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Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

5714 - Efficacy of therapies after progression to up-front Docetaxel (D) with androgen deprivation therapy (ADT) for metastatic hormone-sensitive prostate cancer (mHSPC)

Date

22 Oct 2018

Session

Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

Topics

Cytotoxic Therapy

Tumour Site

Prostate Cancer

Presenters

Pablo Gajate Borau

Citation

Annals of Oncology (2018) 29 (suppl_8): viii271-viii302. 10.1093/annonc/mdy284

Authors

P. Gajate Borau1, A. Martin Marino2, I. Gallegos Sancho3, J.C. Villa Guzman4, A. Velastegui5, T. Alonso Gordoa6, D. Castellano7, G. Rubio Romero8, A. Pinto Marin9, L. Villalobos Leon10, C. Maximiano Alonso11, M.J. Sotelo-Lezama12, M. Sereno Moyano13, J.F. Rodríguez14, C. Perezagua Marin15, J. Ballesteros16, D. Marrupe Gonzalez17, L. Rodriguez Lajusticia18, J.J. Tafalla García19, C. Aguado20

Author affiliations

  • 1 Medical Oncology, Hospital Universitario Ramon y Cajal, 28034 - Madrid/ES
  • 2 Medical Oncology, Hospital Universitario Infanta Leonor, 28031 - Madrid/ES
  • 3 Medical Oncology, Complejo Asistencial de Segovia, Segovia/ES
  • 4 Medical Oncology, Hospital General Ciudad Real, 13005 - Ciudad Real/ES
  • 5 Medical Oncology, Hospital Universitario Rey Juan Carlos, Móstoles (Madrid)/ES
  • 6 Medical Oncology, Hospital Universitario Ramon y Cajal, 28031 - Madrid/ES
  • 7 Medical Oncology Department, University Hospital 12 De Octubre, 28041 - Madrid/ES
  • 8 Medical Oncology, University Hospital "Fundacion Jimenez Diaz", 28040 - Madrid/ES
  • 9 Medical Oncology, Hospital Universitario La Paz, 28046 - Madrid/ES
  • 10 Medical Oncology, Hospital Principe de Asturias, 28805 - Madrid/ES
  • 11 Medical Oncology, Hospital Universitario Puerta de Hierro - Majadahonda, 28222 - Majadahonda/ES
  • 12 Medical Oncology, Hospital Infanta Cristina, Parla (Madrid)/ES
  • 13 Medical Oncology, Hospital Infanta Sofia, 28702 - Madrid/ES
  • 14 Oncology Unit, HM San Chinarro, Madrid/ES
  • 15 Medical Oncology, University Hospital del Henares, 28822 - Coslada/ES
  • 16 Medical Oncology, Hospital Universitario del Sureste, Madrid/ES
  • 17 OncologÍa, Hospital General de Mostoles, 28935 - Mostoles/ES
  • 18 Medical Oncology, Hospital Universitario de Fuenlabrada, 28942 - Madrid/ES
  • 19 Medical Oncology, Hospital Central de la Defensa, 28047 - Madrid/ES
  • 20 Medical Oncology, Hospital Clinico Universitario San Carlos, 28040 - Madrid/ES
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Resources

Abstract 5714

Background

Addition of D to ADT increased overall survival in high volume disease mHSPC. Nevertheless, there is a lack of information about the management after disease progression and predictive factors of efficacy for subsequent therapies are unknown.

Methods

Retrospective analysis of 163 mHSPC patients (pt) treated with D in 23 Spanish Centers from July 2014 to April 2018. Objectives of the study are: describe baseline and progression characteristics, treatment choices and efficacy outcomes of subsequent therapies based on pretreatment features.

Results

After a median follow up of 18.04 months (m), 93 pt (57.1%) developed CRPC. Median time to CRPC was 15.97 m (CI 95%: 10.97 m – 28.16 m). 80 pt received subsequent treatment after progression: 23 (28.8%) received chemotherapy (CT) (3 D, 17 cabazitaxel, 3 carboplatin-etoposide), 52 (65%) androgen receptor axis-targeted agents (31 enzalutamide, 21 abiraterone) and 5 radium-223. Baseline characteristics of pt at CRPC disease were: median age: 67.1 year; median PSA doubling time (PSADT): 2 m, and median PSA, Hemoglobin (Hb), LDH and alkaline phosphatase (alk-P) was 20.3 ng/mL, 12.95 g/dL, 326 UI/mL and 144 UI/mL, respectively. 26.4% of pt had visceral progression. Median progression free survival (PFS) of pt in first-line treatment for mCRPC was 6.93 m (CI95%: 3.58-10.02). In univariate analysis, hormonal therapy showed a significant longer PFS compared to CT (7.49 m vs 6.27 m; HR 0.55; p 0.048), but no association was found after adjustment by other prognostic characteristics (HR 0.77; p 0.79). Although no significant association was observed in multivariate analysis, pt with more aggressive clinical characteristics achieved a longer PFS with CT (Table).Table: 823P

PFS at first-line treatment of mCRPC

HT (m)CT (m)p
PSADT < 3 m PSADT > = 3 m4.46 9.396.27 3.590.6 0.07
Visceral PD Non Visceral PD4.33 5.955.59 3.540.59 0.12
LDH H LDH L4.34 12.05.59 8.210.29 0.3
Hb H Hb LNR 4.05.58 6.270.03 0.63
alk-P H alk-P L3.81 11.996.93 5.520.94 0.03
PSA H PSA L3.81 8.545.52 5.580.35 0.14

Conclusions

Baseline characteristics at CRPC disease could help us to identify the best therapy option for pt pretreated with D + ADT in mHSPC. Our analyses suggest that CT could benefit pt with more aggressive clinical features.

Clinical trial identification

Legal entity responsible for the study

Pablo Gajate Borau.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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