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Effect of baseline metabolic aberrations in men with locally advanced/metastatic prostate cancer treated with ADT on time to disease progression, prostate cancer specific and all cause death

Date

09 Oct 2016

Session

Poster display

Presenters

Danielle Crawley

Citation

Annals of Oncology (2016) 27 (6): 243-265. 10.1093/annonc/mdw372

Authors

D. Crawley1, M. van Hemelrijck1, S. Chowdhury2, N. James3, C. Gilson4, M. Spears4, M.R. Sydes4, S. Rudman2

Author affiliations

  • 1 Research Oncology, King's College London Guy's Hospital, SE1 9RT - London/GB
  • 2 Oncology, Guy's and St. Thomas' Hospital NHS Trust, SE1 9RT - London/GB
  • 3 Clinical Trial Unit, University of Warwick, CV4 7AL - Coventry/GB
  • 4 Clinical Trials Unit, Medical Research Council (MRC) MRC Clinical Trials Unit, WC2B 6NH - London/GB
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Resources

Abstract 2779

Background

Metabolic conditions (diabetes, obesity, or dyslipidaemia) may be linked with prostate cancer (PCa) aggressiveness and death. The presence of these metabolic aberrations may enable us to identify those men who are at risk of early treatment failure. Here, we examine the effect of baseline metabolic aberrations on time to disease progression, PCa specific and all cause death in a cohort of men with locally advanced/metastatic PCa treated with long term androgen deprivation therapy (ADT).

Methods

This study was conducted using a retrospective review of case report forms (CRF) of 2,617 men with locally advanced/metastatic hormone naïve PCa commencing long term ADT who enrolled in the control arm of the STAMPEDE trial (ISRCTN78818544) between 2005 and 2015. Data on the following metabolic aberrations at baseline was included: hypertension (systolic blood pressure ≥140mmHg and/or diastolic blood pressure ≥90mmHg or confirmed history of hypertension), obesity (BMI >30kg/m2),dyslipidaemia (HDL

Results

During a median follow up of 1.75 years those with three or more metabolic aberrations at baseline were more likely to have local progression (HR: 1.61, 95% CI: 1.09-2.36) after adjusting for age, Gleason score, PSA, type of ADT and TNM stage. A similar trend was seen for metastatic progression (HR: 1.24, 95% CI: 0.97-1.58).

Conclusions

Our findings suggest that baseline metabolic aberrations may be associated with earlier treatment failure. Thus identifying a higher risk patient group in which to intensify therapy including management of metabolic risk. Further prospective studies examining this association are required.

Clinical trial identification

EudraCT 2004-000193-31 ISRCTN78818544

Legal entity responsible for the study

MRC

Funding

MRC

Disclosure

All authors have declared no conflicts of interest.

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