Oncotarget

Research Papers:

Predictors of long-term response to abiraterone in patients with metastastic castration-resistant prostate cancer: a retrospective cohort study

Elena Verzoni, Ugo De Giorgi, Lisa Derosa, Orazio Caffo, Francesco Boccardo, Gaetano Facchini, Luca Porcu, Fabio De Vincenzo, Alberto Zaniboni, Vincenzo Emanuele Chiuri, Lucia Fratino, Daniele Santini, Vincenzo Adamo, Rocco De Vivo, Angelo Dinota, Caterina Messina, Riccardo Ricotta, Claudia Caserta, Claudio Scavelli, Marina Susi, Alfredo Tartarone, Giuseppe Surace, Alessandra Mosca, Michele Bruno, Sandro Barni, Paolo Grassi and Giuseppe Procopio _

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Oncotarget. 2016; 7:40085-40094. https://doi.org/10.18632/oncotarget.9485

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Abstract

Elena Verzoni1, Ugo De Giorgi2, Lisa Derosa3, Orazio Caffo4, Francesco Boccardo5, Gaetano Facchini6, Luca Porcu7, Fabio De Vincenzo8, Alberto Zaniboni9, Vincenzo Emanuele Chiuri10, Lucia Fratino11, Daniele Santini12, Vincenzo Adamo13, Rocco De Vivo14, Angelo Dinota15, Caterina Messina16, Riccardo Ricotta17, Claudia Caserta18, Claudio Scavelli19, Marina Susi20, Alfredo Tartarone21, Giuseppe Surace22, Alessandra Mosca23, Michele Bruno24, Sandro Barni25, Paolo Grassi1, Giuseppe Procopio1

1Unit of Medical Oncology 1, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy

2Department of Medical Oncology, IRST, IRCCS, Meldola, Italy

3Unit of Medical Oncology 2, Istituto Toscano Tumori, Pisa, Italy

4Ospedale Santa Chiara, Trento, Italy

5IRCCS AOU San Martino IST and University of Genoa, Italy

6Unit of Medical Oncology, Department of Uro-Gynecological Oncology, Istituto Nazionale Tumori, Fondazione G. Pascale IRCCS, Naples, Italy

7Department of Oncology, IRCCS- Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy

8Istituto Clinico Humanitas, Rozzano, Italy

9Fondazione Poliambulanza, Brescia, Italy

10Ospedale Vito Fazzi, Lecce, Italy

11Istituto Nazionale Tumori CRO, Aviano, Italy

12Policlinico Universitario Campus Biomedico, Roma, Italy

13Medical Oncology Unit, AO Papardo, Messina, Italy

14Ospedale San Bortolo, Vicenza, Italy

15Ospedale San Carlo, Potenza, Italy

16Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy

17Niguarda Cancer Center, Ospedale Niguarda Ca’ Granda, Milan, Italy

18AO Santa Maria, Terni, Italy

19Ospedale S. Cuore di Gesù, Gallipoli, Italy

20Ospedale Madonna delle Grazie, Matera, Italy

21IRCCS Centro di Riferimento Oncologico della Basilicata (CROB), Rionero in Vulture, Italy

22Ospedale D. Camberlingo, Francavilla Fontana, Italy

23AOU Maggiore della Carità, Novara, Italy

24PO San G. Moscati, ASL Taranto, Italy

25AO Treviglio, Italy

Correspondence to:

Giuseppe Procopio, e-mail: giuseppe.procopio@istitutotumori.mi.it

Keywords: abiraterone acetate, castration-resistant, predictive factors, prostate cancer, retrospective studies

Received: February 28, 2016    Accepted: April 10, 2016    Published: May 19, 2016

ABSTRACT

We aimed to identify clinical predictors of long-term response to abiraterone (defined as >12 months drug exposure) in a retrospective cohort of metastatic castration-resistant prostate cancer patients treated in post-docetaxel setting at 24 Italian centers. The Cox proportional hazards model was used to analyze the association between clinical features and the duration of drug exposure. Results were expressed as hazard ratios (HR) with associated 95% confidence intervals (CI). A total of 143 patients met the inclusion criteria. Their median age was 73 years, median Gleason score 8 and median abiraterone exposure 20 months. At the univariate analysis, a significant correlation with the duration of abiraterone exposure was found for Gleason score (HR 0.82, 95% CI 0.71-0.96; p=0.012), PSA (HR 1.10, 95% CI 1.03-1.18; p=0.08) and lactic dehydrogenase levels (HR 1.22, 95% CI 1.02-1.46; p=0.027), while the association between lower alkaline phosphatase levels and treatment duration was marginally significant (HR 1.07, 95% CI 0.99-1.16; p=0.074). Only PSA and Gleason score were predictive of long-term treatment duration in the multivariate analysis. No other clinical factors resulted to be predictive of sustained response to abiraterone, including metastatic disease at diagnosis and visceral disease, suggesting that all subgroups of patients may derive a substantial clinical benefit from abiraterone treatment. These findings need to be validated in prospective, larger studies.


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