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Poster Display session 3

2527 - Circulating Tumor Cells (CTC) count and Prostate-Specific Antigen (PSA) response measures in metastatic Castration-Resistant Prostate Cancer (mCRPC) patients (pts) treated with Docetaxel (Doc)

Date

30 Sep 2019

Session

Poster Display session 3

Topics

Tumour Site

Prostate Cancer

Presenters

Rebeca Lozano Mejorada

Citation

Annals of Oncology (2019) 30 (suppl_5): v325-v355. 10.1093/annonc/mdz248

Authors

R. Lozano Mejorada1, D. Lorente2, E. Castro3, D. Bianchini4, P. Nombela5, S.K. Sandhu6, N. Romero Laorden7, Y. Cendón5, A. Sharp8, E. Almagro Casado9, M.I. Pacheco5, P. Rescigno10, C. LLácer11, M. Saez11, L. Rivera5, F. Vitrone5, C. Moreno5, J. Mateo12, J.S. de Bono13, D. Olmos Hidalgo14

Author affiliations

  • 1 Prostate Cancer Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), Madrid and Instituto de Investigación Biomédica de Málaga (IBIMA), 28029 - Madrid/ES
  • 2 Medical Oncology, Hospital Provincial de Castellón, 12002 - Castellón/ES
  • 3 Prostate Cancer Clinical Research Unit, Instituto de Investigación Biomédica de Málaga (IBIMA) and Hospitales Universitarios Virgen de la Victoria y Regional de Málaga, Malaga/ES
  • 4 Pcttg, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, SM2 5NG - London/GB
  • 5 Prostate Cancer Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), 28029 - Madrid/ES
  • 6 Division Of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne/AU
  • 7 Medical Oncology, Hospital Universitario de La Princesa, 28006 - Madrid/ES
  • 8 Medical Oncology, The Institute of Cancer Research/Royal Marsden NHS Foundation Trust, SM2 5PT - Sutton/GB
  • 9 Medical Oncology, Hospital Universitario Quirón Salud, Madrid/ES
  • 10 Clinical Medicine And Surgery, Department Of Translational Medical Science, Azienda Ospedaliera Universitaria Federico II, 80131 - Napoli/IT
  • 11 Medical Oncology, Hospitales Universitarios Virgen de la Victoria y Regional de Málaga, Málaga/ES
  • 12 Grupo De Investigación Traslacional En Cáncer De Próstata, Vall d'Hebron University Hospital, 08035 - Barcelona/ES
  • 13 Drug Development Unit, The Royal Marsden Foundation Trust and The Institute of Cancer Research, SM2 5FR - London/GB
  • 14 Prostate Cancer Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), Madrid and Hospitales Universitarios Virgen de la Victoria y Regional de Málaga, 28029 - Madrid/ES

Resources

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Abstract 2527

Background

Clinically meaningful measures of response are needed in mCRPC. Post-treatment CTC decline have shown to be superior to PSA response in determining outcome in pts treated with AR signalling inhibitors. We compared the performance of CTC and PSA measures of response in mCRPC Doc-treated pts.

Methods

Baseline and post-treatment (6 to 9 weeks) CTC of mCRPC pts treated with Doc at first or second-line in a prospective study were determined with CellSearchTM platform. CTC response was defined: 30% decline from baseline (CTC30%), conversion (≥5 to < 5; CTCConv) or decline to 0 CTC in pts with >0 baseline CTC (CTC0). PSA response was determined at 12w as 30% (PSA30) or 50% decline (PSA50) from baseline. Cox-regression model were used to evaluate the association of baseline CTC (BLCTC), CTC response and PSA response measures with overall survival (OS), progression-free survival (PFS) or time to PSA progression (TTPP). C-index were used to evaluate the performance of each of the Cox regression model.

