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Clinical Trial
. 2016 Mar;5(3):407-14.
doi: 10.1002/cam4.594. Epub 2016 Jan 14.

Predictors of early androgen deprivation treatment failure in prostate cancer with bone metastases

Eberhard Varenhorst  1 , Rami Klaff  1 , Anders Berglund  2 , Per Olov Hedlund  3 , Gabriel Sandblom  4 ; Scandinavian Prostate Cancer Group (SPCG) Trial No. 5
Affiliations
Clinical Trial

Predictors of early androgen deprivation treatment failure in prostate cancer with bone metastases

Eberhard Varenhorst et al. Cancer Med. 2016 Mar.

Abstract

Approximately 15% of men with hormone naïve metastatic prostate cancer primarily fail to respond to androgen deprivation treatment (ADT). The reason why the response to ADT differs in this subgroup of men with prostate cancer remains unclear. The aim of this study was to describe the characteristics of these men and to thereby define predictors of early ADT failure in prostate cancer patients with bone metastases. The study was based on 915 men from the prospective randomized multicenter trial (no. 5) conducted by the Scandinavian Prostate Cancer Group comparing parenteral estrogen with total androgen blockade. Early ADT failure was defined as death from metastatic prostate cancer within 12 months after the start of ADT. Multivariate logistic regression models were applied to identify clinical predictors of early ADT failure. Ninety-four (10.3%) men were primarily nonresponders to ADT. Independent predictors of early ADT failure were poor Eastern Cooperative Oncology Group performance status (PS), analgesic consumption, low hemoglobin, and high Soloway score (extent of disease observed on the scan), in where patients with poor PS and/or high analgesic consumption had a threefold risk of early ADT failure. Not significantly factors related to early ADT failure were age, treatment, cardiovascular comorbidity, T category, grade of malignancy, serum estrogen level, and SHBG at enrolment. We analyzed characteristics of a subgroup of patients who primarily failed to respond to ADT. Four independent clinical predictors of early ADT failure could be defined, and men exhibiting these features should be considered for an alternative treatment.

Keywords: Androgen deprivation treatment; bone metastases; clinical predictors; early failure; prostate cancer.

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Figures

Figure 1
Figure 1
Flowchart showing study group assembly and follow‐up of the Scandinavian Prostate Cancer Group (SPCG) No. 5 Trial on androgen deprivation treatment (ADT) in men with prostate cancer and bone metastases. Early ADT failure was defined as disease‐specific death within 12 months after start of treatment.
See this image and copyright information in PMC

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