904P - The characteristics of different pattern of metastases in patients with castrate resistant prostate cancer treated with taxotere chemotherapy

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Anticancer agents
Prostate Cancer
Therapy
Biological Therapy
Presenter Sanjay Dixit
Authors S. Dixit1, J. Tito1, P. Afzal2
  • 1Oncology, Hull & East Yorkshire NHS Trust, HU165JQ - Hull/UK
  • 2Oncology, Diana princess of Wales Hospital, Grimsby, DN15 7BH - Grimsby/UK

Abstract

Introduction

Many new agents are being tested in patients with castrate resistant metastatic prostate cancer. Understanding the characteristics of different pattern of metastases and their responses to taxotere chemotherapy may help in stratifying the patients in different prognostic and predictive groups.

Methods

Based on the metastases observed on bone scan and CT- scan, before starting chemotherapy, three metastatic patterns were identified. Metastases predominantly limited to the bones with small volume lymph node metastases (bone predominant), metastases limited to the bones (bones only), and metastases with bulky lymphadenopathy without bone metastases (lymph nodes only). Median survival and the distribution of known prognostic factors were analysed in these three groups.

Results

Seventy eight patients with a median age of 70 (Range, 47-86) and a median PSA of 174 (11-3000) had a median survival of 17 months (95% C.I. 13-20). Factors associated with statistically significant shorter survival were symptomatic state, haemoglobin, PSA level, the duration of hormone response, and three metastases pattern. Gleason score and age were not significant. The median survival for three metastatic pattern, bone predominant (32), bone only (35), and lymph node only (11) metastases, were 12, 19 and 23 months respectively. The distributions of age, Gleason score, PSA level before starting chemotherapy, and PSA response were not significantly different in the three metastatic groups. However, patients with bone predominant metastatic group were symptomatic (not significant), had fewer number of chemotherapy cycles, and had a lower median Haemoglobin level (significant) compared with the bone only metastases and lymph node only metastases group.

Conclusion

The bone predominant pattern of metastases could be biologically different disease than the bone only and the lymph node only (bulky) metastases. The trials using newer agents stratifying patients based on these metastases pattern may help in understanding the diverse biological behaviour of castrate resistant prostate cancer.

Disclosure

S. Dixit: Sanofi- aventis has provided an educational grant to conduct this study.

J. Tito: Sanofi aventis provided an educational grant for this study.

P. Afzal: Sanofi -aventis provided an education grant for this study