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Clinical progression is associated with poor prognosis whatever the treatment line in metastatic castration resistant prostate cancer: The CATS international database

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  • Nicolas Delanoy
  • Anne-Claire Hardy-Bessard
  • Eleni Efstathiou
  • Sylvestre Le Moulec
  • Umberto Basso
  • Alison Birtle
  • Alastair Thomson
  • Michael Krainer
  • Aline Guillot
  • Ugo De Giorgi
  • Ali Hasbini
  • Gedske Daugaard
  • Amit Bahl
  • Simon Chowdhury
  • Orazio Caffo
  • Philippe Beuzeboc
  • Dominique Spaeth
  • Jean-Christophe Eymard
  • Aude Fléchon
  • Jerome Alexandre
  • Carole Helissey
  • Mohamed Butt
  • Frank Priou
  • Eric Lechevallier
  • Jean-Laurent Deville
  • Marine Gross-Goupil
  • Rafael Morales
  • Antoine Thiery-Vuillemin
  • Tatiana Gavrikova
  • Philippe Barthélémy
  • Avishay Sella
  • Karim Fizazi
  • Jean-Marc Ferrero
  • Brigitte Laguerre
  • Constance Thibault
  • Sophie Hans
  • Stéphane Oudard
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AIM OF THE STUDY: Our goal was to evaluate the impact of progression type (prostate-specific antigen [PSA] only, radiological or clinical) at initiation of first-, second- and third life-extending therapy (LET) on treatment outcomes in metastatic castration-resistant prostate cancer (mCRPC) patients, by performing a post-hoc analysis using data from the CATS international registry.

METHODS: The 669 consecutive mCRPC patients of the CATS registry were classified according to their type of progression at initiation of each LET: PSA only (PSA-p), radiological (±PSA) (Radio-p); or clinical (±PSA, ±radiological) progression (Clin-p). Overall survival (OS), the primary endpoint, was calculated from initiation of the first-, second- and third-LET to death for each sequence.

RESULTS: Median OS was shorter in the Clin-p group compared with the PSA-p group (14-month difference in first line; around 7-month difference in second- and third line). Shorter progression-free survival (PFS) was also observed in Clin-p patients, whatever the treatment is. Clinical progression seemed to be associated with a shorter duration of therapy with androgen receptor-targeted therapy (ART) compared with taxanes.

CONCLUSIONS: Clinical progression at initiation of a LET is associated with poor outcomes including shorter PFS and OS as well as clinical and biological features of aggressive disease. Stratifying patients in clinical trials according to disease progression type may prevent selection bias and data heterogeneity. In daily practice, first signs of clinical progression may prompt physicians to consider starting a new LET, independently of PSA levels.

OriginalsprogEngelsk
TidsskriftEuropean Journal of Cancer
Vol/bind125
Sider (fra-til)153-163
Antal sider11
ISSN0959-8049
DOI
StatusUdgivet - jan. 2020

Bibliografisk note

Funding Information:
This work was supported by the ARTIC association.

