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Van Praet C, Rottey S, Van Hende F, Pelgrims G, Demey W, Van Aelst F, Wynendaele W, Gil T, Schatteman P, Filleul B, Schallier D, Machiels JP, Schrijvers D, Everaert E, D'Hondt L, Werbrouck P, Vermeij J, Mebis J, Clausse M, Rasschaert M, Van Erps J, Verheezen J, Van Haverbeke J, Goeminne JC, Lumen N. Which Factors Predict Overall Survival in Patients With Metastatic Castration-Resistant Prostate Cancer Treated With Abiraterone Acetate Post-Docetaxel? Clin Genitourin Cancer 2017; 15:502-508. [PMID: 28258960 DOI: 10.1016/j.clgc.2017.01.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 01/22/2017] [Accepted: 01/23/2017] [Indexed: 01/21/2023]
Abstract
BACKGROUND Abiraterone acetate (AA) increases overall survival (OS) in patients with metastatic castration-resistant prostate cancer (mCRPC) previously treated with docetaxel. However, survival time varies substantially between individuals. Our goal was to identify prognostic factors that better estimate OS. MATERIALS AND METHODS This is a retrospective multicentric analysis of 368 patients with mCRPC starting AA with prednisone after docetaxel. Cox proportional hazards statistics were applied. A multivariate model was constructed based on significant univariate predictors by using a manual stepwise forward and backward selection strategy. Model performance was determined by using receiver operating characteristic (ROC) curves. RESULTS Univariate analysis identified 20 significant OS predictors. A multivariate model was constructed, based on 220 patients, incorporating 5 independent risk factors for decreased OS at the time of AA initiation: hemoglobin < 12 g/dL (hazard ratio [HR] 2.02), > 10 metastases (HR 1.80), ECOG performance status ≥ 2 (HR 1.88), radiographic progression (HR 1.50), and time since diagnosis < 90 months (HR 1.66, all P < .05). Patients were stratified into 3 groups: good (0-2 risk factors, median OS 22.6 months), intermediate (3 risk factors, median OS 13.9 months), and poor prognosis (4-5 risk factors, median OS 6.2 months). The area under the ROC curve based on the event "death by the time of median OS (13.3 months)" was 0.736 (95% confidence interval 0.670-0.803). CONCLUSION We identified 5 readily available risk factors independently associated with decreased OS. The resulting model may be used for patient counseling in daily clinical practice, as well as patient stratification in clinical trials.
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Affiliation(s)
| | - Sylvie Rottey
- Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | - Fransien Van Hende
- Department of Medical Oncology, University Hospital Leuven, Leuven, Belgium
| | - Gino Pelgrims
- Department of Medical Oncology, AZ Turnhout, Turnhout, Belgium
| | - Wim Demey
- Department of Medical Oncology, AZ Klina, Kalmthout, Belgium
| | - Filip Van Aelst
- Department of Medical Oncology, AZ Delta, Roeselare, Belgium
| | - Wim Wynendaele
- Department of Medical Oncology, Imelda Hospital, Bonheiden, Belgium
| | - Thierry Gil
- Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Peter Schatteman
- Department of Urology, Onze-Lieve-Vrouw Hospital, Aalst, Belgium
| | - Bertrand Filleul
- Department of Medical Oncology, Hopital De Jolimont, Haine Saint Paul, Belgium
| | - Denis Schallier
- Department of Medical Oncology, University Hospital Brussels, Jette, Belgium
| | - Jean-Pascal Machiels
- Department of Medical Oncology, Institut Roi Albert II, Cliniques universitaires Saint Luc, Brussels, Belgium
| | - Dirk Schrijvers
- Department of Medical Oncology, Ziekenhuis Netwerk Antwerpen (ZNA) Middelheim, Antwerp, Belgium
| | - Els Everaert
- Department of Medical Oncology, AZ Nikolaas, Sint-Niklaas, Belgium
| | - Lionel D'Hondt
- Department of Medical Oncology, CHU Dinant-Godinne, Yvoir, Belgium
| | | | - Joanna Vermeij
- Department of Medical Oncology, ZNA Jan Palfijn, Merksem, Belgium
| | - Jeroen Mebis
- Department of Medical Oncology, AZ Jessa, Hasselt, Belgium
| | | | | | - Joanna Van Erps
- Department of Medical Oncology, Algemeen Stedelijk Ziekenhuis, Aalst, Belgium
| | - Jolanda Verheezen
- Department of Medical Oncology, AZ Sint-Trudo, Sint-Truiden, Belgium
| | | | | | - Nicolaas Lumen
- Department of Urology, Ghent University Hospital, Ghent, Belgium
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Rottey S, Van Praet C, Van Hende F, Pelgrims G, Demey W, Van Aelst F, Wynendaele W, Gil T, Schatteman P, Filleul B, Schallier DCC, Machiels JPH, Schrijvers DL, Everaert EG, D'Hondt LA, Werbrouck P, Vermeij J, Mebis J, Clausse M, Lumen N. Evaluation of abiraterone acetate post-docetaxel in the Belgian compassionate use program. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e16057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | | | - Wim Wynendaele
- Medische Oncologie, Imelda Ziekenhuis Bonheiden, Bonheiden, Belgium
| | - Thierry Gil
- Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
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