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Poster Display session 3

5637 - External Validation of a Prognostic Score in First-Line Metastastic Castration-Resistant Prostate Cancer (mCRPC)


30 Sep 2019


Poster Display session 3


Tumour Site

Prostate Cancer


David Lorente


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


D. Lorente1, R. Lozano Mejorada2, G.A. De Velasco Oria de Rueda3, A. Sanchez Hernandez1, M. Rodrigo Aliaga4, Á. Sánchez Iglesias5, M. de Julián Campayo1, F. Lopez Campos6, N. Romero Laorden7, E. Castro2, D. Olmos Hidalgo2

Author affiliations

  • 1 Medical Oncology Department, Hospital Provincial de Castellón, 12002 - Castellón de la Plana/ES
  • 2 Prostate Cancer Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), Madrid and Instituto de Investigación Biomédica de Málaga (IBIMA), 28029 - Madrid/ES
  • 3 Medical Oncology, University Hospital 12 De Octubre, 28041 - Madrid/ES
  • 4 Urology, Hospital General de Castellón, Castellón de la Plana/ES
  • 5 Radiotherapy Department, Hospital Provincial de Castellón, 12002 - Castellón de la Plana/ES
  • 6 Radiotherapy Department, Hospital Universitario Ramon y Cajal, 28031 - Madrid/ES
  • 7 Prostate Cancer, CNIO - Centro Nacional de Investigaciones Oncologicas, 28029 - Madrid/ES


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Abstract 5637


Due to improved outcome in mCRPC, most prognostic models may not reflect the current treatment landscape. Recently, Armstrong et al (Ann Oncol 2018) published a prognostic model based on the phase III PREVAIL trial.


We applied the Armstrong prognostic model to patients (pts) treated in the COU-AA-302 trial. Variables included in the model: albumin, ALP, Hb, LDH, NLR, number of bone metastases, pain, pattern of spread, PSA, time from diagnosis. Pts were categorized into low ( < =3), intermediate (4-6) or high (7-10 risk factors) risk. A continuous score was calculated. Association with overall survival (OS), radiographic progression-free survival (rPFS) and time to PSA progression (TTPSAP) was calculated with Cox-regression models, with Kaplan Meier estimates for median values. C-indices were used to assess the performance of the continuous risk score.


918 pts (84,4%) had data on all variables. Risk score (continuous) was associated with OS (HR 2.19; p < 0.001) with a c-index of 0.68 (se = 0.011). 483 (52.6%), 403 (43.9%) and 32 (3.5%) pts were classified as low-, intermediate- and high-risk. OS was longer in low- than in intermediate- (HR: 0.4; p < 0.001) and high-risk (HR: 0.24; p < 0.001) pts. rPFS was prolonged in low risk versus intermediate (HR: 0.57; p < 0.001) and high-risk (HR: 0.41; p < 0.001) pts. TTPSAP was also improved in low-risk vs intermediate (HR: 0.6; p < 0.001) and high-risk (HR: 0.41; p < 0.001) pts. The association of risk group with OS, rPFS and TTPSAP was independent of treatment arm (Table). KM estimates of median (95%CI) OS, rPFS and TTPSAP.Table:


Low41.7m (38.7-46.8)16.4m (13.8-19.1)11.1m (8.3-11.2)
Intermediate24.6m (23.1-26.8)8.3m (8-11)5.6m (5.5-8.2)
High16.7m (11.7-30.2)3.9m (3.6-4.1)5.3m (3.7-8.3)


The Armstrong model is valid for mCRPC pts treated with first-line abiraterone. Less pts with high-risk features were included in COU-AA-302 than PREVAIL. These results may improve individual prognostic estimation and patient stratification in clinical trials. Study carried out under YODA Project #2018-3813.

Clinical trial identification


Editorial acknowledgement

Legal entity responsible for the study

The authors.


Has not received any funding.


D. Lorente: Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Sanofi; Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Janssen; Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Astellas; Advisory / Consultancy, Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Bayer. All other authors have declared no conflicts of interest.

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