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Metastasis-free survival associated with OS in recurrent prostate cancer
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Metastasis-free survival appeared to independently predict OS in men with recurrent prostate cancer who underwent androgen deprivation therapy after metastases, according to study results.
Men with biochemically recurrent prostate cancer tend to survive for long periods. OS has proven to be a difficult endpoint to reach, hindering clinical trials that involve this patient population.
Consequently, researchers have identified a need for intermediate endpoints to help conduct these types of trials in a shorter time, according to background information in the study.
Emmanuel S. Antonarakis, MBBCh, of the prostate cancer research program at Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University School of Medicine, and colleagues conducted a retrospective analysis that included 450 men with recurrent prostate cancer.
All men underwent prostatectomy at a single institution between 1981 and 2010. Androgen deprivation therapy (ADT) was deferred until after patients developed metastases.
Subsequently, 140 patients developed metastases.
Antonarakis and colleagues determined median metastasis-free survival was 10.2 years (95% CI, 7.6-14) and median OS after metastasis was 6.6 years (95% CI, 5.8-8.4).
Using multivariable Cox regression models, researchers identified four independent prognostic variables for OS. They were metastasis-free survival (HR=0.77; 95% CI, 0.63-0.94); bisphosphonate use (HR=0.60; 95% CI, 0.37-0.98); number of metastases (≤3 vs. ≤4; HR=0.50; 95% CI, 0.29-0.85); and pain (absent vs. present; HR=0.43; 95% CI, 0.25-0.72).
“Metastasis-free survival emerged as an independent predictor of OS in men with biochemically recurrent prostate cancer treated with deferred ADT after the development of metastases,” Antonarakis and colleagues concluded. “Metastasis-free survival may be a reasonable intermediate endpoint in future clinical trials. This observation requires prospective validation.”
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