosterone had a worse outcome compared to those with one or none of them (median OS: 17.9 vs 22.4 vs 38.1 months; P=0.0024). High vs Low TL was associated with PSA response rate (55.6% vs 21.7%) in 41 patients receiving SHT.

Conclusion: Testosterone level under castration range was a prognostic factor for survival mCRPC patients. The PSA response to SHT differed depending on TLs. Testosterone levels might help in treatment decision.

Show MeSH
Related in: MedlinePlus