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Observational Study
. 2022 Oct;40(10):2459-2466.
doi: 10.1007/s00345-022-04108-x. Epub 2022 Sep 4.

Development of castration resistance in prostate cancer patients treated with luteinizing hormone-releasing hormone analogues (LHRHa): results of the ANARESISTANCE study

J C Angulo  1 , J P Ciria Santos  2 , A Gómez-Caamaño  3 , R Poza de Celis  4 , J L González Sala  5 , J M García Garzón  6 , J A Galán-Llopis  7 , M Pérez Sampietro  8 , V Perrot  8 , J Planas Morin  9 ; ANARESISTANCE study group
Collaborators, Affiliations
Observational Study

Development of castration resistance in prostate cancer patients treated with luteinizing hormone-releasing hormone analogues (LHRHa): results of the ANARESISTANCE study

J C Angulo et al. World J Urol. 2022 Oct.

Abstract

Purpose: Evaluate the percentage of patients with prostate cancer treated with luteinizing hormone-releasing hormone analogues (LHRHa) that develop castration resistance after a follow-up period of 3 years. The secondary objective is to evaluate the variables potentially related to the progression to castration resistant prostate cancer (CRPC).

Methods: A post-authorization, nation-wide, multicenter, prospective, observational, and longitudinal study that included 416 patients treated with LHRHa between 2012 and 2017 is presented. Patients were followed for 3 years or until development of CRPC, thus completing a per-protocol population of 350 patients. A Cox regression analysis was carried out to evaluate factors involved in progression to CRPC.

Results: After 3 years of treatment with LHRHa 18.2% of patients developed CRPC. In contrast, in the subgroup analysis, 39.6% of the metastatic patients developed CRPC, compared with 8.8% of the non-metastatic patients. The patients with the highest risk of developing CRPC were those with a nadir prostate-specific antigen (PSA) > 2 ng/ml (HR 21.6; 95% CI 11.7-39.8; p < 0.001) and those receiving concomitant medication, most commonly bicalutamide (HR 1.8; 95% CI 1-3.1, p = 0.0431).

Conclusions: The proportion of metastatic patients developing CRPC after 3 years of treatment with LHRHa is consistent with what has been previously described in the literature. In addition, this study provides new findings on CRPC in non-metastatic patients. Concomitant medication and nadir PSA are statistically significant predictive factors for the time to diagnosis of CRPC, the nadir PSA being the strongest predictor.

Keywords: Castration-resistant prostatic neoplasms; Gonadotropin-releasing hormone; Observational study; Prospective study.

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Conflict of interest statement

Pérez Sampietro M. and Perrot V. are employees of Ipsen Pharma S.A.U. The other authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Flowchart of the population in the study
Fig. 2
Fig. 2
Kaplan–Meier curves for time from LHRHa treatment date to Castration-Resistant Prostate Cancer (CRPC) diagnosis, per-protocol population (A) and stratification for metastatic vs non-metastatic patients (B)
See this image and copyright information in PMC

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