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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

5588 - Kinetics of prostate-specific antigen (PSA) as a marker of abiraterone acetate (AA) efficacy in patients (p) with metastatic castrate-resistant prostate cancer (mCRPC)

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

Sofia España Fernandez

Citation

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

Authors

S. España Fernandez1, J.M. Piulats2, N. Sala3, J.M. Velarde4, U. Ferrandiz1, O. Etxaniz Ulazia1, L. Heras Lopez5, M.P. Barretina Ginesta6, X. Garcia del Muro7, A. Font4

Author affiliations

  • 1 Medical Oncology, Catalan Institute of Oncology (ICO Badalona), Hospital Germans Trias i Pujol, 8916 - Badalona/ES
  • 2 Medical Oncology, Catalan Institute of Oncology, Barcelona/ES
  • 3 Medical Oncology, ICO Girona, Hospital Josep Trueta, Girona/ES
  • 4 Medical Oncology, Catalan Institute of Oncology (ICO Badalona), Hospital Germans Trias i Pujol, 08916 - Badalona/ES
  • 5 Medical Oncologist, ICO, Barcelona/ES
  • 6 Medical Oncology, Catalan Institute of Oncology (ICO)-Hospital Universitari Josep Trueta, 17007 - Girona/ES
  • 7 Medical Oncology, Institut Català d'Oncologia L'Hospitalet, Barcelona/ES
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Resources

Abstract 5588

Background

Studies have suggested an association between PSA kinetics and outcome to AA. In order to identify p with resistance to AA, we assessed potential factors associated with overall survival (OS) in p with mCRPC treated with AA after progression to docetaxel.

Methods

We included 104 p with mCRPC treated with AA plus prednisone after progression to docetaxel at three centers of the Catalan Institute of Oncology from August 2011 to October 2014. All p were assessed monthly to check PSA levels and hematological parameters. We used a multivariable Cox proportional hazards model to explore the association of baseline characteristics and PSA parameters with OS.

Results

Median OS was 16.4 months (m) and the median of duration of treatment was 7.54 m. In the univariate analysis, 14 factors were significantly associated with OS: ECOG PS, metastatic site, hemoglobin, alkaline phosphatase, lactate dehydrogenase (LDH), baseline PSA levels (classified by terciles), neutrophil-lymphocyte ratio (NLR), interval between end of docetaxel and start of AA, early PSA response (decrease >30% at week 4), PSA nadir, time to PSA nadir, PSA decrease >50%, end-of-treatment (EOT) PSA levels, and EOT PSA doubling time (PSADT). The multivariate analysis identified lymph node metastases (P = 0.016), NLR <4 (P = 0.038), baseline PSA levels <43 ng/ml (P = 0.026), normal LDH (P = 0.035), early PSA response (P = 0.001), and EOT PSADT >1.5 m (P < 0.001) as independent markers of longer OS.

Conclusions

Our results suggest an association between PSA kinetics, primarily early PSA response, with outcome to AA after progression to docetaxel. Taken together with other factors, lack of an early PSA response could identify patients that will probably not obtain a benefit from AA and who might be considered for alternative therapies.

Clinical trial identification

Legal entity responsible for the study

Catalan Institute of Oncology, Hospital Universitary Germans Trias i Pujol.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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