Effect of Prior Local Therapy on Response to First-line Androgen Receptor Axis Targeted Therapy in Metastatic Castrate-resistant Prostate Cancer: A Secondary Analysis of the COU-AA-302 Trial

被引:7
作者
Roy, Soumyajit [1 ,9 ]
Sun, Yilun [2 ]
Morgan, Scott C. [3 ]
Wallis, Christopher J. D. [4 ,5 ]
King, Kevin [1 ]
Zhou, Yu M. [1 ]
D'souza, Leah A. [1 ]
Azem, Omar [1 ]
Cueto-Marquez, Adrianna E. [1 ]
Camden, Nathaniel B. [1 ]
Spratt, Daniel E. [6 ]
Kishan, Amar U. [7 ]
Saad, Fred [8 ]
Malone, Shawn [3 ]
机构
[1] Rush Univ, Dept Radiat Oncol, Med Ctr, Chicago, IL USA
[2] Case Western Reserve Univ, Sch Med, Dept Populat & Quantitat Hlth Sci, Cleveland Hts, OH USA
[3] Univ Ottawa, Ottawa Hosp, Div Radiat Oncol, Canc Ctr, 501 Smyth Rd, Box 903, Ottawa, ON K1H 8L6, Canada
[4] Univ Toronto, Mt Sinai Hosp, Dept Urol, Toronto, ON, Canada
[5] Univ Toronto, Univ Hlth Network, Toronto, ON, Canada
[6] Case Western Reserve Univ, Univ Hosp Seidman Canc Ctr, Dept Radiat Oncol, Cleveland Hts, OH USA
[7] Univ Calif Los Angeles, Dept Radiat Oncol, Los Angeles, CA USA
[8] Univ Montreal, Dept Surg, Montreal, PQ, Canada
[9] Rush Univ, Womans Board Ctr Radiat Therapy, Dept Radiat Oncol, Med Ctr, 500 S Paulina St Ground Floor Atrium 032, Chicago, IL 60612 USA
关键词
Metastatic castrate-resistant  prostate cancer; Abiraterone; Local therapy; Radiation therapy; Radical prostatectomy; NEUROENDOCRINE DIFFERENTIATION; INCREASED SURVIVAL; ABIRATERONE; ENZALUTAMIDE; PREDNISONE;
D O I
10.1016/j.eururo.2023.02.017
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background: Men with localized prostate cancer are often treated with local therapy (LT). However, a proportion of these patients will eventually develop recurrence and progression requiring systemic therapy. Whether primary LT affects the response to this subsequent systemic treatment is unclear.Objective: We investigated whether the receipt of prior prostate-directed LT influenced the response to first-line systemic therapy and survival in docetaxel-naive metastatic castrate-resistant prostate cancer (mCRPC) patients.Design, setting, and participants: This is an exploratory analysis of the COU-AA-302 trial, a multicentric double-blinded phase 3 randomized controlled trial in which mCRPC patients with no to mild symptoms were randomized to receive abiraterone plus pred-nisone or placebo plus prednisone.Outcome measurements and statistical analysis: We compared the time-varying effects of first-line abiraterone in patients with and without prior LT using a Cox proportional hazard model. The cut points were chosen using grid search, and were 6 and 36 mo for radiographic progression-free survival (rPFS) and overall survival (OS), respectively. We also investigated whether there was any difference in treatment effect on score change (relative to baseline) in various patient-reported outcomes (measured by Functional Assessment of Cancer Therapy-Prostate [FACT-P]) over time depending on the receipt of prior LT. The adjusted association of prior LT with survival was determined using weighted Cox regression models.Results and limitations: Among 1053 eligible patients, 64% (n = 669) received prior LT. We did not find any statistically significant heterogeneity of time-dependent treatment effect from abiraterone on rPFS in patients with (hazard ratio [HR]: 0.36 [95% confidence interval: 0.27-0.49] at <6 mo; 0.64 [0.49-0.83] at >6 mo) or without (HR: 0.37 [0.26- 0.55] at <6 mo; 0.72 [0.50-1.03] at >6 mo) prior LT. Similarly, there was no significant heterogeneity in time-dependent treatment effect on OS with (HR: 0.88 [0.71-1.10] at <36 mo; 0.76 [0.52-1.11] at >36 mo) or without (0.78 [0.60-1.01] at <36 mo; 0.55 [0.30-0.99] at >36 mo) prior LT. We did not find sufficient evidence of a difference in treatment effect from abiraterone on score change over time in prostate cancer subscale (interaction p = 0.4), trial outcome index (interaction p = 0.8), and FACT-P total score (in-teraction p = 0.6) depending on the receipt of prior LT. Receipt of prior LT was associated with a significant improvement in OS (average HR: 0.72 [0.59-0.89]).Conclusions: This study demonstrates that the efficacy of first-line abiraterone and pred-nisone in docetaxel-naive mCRPC do not vary significantly based on the receipt of prior prostate-directed LT. Further studies are needed to explore the plausible mechanisms of the association of prior LT with superior OS.Patient summary: This secondary analysis of the COU-AA-302 trial suggests that survival benefits and temporal changes in quality of life with first-line abiraterone in docetaxel-naive mCRPC do not differ significantly among patients who received versus those who did not receive prior prostate-directed local therapy.(c) 2023 European Association of Urology. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:571 / 579
页数:9
相关论文
共 28 条
[21]   Alpha Emitter Radium-223 and Survival in Metastatic Prostate Cancer [J].
Parker, C. ;
Nilsson, S. ;
Heinrich, D. ;
Helle, S. I. ;
O'Sullivan, J. M. ;
Fossa, S. D. ;
Chodacki, A. ;
Wiechno, P. ;
Logue, J. ;
Seke, M. ;
Widmark, A. ;
Johannessen, D. C. ;
Hoskin, P. ;
Bottomley, D. ;
James, N. D. ;
Solberg, A. ;
Syndikus, I. ;
Kliment, J. ;
Wedel, S. ;
Boehmer, S. ;
Dall'Oglio, M. ;
Franzen, L. ;
Coleman, R. ;
Vogelzang, N. J. ;
O'Bryan-Tear, C. G. ;
Staudacher, K. ;
Garcia-Vargas, J. ;
Shan, M. ;
Bruland, O. S. ;
Sartor, O. .
NEW ENGLAND JOURNAL OF MEDICINE, 2013, 369 (03) :213-223
[22]   Radiotherapy to the primary tumour for newly diagnosed, metastatic prostate cancer (STAMPEDE): a randomised controlled phase 3 trial [J].
Parker, Christopher C. ;
James, Nicholas D. ;
Brawley, Christopher D. ;
Clarke, Noel W. ;
Hoyle, Alex P. ;
Ali, Adnan ;
Ritchie, Alastair W. S. ;
Attard, Gerhardt ;
Chowdhury, Simon ;
Cross, William ;
Dearnaley, David P. ;
Gillessen, Silke ;
Gilson, Clare ;
Jones, Robert J. ;
Langley, Ruth E. ;
Malik, Zafar I. ;
Mason, Malcolm D. ;
Matheson, David ;
Millman, Robin ;
Russell, J. Martin ;
Thalmann, George N. ;
Amos, Claire L. ;
Alonzi, Roberto ;
Bahl, Amit ;
Birtle, Alison ;
Din, Omar ;
Douis, Hassan ;
Eswar, Chinnamani ;
Gale, Joanna ;
Gannon, Melissa R. ;
Jonnada, Sai ;
Khaksar, Sara ;
Lester, Jason F. ;
O'Sullivan, Joe M. ;
Parikh, Omi A. ;
Pedley, Ian D. ;
Pudney, Delia M. ;
Sheehan, Denise J. ;
Srihari, Narayanan Nair ;
Tran, Anna T. H. ;
Parmar, Mahesh K. B. ;
Sydes, Matthew R. .
LANCET, 2018, 392 (10162) :2353-2366
[23]   Impact of prior local therapy on overall survival in men with metastatic castration-resistant prostate cancer: Results from Shared Equal Access Regional Cancer Hospital [J].
