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).
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
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).
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
All authors have declared no conflicts of interest.