Oncotarget

Research Papers:

A prognostic score for overall survival in patients treated with abiraterone in the pre- and post-chemotherapy setting

Martin Boegemann _, Katrin Schlack, Lena Früchtenicht, Julie Steinestel, Andres Jan Schrader, Yvonne Wennmann, Laura-Maria Krabbe and Okyaz Eminaga

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Oncotarget. 2019; 10:5082-5091. https://doi.org/10.18632/oncotarget.27133

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Abstract

Martin Boegemann1, Katrin Schlack1, Lena Früchtenicht1, Julie Steinestel2, Andres Jan Schrader1, Yvonne Wennmann1, Laura-Maria Krabbe1,3 and Okyaz Eminaga4

1 Department of Urology, University of Muenster Medical Center, Muenster, Germany

2 Department of Urology, Augsburg Medical Center, Augburg, Germany

3 Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA

4 Department of Urology, Stanford Medical School, Stanford, CA, USA

Correspondence to:

Martin Boegemann,email: martin.boegemann@ukmuenster.de

Keywords: risk score; mCRPC; abiraterone; survival; outcome

Received: March 13, 2019     Accepted: July 21, 2019     Published: August 20, 2019

ABSTRACT

Background: Therapy resistance remains a serious dilemma in metastatic castration-resistant prostate cancer (mCRPC) with primary or secondary resistance frequently occurring against any given therapy. Available prognostic models for Abiraterone Acetate (AA) are specifically designed for either pre- or post-chemotherapy settings and mostly based on trial datasets not necessarily reflecting real-life.

Results: A score of 0–2 (low-risk) is associated with an OS-probability of 80.0% (95%CI: 71.3–90.6) and 50.5% (95%CI: 38.7–66.0) after 1 and 2 years while a score of 3–4 (high risk) is associated with an OS-probability of 35.3% (95%CI: 22.3–55.8) and 5.7% (95%CI: 1.5–21.8), respectively. The bootstrapping survival analysis of the scoring-system revealed a median c-index of 0.80 (IQR: 0.79–0.82).

Material and Methods: We developed a scoring-system using four real-life parameters 117 mCRPC patients treated with AA either pre- or post-chemotherapy. These parameters were evaluated using COX regression analysis. The scoring-system consists of binary-categorized parameters; when any of these exceeds the given cut-off, one point is added up to a final score ranging between 0–4 points. The final score was stratified by a median threshold of 2 into low- and high-risk groups. We evaluated the discriminative ability of our scoring-system using concordance probability (C-index) and Kaplan–Meier-analysis and applied a 100-times bootstrap for survival analysis.

Conclusions: Our study introduces a novel prognostic scoring-system for OS of real-life mCRPC patients receiving AA treatment irrespective of the line of therapy. The scoring-system is simple and can be easily utilized based on PSA and LDH values, neutrophil to lymphocyte ratio, and ECOG performance status.


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