Patel, Devin N. ;
Jha, Shalini ;
Howard, Lauren E. ;
Amling, Christopher L. ;
Aronson, William J. ;
Cooperberg, Matthew R. ;
Kane, Christopher J. ;
Terris, Martha K. ;
Chapin, Brian F. ;
Freedland, Stephen J. .
INTERNATIONAL JOURNAL OF UROLOGY, 2018, 25 (12) :998-1004
[24]   Abiraterone acetate plus prednisone versus placebo plus prednisone in chemotherapy-naive men with metastatic castration-resistant prostate cancer (COU-AA-302): final overall survival analysis of a randomised, double-blind, placebo-controlled phase 3 study [J].
Ryan, Charles J. ;
Smith, Matthew R. ;
Fizazi, Karim ;
Saad, Fred ;
Mulders, Peter F. A. ;
Sternberg, Cora N. ;
Miller, Kurt ;
Logothetis, Christopher J. ;
Shore, Neal D. ;
Small, Eric J. ;
Carles, Joan ;
Flaig, Thomas W. ;
Taplin, Mary-Ellen ;
Higano, Celestia S. ;
de Souza, Paul ;
de Bono, Johann S. s ;
Griffin, Thomas W. ;
De Porre, Peter ;
Yu, Margaret K. ;
Park, Youn C. ;
Li, Jinhui ;
Kheoh, Thian ;
Naini, Vahid ;
Molina, Arturo ;
Rathkopf, Dana E. .
LANCET ONCOLOGY, 2015, 16 (02) :152-160
[25]   Abiraterone in Metastatic Prostate Cancer without Previous Chemotherapy [J].
Ryan, Charles J. ;
Smith, Matthew R. ;
de Bono, Johann S. ;
Molina, Arturo ;
Logothetis, Christopher J. ;
de Souza, Paul ;
Fizazi, Karim ;
Mainwaring, Paul ;
Piulats, Josep M. ;
Ng, Siobhan ;
Carles, Joan ;
Mulders, Peter F. A. ;
Basch, Ethan ;
Small, Eric J. ;
Saad, Fred ;
Schrijvers, Dirk ;
Van Poppel, Hendrik ;
Mukherjee, Som D. ;
Suttmann, Henrik ;
Gerritsen, Winald R. ;
Flaig, Thomas W. ;
George, Daniel J. ;
Yu, Evan Y. ;
Efstathiou, Eleni ;
Pantuck, Allan ;
Winquist, Eric ;
Higano, Celestia S. ;
Taplin, Mary-Ellen ;
Park, Youn ;
Kheoh, Thian ;
Griffin, Thomas ;
Scher, Howard I. ;
Rathkopf, Dana E. .
NEW ENGLAND JOURNAL OF MEDICINE, 2013, 368 (02) :138-148
[26]   Increased Survival with Enzalutamide in Prostate Cancer after Chemotherapy [J].
Scher, Howard I. ;
Fizazi, Karim ;
Saad, Fred ;
Taplin, Mary-Ellen ;
Sternberg, Cora N. ;
Miller, Kurt ;
de Wit, Ronald ;
Mulders, Peter ;
Chi, Kim N. ;
Shore, Neal D. ;
Armstrong, Andrew J. ;
Flaig, Thomas W. ;
Flechon, Aude ;
Mainwaring, Paul ;
Fleming, Mark ;
Hainsworth, John D. ;
Hirmand, Mohammad ;
Selby, Bryan ;
Seely, Lynn ;
de Bono, Johann S. .
NEW ENGLAND JOURNAL OF MEDICINE, 2012, 367 (13) :1187-1197
[27]   Resetting the Bar of Castration Resistance-Understanding Androgen Dynamics in Therapy Resistance and Treatment Choice in Prostate Cancer [J].
Shore, Neal D. ;
Morgans, Alicia K. ;
Ryan, Charles J. .
CLINICAL GENITOURINARY CANCER, 2021, 19 (03) :199-207
[28]   Neuroendocrine-like prostate cancer cells: Neuroendocrine transdifferentiation of prostate adenocarcinoma cells [J].
Yuan, Ta-Chun ;
Veeramani, Suresh ;
Lin, Ming-Fong .
ENDOCRINE-RELATED CANCER, 2007, 14 (03) :531-547