Funding Information:
Nicolas Delanoy has received travel expenses for participation in medical meetings from Sanofi. Eleni Efstathiou has participated in studies and advisory boards for and received honoraria from Sanofi, Jannsen and Astellas and has participated in advisory boards for Tolmar, Takeda, Bayer and Tracon. Umberto Basso has received speaker fees from Bristol Meyer Squibb, Pfizer, Novartis, Pierre-Fabre and Sanofi and has participated in advisory boards for Janssen, Pfizer and Novartis. Alison Birtle has participated in an advisory board and received an educational grant from Sanofi Aventis  and has participated in advisory boards for Janssen , Astellas , Bayer  and Roche . Alastair Thomson has received speaker fees for Roche and travel support from Merck and Astellas. Michael Krainer has acted in an advisory role or provided expert testimony for Jannsen, Astellas, Dendreon, Sanofi-Aventis and Medivation and has received research funding from BMS , Astellas, Medivation , Pfizer , Sotio  and Sanofi Aventis. Ugo De Giorgi has participated in advisory boards for and received travel support for participation in medical meetings from Sanofi, BMS, Astellas, Janssen, Novartis, Ipsen and Roche. Ali Hasbini has participated in advisory boards for and received travel support for participation in medical meetings from Sanofi, Astellas, Janssen, Pfizer, Novartis and Ferring. Gedske Daugaard has participated in advisory boards for and received travel support for participation in medical meetings from Sanofi, Astellas, Bayer and Janssen. Amit Bahl has participated in advisory boards for Janssen, Sanofi, BMS and Roche; has received support for meetings from Sanofi, Janssen, Astellas, Bayer , Roche, and Ipsen ; has received lecture honoraria from Sanofi, Janssen, Astellas, Bayer and Ipsen; and has received research grants from Sanofi and Janssen. Orazio Caffo has received honoraria as speaker or advisor for Astellas, Bayer, Janssen and Sanofi. Philippe Beuzeboc has received financial support from Sanofi and Jansen. Dominique Spaeth has participated in advisory boards for Sanofi, Novartis, Roche and Astra Zeneca and has received travel support for participation in medical meetings from Janssen, Novartis, Roche and Pierre Fabre Oncology. Jean-Christophe Eymard has acted as consultant, participated in speaker bureaus and advisory boards for, and received travel support for participation in medical meetings from Sanofi, Janssen, Astallas, Pfizer, Novartis and Sandoz. Aude Fléchon acted as consultant, participated in speaker bureaus and advisory boards for and received travel support for participation in medical meetings from Sanofi, Astellas, Bayer and Janssen. Jérôme Alexandre has acted as consultant and participated in advisory boards for and received travel support for participation in medical meetings from Janssen, Roche, Novartis, Ipsen and Astra Zeneca. Carole Helissey has participated in scientific advisory boards for and received travel support for participation in medical meetings from Sanofi, Astellas, Janssen and Roche. Frank Priou has acted as consultant and participated in speaker bureaus and advisory boards for and received travel support for participation in medical meetings from Sanofi, BMS, Astellas, Bayer, Janssen, Pfizer, Novartis, Roche and Merck. Éric Lechevallier has acted as consultant and participated in speaker bureaus and advisory boards for and received travel support for participation in medical meetings from Sanofi, Astellas, Bayer, Janssen, Pfizer and Novartis. Jean-Laurent Deville has acted as consultant and participated in speaker bureaus and advisory boards for and received travel support for participation in medical meetings from Sanofi, Astellas, Janssen, Pfizer and Novartis. Marine Grosse Goupil has acted as consultant and participated in speaker bureaus and advisory boards for, and received travel support for participation in medical meetings from Sanofi, BMS, Astellas, Bayer, Janssen, Pfizer, Novartis, Roche and MSD. Antoine Thiery-Vuillemin has acted as consultant and participated in advisory boards for and received travel support for participation in medical meetings from Astellas, Sanofi and JNJ and has acted as consultant and participated in speaker bureaus and advisory boards for and received travel support for participation in medical meetings from BMS, Pfizer, Novartis and Roche. Philippe Barthelemy has participated in advisory boards for and received travel support for participation in medical meetings from Sanofi, BMS, Astellas, Bayer, Janssen, Pfizer, Novartis, Roche and Ipsen. Avishay Sella has received consultancy fees and honoraria from Sanofi, Astellas and Jansen Cillag. Karim Fizazi has acted as consultant and participated in advisory boards for CureVac, Sanofi, Astellas, Bayer, Janssen, Amgen, Merck and Orion. Brigitte Laguerre has acted as consultant and participated in advisory boards for and received travel support for participation in medical meetings from: Sanofi, BMS, Bayer, Janssen, Pfizer, Novartis and Merck. Sophie Hans has received financial support from Sanofi, Roche, BMS and Amgen. Stéphane Oudard has received consulting fees, travel support and honorarium from Sanofi, Astellas, Bayer and Janssen during the conduct of the study. Anne-Claire Hardy-Bessard, Sylvestre Le Moulec, Aline Guillot, Simon Chowdhury, Mohamed Butt, Rafael Morales, Tatiana Gavrikova and Jean-Marc Fererro have nothing to disclose. Appendix A

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