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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

2334 - Prognostic associations of early prostate-specific antigen (PSA) changes in patients with Metastatic Castration-resistant Prostate Cancer treated with with abiraterone acetate or enzalutamide


22 Oct 2018


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


Cytotoxic Therapy

Tumour Site

Prostate Cancer


Fernando López Campos


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


F. López Campos1, I. Moreno2, A. Conde-Moreno3, A. Gómez-Iturriaga4, M. Ruiz Vico5, N. Romero Laorden6, I. Henríquez López7, P. Peleteiro Higuero8, R. Lozano Mejorada6, T. Piquer9, M. Couselo10, J. Gómez Ramos7, J. Navarro10, P. Barrionuevo Castillo1, R. García11, R. Villatoro12, A. Montesa13, M.I. Saez13, B. Herrera13, E. Castro Marcos6

Author affiliations

  • 1 Radiation oncology, Hospital Universitario Ramon y Cajal, 28031 - Madrid/ES
  • 2 Medical Oncology, Hospital Universitario Virgen de la Victoria, 29010 - Malaga/ES
  • 3 Radiation oncology, Hospital Universitario y Politécnico La Fe, 46026 - Valencia/ES
  • 4 Radiation oncology, Hospital de Cruces, 48903 - Baracaldo/ES
  • 5 Medical Oncology, Hospital Regional Universitario Carlos Haya, 29010 - Malaga/ES
  • 6 Prostate Cancer Unit, CNIO- Spanish National Cancer Center, 28029 - Madrid/ES
  • 7 Radiation oncology, Hospital Universitario San Joan de Reus, 43204 - Reus/ES
  • 8 Radiation oncology, Hospital Clínico Universitario De Santiago de Compostela, 15706 - Santiago de Compostela/ES
  • 9 Radiation oncology, Hospital Provincial de Castellón, 12002 - Castellón/ES
  • 10 Radiation oncology, Hospital Central de la Defensa Gómez Ulla, 28047 - Madrid/ES
  • 11 Radiation oncology, Hospital Clínico Universitario de Valencia, 46010 - Valencia/ES
  • 12 Medical Oncology, Hospital Costa del Sol, Malaga/ES
  • 13 Unidad De Investigación Cnio-ibima, Hospitales Universitarios Virgen de la Victoria y Regional de Málaga, 29010 - Malaga/ES

Abstract 2334


The availability of multiple treatments for metastatic castration-resistant prostate cancer (mCRPC) mandates the need to identify prognostic factors applicable to clinical practice. Variations in (PSA) levels are widely used in the monitoring of response to treatment with abiraterone acetate (AA) or enzalutamide, but are not validated as an early biomarker for overall survival (OS). Objective: To evaluate the association between early PSA changes and OS following enzalutamide or AA treatments in mCRPC.


We retrospectively evaluated mCRPC patients treated with AA or enzalutamide, before or after docetaxel, in 11 reference hospitals between 2011 and 2017. A descriptive and multivariate analysis of the data was carried out in order to establish the association of PSA variations at 4 and 12 weeks (expressed as 30% and 50% percentage modifications, respectively, relative to baseline value at the start of AA or enzalutamide) with OS. Association with OS was analyzed using multivariate Cox regression and log-rank analyses. Spearman’s rho correlation coefficient (r) was calculated to evaluate the association between PSA changes at 4 and 12 weeks.


We analyzed 450 mCRPC patients with a median follow-up of 16 months (1-65). A 30% PSA decline at 4 weeks was associated with longer OS (30 vs 20 months; hazard ratio [HR] 0.55 (0.42-0.73), p < 0.001), as well as a 50% PSA decrease at 12 weeks (39 vs 19 months; HR 0.42 (0.31-0.56), p < 0.001). We found a detriment in survival in patients with a 30% PSA rise at 4 weeks, with shorter OS (22 vs 26 months; HR 1.5 (1.07-2.21), p = 0.025) and a 50% PSA increase at 12 weeks after starting treatment (14 vs 29 months; 2.66 (1.93-3.67) p < 0.001), in both univariate and multivariable models. The percentage PSA decline at 4 weeks was significantly correlated with the percentage PSA change at 12 weeks (r = 0.635; p < 0.001). Limitations include the retrospective design of this analysis.


PSA changes as early as 4 weeks after enzalutamide or AA initiation are highly associated with OS in mCPRC. Prospective multicentre validation studies are needed to confirm these findings.

Clinical trial identification

Legal entity responsible for the study

Fernando López Campos.


Has not received any funding.

Editorial Acknowledgement


All authors have declared no conflicts of interest.

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