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

PDF  |  Full Text  |  Supplementary Files  |  How to cite

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

Metrics: PDF 902 views  |   Full Text 1328 views  |   ?  


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: [email protected]

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

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


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.

Creative Commons License All site content, except where otherwise noted, is licensed under a Creative Commons Attribution 4.0 License.
PII: 27133