Time from definitive therapy to onset of metastatic disease predicts outcomes in men with metastatic hormone sensitive prostate cancer

04.03.2019

In men with new Metastatic Hormone-sensitive prostate cancer, time from definitive therapy to initiation of androgen deprivation therapy (<5 vs. ≥5 years) is predictive of time to Castration-resistant Prostate Cancer on Androgen Deprivation Therapy.

Contemporary treatment for metastatic hormone-sensitive prostate cancer (mHSPC) includes androgen deprivation therapy (ADT) plus abiraterone or docetaxel. While these intensified regimens have improved efficacy, they are also associated with increased cost and toxicities. Not all men with mHSPC may be candidates for these intensified regimens, yet there are no clinical models or biomarkers used to optimize treatment selection.

In a multivariate analysis, increasing years from DT to the start of ADT was an independent predictor of time to metastatic castration-resistant prostate cancer and improved overall survival in patients with new mHSPC.

Time from DT to start of ADT is an independent predictor of time to mCRPC and overall survival in men with new mHSPC, and may assist with risk stratification of these patients for systemic therapy selection.

If validated, time from DT to initiation of ADT is a predictive biomarker that could help in determining the intensity of upfront treatment for mHSPC.

Reference

Hahn AW, Stenehjem DD, Alex AB, et al. Time from definitive therapy to the onset of metastatic disease predicts outcomes in men with metastatic hormone-sensitive prostate cancer. Urol Oncol. 2019; published online ahead of print.

https://www.sciencedirect.com/science/article/pii/S107814391930050X?via%3Dihub