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Randomized Controlled Trial
. 2022 Sep;82(12):1176-1185.
doi: 10.1002/pros.24369. Epub 2022 May 10.

Association between baseline body mass index and survival in men with metastatic hormone-sensitive prostate cancer: ECOG-ACRIN CHAARTED E3805

Alicia K Morgans  1 , Yu-Hui Chen  2 , David F Jarrard  3 , Michael Carducci  4 , Glenn Liu  3 , Mario Eisenberger  4 , Elizabeth R Plimack  5 , Alan Bryce  6 , Jorge A Garcia  7 , Robert Dreicer  8 , Nicholas J Vogelzang  9 , Joel Picus  10 , Daniel Shevrin  11   12 , Maha Hussain  1 , Robert S DiPaola  13 , David Cella  1 , Christopher J Sweeney  14 ; ECOG-ACRIN E3805 Investigators
Affiliations
Randomized Controlled Trial

Association between baseline body mass index and survival in men with metastatic hormone-sensitive prostate cancer: ECOG-ACRIN CHAARTED E3805

Alicia K Morgans et al. Prostate. 2022 Sep.

Abstract

Background: E3805 (CHAARTED) is a phase 3 trial demonstrating improved survival for men with metastatic hormone-sensitive prostate cancer (mHSPC) randomized to treatment with docetaxel (D) and androgen-deprivation therapy (ADT) versus ADT alone. We assessed the association of baseline body mass index (BMI) and metformin exposure with quality of life (QOL) and prostate cancer outcomes including survival in patients enrolled in the CHAARTED study.

Methods: We performed a posthoc exploratory analysis of the CHAARTED trial of men with mHSPC randomized to treatment with ADT with or without D between 2006 and 2012. Cox proportional hazards models and Kruskal-Wallis test were used to evaluate the association between BMI with QOL and prostate cancer outcomes and between metformin exposure and survival.

Results: In 788 of 790 enrolled patients with prospectively recorded baseline BMI and metformin exposure status, lower BMI was not associated with survival, but was associated with high volume disease (p < 0.0001) and poorer baseline QOL on functional assessment of cancer therapy-prostate (p = 0.008). Only 68 patients had prevalent metformin exposure at baseline in the CHAARTED trial. Four groups were identified: ADT + D + metformin (n = 39); ADT + D (n = 357); ADT + metformin (n = 29); and ADT alone (n = 363). Baseline clinicopathologic characteristics were similar between groups. In this small exploratory multivariable analysis, metformin exposure was not associated with survival (hazard ratio: 1.15; 95% confidence interval: 0.81-1.63, p = 0.44).

Conclusions: There was no link between baseline BMI and survival, but lower baseline BMI was associated with features of greater cancer burden and poorer QOL.

Keywords: chemohormonal therapy; metabolism; metastatic prostate cancer; quality of life.

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Figures

Figure 1:
Figure 1:
Effect of body mass index (BMI) on survival. (A) Including all E3805 treatment arms, no significant survival difference was noted between patients of different BMI at study presentation, but a trend seen towards improved survival in obese patients (BMI>30) was noted (see Table 3). (B) Effect of BMI on survival comparing ADT + D versus ADT alone for BMI<25). (C) Effect of BMI on survival comparing ADT + D versus ADT alone for BMI>25<30 (D) Effect of BMI on survival comparing ADT + D versus ADT alone for BMI>30.
Figure 1:
Figure 1:
Effect of body mass index (BMI) on survival. (A) Including all E3805 treatment arms, no significant survival difference was noted between patients of different BMI at study presentation, but a trend seen towards improved survival in obese patients (BMI>30) was noted (see Table 3). (B) Effect of BMI on survival comparing ADT + D versus ADT alone for BMI<25). (C) Effect of BMI on survival comparing ADT + D versus ADT alone for BMI>25<30 (D) Effect of BMI on survival comparing ADT + D versus ADT alone for BMI>30.
Figure 1:
Figure 1:
Effect of body mass index (BMI) on survival. (A) Including all E3805 treatment arms, no significant survival difference was noted between patients of different BMI at study presentation, but a trend seen towards improved survival in obese patients (BMI>30) was noted (see Table 3). (B) Effect of BMI on survival comparing ADT + D versus ADT alone for BMI<25). (C) Effect of BMI on survival comparing ADT + D versus ADT alone for BMI>25<30 (D) Effect of BMI on survival comparing ADT + D versus ADT alone for BMI>30.
Figure 1:
Figure 1:
Effect of body mass index (BMI) on survival. (A) Including all E3805 treatment arms, no significant survival difference was noted between patients of different BMI at study presentation, but a trend seen towards improved survival in obese patients (BMI>30) was noted (see Table 3). (B) Effect of BMI on survival comparing ADT + D versus ADT alone for BMI<25). (C) Effect of BMI on survival comparing ADT + D versus ADT alone for BMI>25<30 (D) Effect of BMI on survival comparing ADT + D versus ADT alone for BMI>30.
Figure 2:
Figure 2:
Kaplan-Meier Estimates of Overall Survival Based on Metformin Use, Docetaxel (D) and Androgen Deprivation Therapy (ADT) for Patients with Metastatic Hormone Sensitive Prostate Cancer.
See this image and copyright information in PMC

References

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