Presentation Authors: Hiromi Sato*, Shintaro Narita, Kyoko Nomura, Akita, Japan, Shingo Hatakeyama, Hirosaki, Japan, Masahiro Takahashi, Sendai, Japan, Toshihiko Sakurai, Yamagata, Japan, Sadafumi Kawamura, Natori, Japan, Senji Hoshi, Yamagata, Japan, Masanori Ishida, Mizusawa, Japan, Toshiaki Kawaguchi, Aomori, Japan, Shigeto Ishidoya, Sendai, Japan, Jiro Shimoda, Mizusawa, Japan, Koji Mitsuzuka, Sendai, Japan, Tatsuo Tochigi, Natori, Japan, Norihiko Tsuchiya, Yamagata, Japan, Chikara Ohyama, Hirosaki, Japan, Yoichi Arai, Sendai, Japan, Tomonori Habuchi, Akita, Japan
Introduction: There is still less evidence regarding the impact of early changes in serum biomarker levels on clinical outcomes after ADT in recent diagnosed patients with metastatic hormone-naive prostate cancer (mHNPC). Here we evaluated the impact of pretreatment prognostic factors and early changes in serum biomarkers on survivals in patients with mHNPC.
Methods: We retrospectively reviewed the medical records of 629 patients with newly diagnosed mHNPC who were initially treated with androgen deprivation therapy (ADT) from 2008 to 2016. We investigated 330 patients whose laboratory data were available at baseline and at 2-4 months. The final multivariable Cox proportional hazards regression model was developed using the lowest Akaike Information Criterion and highest score, confirming the proportional hazard assumption.
Results: The median OS was 6.47 years (median follow-up, 2.53 years). The final Cox models demonstrated that the higher half value of prostate-specific antigen (PSA) >3.1 ng/mL and the lower half value of hemoglobin (HGB) â‰¤12g/dL in 2-4 months after ADT were independently associated with worse cancer specific survival (CSS) and overall survival (OS) along with the extent of osseous disease with â‰¥2, and higher half value of lactate dehydrogenase >220 U/L at baseline. Based on the presence of zero, one, or two prognostic factors of serum PSA and HGB levels at 2-4 months, the risk group analysis showed that median OS estimates for these groups were 2.76, 5.65, and 7.87 years, respectively.
Conclusions: Risk classification based on early changes in serum biomarker levels may be a promising for identifying patients with poor survival. Not only pretreatment risk factors but also early changes in serum biomarker levels may be useful for predicting poor outcomes in patients with mHNPC.