Results

80 pts had evaluable BLCTC, 52 had evaluable post-treatment CTC count. Of 80 eligible pts, 53 (66.3%) received Doc at first-line. Median OS was 19 m (95%CI:16.4-21.8); median BLCTC was 7. BLCTC were associated with bone mts, higher PSA, ALP and LDH, and lower albumin levels. BLCTC was associated with OS (HR: 3.5; p < 0.001), PFS (HR: 1.98; p = 0.001) and TTPP (HR: 1.8; p = 0.001). CTC (CTC30%, CTCConv, CTC0) but not PSA (PSA30, PSA50) response measures were significantly associated with OS. C-index values were higher for CTC resp endpoints (Table). 24 pts had discordant PSA30 and CTC30% response; longer OS (18.4 vs 8.4m; p = 0.188) was observed in pts with CTC30% resp, without PSA30 resp.Table:

889P

N (%)HR (95%CI); p-valueC-index
CTC Conv27 (51.9)0.33 (0.18-0.60); p < 0.0010.665
CTC08 (15.4)0.26 (0.10-0.67); p = 0.0050.602
CTC30%34 (65.4)0.33 (0.18-0.61); p < 0.0010.644
PSA3032 (61.5)0.72 (0.40-1.30); p = 0.2710.563
PSA5022 (42.3)0.68 (0.38-1.20); p = 0.1830.595

Conclusions

Baseline CTC were associated with OS, PFS and TTPP. CTC response measures were significantly associated with outcome, and showed a greater performance than PSA response measures in mCRPC Doc-treated pts.

Editorial acknowledgement

Legal entity responsible for the study

Spanish National Cancer Research Center (CNIO) and The Institute of Cancer Research (ICR).

Funding

Has not received any funding.

Disclosure

R. Lozano Mejorada: Honoraria (self): Roche, Janssen-Cilag, Bayer; Research grant / Funding (institution): Bayer, Janssen-Cilag; Travel / Accommodation / Expenses: Roche, Janssen-Cilag, Astellas Pharma. D. Lorente: Honoraria (self): Janssen-Cilag, Bayer, Astellas Pharma, Sanofi; Advisory / Consultancy: Janssen-Cilag, Bayer, Sanofi; Travel / Accommodation / Expenses: Sanofi, Astellas, Janssen-Cilag, Celgene. E. Castro: Honoraria (self): Astellas Pharma, Janssen-Cilag, AstraZeneca, Bayer, Pfizer; Advisory / Consultancy: Bayer, Janssen-Cilag, AstraZeneca, Clovis Oncology; Research grant / Funding (institution): Janssen-Cilag, AstraZeneca, Bayer; Travel / Accommodation / Expenses: Bayer, Janssen-Cilag, Roche, Astellas Pharma. N. Romero Laorden: Honoraria (self): MSD, Sanofi-Aventis, Astellas, Janssen-Cilag; Travel / Accommodation / Expenses: Bayer, Janssen-Cilag, Roche, PharmaMar; Research grant / Funding (institution): Bayer, Astellas, Janssen-Cilag, Sanofi-Aventis. E. Almagro Casado: Honoraria (self): MSD; Travel / Accommodation / Expenses: BMS. M. Saez: Honoraria (self): Bristol-Myers Squibb, Pfizer, Novartis, Bayer, Janssen-Cilag, Sanofi-Aventis, Astellas Pharma, Ipsen, EUSA Pharma; Advisory / Consultancy: Bristol-Myers Squibb, Pfizer, Novartis, Bayer, Janssen-Cilag, Sanofi-Aventis, Astellas Pharma, Ipsen, EUSA Pharma; Travel / Accommodation / Expenses: Bristol-Myers Squibb, Pfizer, Novartis, Bayer, Janssen-Cilag, Sanofi-Aventis, Astellas Pharma, Ipsen, EUSA Pharma. D. Olmos Hidalgo: Honoraria (self): Janssen-Cilag, Bayer, Sanofi; Advisory / Consultancy: Bayer, Janssen-Cilag, AstraZeneca, Clovis Oncology; Research grant / Funding (institution): Bayer, Janssen-Cilag, AstraZeneca, Roche/Genentech, Medications/Pfizer, Astellas, Tokai, MSD, GSK; Travel / Accommodation / Expenses: Bayer, Janssen-Cilag, Ipsen. All other authors have declared no conflicts of interest.

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