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Predictors of early androgen deprivation treatment failure in prostate cancer with bone metastases
Linköping University, Department of Clinical and Experimental Medicine, Urology. Linköping University, Faculty of Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Urology in Östergötland.
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences.
EpiStat, Sweden.
Karolinska Institute, Sweden.
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2016 (English)In: Cancer Medicine, ISSN 2045-7634, E-ISSN 2045-7634, Vol. 5, no 3, 407-414 p.Article in journal (Refereed) PublishedText
Abstract [en]

Approximately 15% of men with hormone naive 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 12months 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.

Place, publisher, year, edition, pages
WILEY-BLACKWELL , 2016. Vol. 5, no 3, 407-414 p.
Keyword [en]
Androgen deprivation treatment; bone metastases; clinical predictors; early failure; prostate cancer
National Category
Clinical Medicine
URN: urn:nbn:se:liu:diva-127443DOI: 10.1002/cam4.594ISI: 000373203000003PubMedID: 26765317OAI: diva2:925215

Funding Agencies|Ferring AB Malmo, Sweden; Ferring Laegemidler A/S Copenhagen, Denmark; Pharmacia AB, Uppsala, Sweden; Schering-Plough AB, Stockholm, Sweden

Available from: 2016-04-30 Created: 2016-04-26 Last updated: 2016-05-17

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Varenhorst, EberhardKlaff, Rami
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UrologyFaculty of Health SciencesDepartment of Urology in ÖstergötlandDepartment of Clinical and Experimental MedicineFaculty of Medicine and Health Sciences
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