The association between radiographic response and overall survival in men with metastatic castration-resistant prostate cancer receiving chemotherapy

Guru Sonpavde, Gregory R. Pond, William R. Berry, Ronald De Wit, Mario Eisenberger, Ian F. Tannock, Andrew J. Armstrong

Research output: Contribution to journalArticle

Abstract

Background: In men with metastatic castration-resistant prostate cancer (CRPC), the association of measurable tumor responses with overall survival (OS) is unknown. The authors retrospectively evaluated the TAX327 phase 3 trial to study this relation. Methods: Eligible patients for this analysis included those with World Health Organization (WHO)-defined measurable metastatic disease randomized to receive either docetaxel or mitoxantrone. OS was estimated by using the Kaplan-Meier method, and the prognostic relation of WHO-defined radiologic response with OS was performed by using Cox proportional hazards regression. Landmark analyses evaluated survival from baseline and at 2, 3, 4, and 6 months after baseline. Results: Four hundred twelve patients enrolled on the TAX327 trial had measurable tumors. Thirty-seven patients exhibited a complete or partial objective response (CR/PR, 9.0%), 116 had stable disease (SD, 28.2%), 99 had progressive disease (PD, 24%) and 160 (38.8%) did not have a after-baseline objective assessment. Partial responders demonstrated longer median OS (29.0 months) than patients with SD (22.1 months) or those with PD (10.8 months) or those who were not assessed (12.7 months). These results remained after landmark analysis. The authors found a significant association between ≥30% prostate-specific antigen (PSA) declines and radiologic response, with ≥30% PSA declines occurring in all patients with CR/PR, 79.8% of patients with SD, and 34.4% with PD. Radiologic response remained a significant but modest post-treatment prognostic factor for OS after adjusting for treatment, pain response, and ≥30% PSA decline (P =.009). Conclusions: In men with metastatic CRPC and measurable disease receiving chemotherapy, objective tumor response was prognostic for OS and appeared to complement PSA assessment.

Original languageEnglish (US)
Pages (from-to)3963-3971
Number of pages9
JournalCancer
Volume117
Issue number17
DOIs
StatePublished - Sep 1 2011

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Castration
Prostatic Neoplasms
Prostate-Specific Antigen
Drug Therapy
Survival
docetaxel
Neoplasms
Mitoxantrone
Survival Analysis
Pain
Therapeutics

Keywords

  • castration-resistant prostate cancer
  • measurable disease
  • overall survival
  • PSA response
  • WHO response

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

The association between radiographic response and overall survival in men with metastatic castration-resistant prostate cancer receiving chemotherapy. / Sonpavde, Guru; Pond, Gregory R.; Berry, William R.; De Wit, Ronald; Eisenberger, Mario; Tannock, Ian F.; Armstrong, Andrew J.

In: Cancer, Vol. 117, No. 17, 01.09.2011, p. 3963-3971.

Research output: Contribution to journalArticle

Sonpavde, Guru ; Pond, Gregory R. ; Berry, William R. ; De Wit, Ronald ; Eisenberger, Mario ; Tannock, Ian F. ; Armstrong, Andrew J. / The association between radiographic response and overall survival in men with metastatic castration-resistant prostate cancer receiving chemotherapy. In: Cancer. 2011 ; Vol. 117, No. 17. pp. 3963-3971.
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title = "The association between radiographic response and overall survival in men with metastatic castration-resistant prostate cancer receiving chemotherapy",
abstract = "Background: In men with metastatic castration-resistant prostate cancer (CRPC), the association of measurable tumor responses with overall survival (OS) is unknown. The authors retrospectively evaluated the TAX327 phase 3 trial to study this relation. Methods: Eligible patients for this analysis included those with World Health Organization (WHO)-defined measurable metastatic disease randomized to receive either docetaxel or mitoxantrone. OS was estimated by using the Kaplan-Meier method, and the prognostic relation of WHO-defined radiologic response with OS was performed by using Cox proportional hazards regression. Landmark analyses evaluated survival from baseline and at 2, 3, 4, and 6 months after baseline. Results: Four hundred twelve patients enrolled on the TAX327 trial had measurable tumors. Thirty-seven patients exhibited a complete or partial objective response (CR/PR, 9.0{\%}), 116 had stable disease (SD, 28.2{\%}), 99 had progressive disease (PD, 24{\%}) and 160 (38.8{\%}) did not have a after-baseline objective assessment. Partial responders demonstrated longer median OS (29.0 months) than patients with SD (22.1 months) or those with PD (10.8 months) or those who were not assessed (12.7 months). These results remained after landmark analysis. The authors found a significant association between ≥30{\%} prostate-specific antigen (PSA) declines and radiologic response, with ≥30{\%} PSA declines occurring in all patients with CR/PR, 79.8{\%} of patients with SD, and 34.4{\%} with PD. Radiologic response remained a significant but modest post-treatment prognostic factor for OS after adjusting for treatment, pain response, and ≥30{\%} PSA decline (P =.009). Conclusions: In men with metastatic CRPC and measurable disease receiving chemotherapy, objective tumor response was prognostic for OS and appeared to complement PSA assessment.",
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T1 - The association between radiographic response and overall survival in men with metastatic castration-resistant prostate cancer receiving chemotherapy

AU - Sonpavde, Guru

AU - Pond, Gregory R.

AU - Berry, William R.

AU - De Wit, Ronald

AU - Eisenberger, Mario

AU - Tannock, Ian F.

AU - Armstrong, Andrew J.

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AB - Background: In men with metastatic castration-resistant prostate cancer (CRPC), the association of measurable tumor responses with overall survival (OS) is unknown. The authors retrospectively evaluated the TAX327 phase 3 trial to study this relation. Methods: Eligible patients for this analysis included those with World Health Organization (WHO)-defined measurable metastatic disease randomized to receive either docetaxel or mitoxantrone. OS was estimated by using the Kaplan-Meier method, and the prognostic relation of WHO-defined radiologic response with OS was performed by using Cox proportional hazards regression. Landmark analyses evaluated survival from baseline and at 2, 3, 4, and 6 months after baseline. Results: Four hundred twelve patients enrolled on the TAX327 trial had measurable tumors. Thirty-seven patients exhibited a complete or partial objective response (CR/PR, 9.0%), 116 had stable disease (SD, 28.2%), 99 had progressive disease (PD, 24%) and 160 (38.8%) did not have a after-baseline objective assessment. Partial responders demonstrated longer median OS (29.0 months) than patients with SD (22.1 months) or those with PD (10.8 months) or those who were not assessed (12.7 months). These results remained after landmark analysis. The authors found a significant association between ≥30% prostate-specific antigen (PSA) declines and radiologic response, with ≥30% PSA declines occurring in all patients with CR/PR, 79.8% of patients with SD, and 34.4% with PD. Radiologic response remained a significant but modest post-treatment prognostic factor for OS after adjusting for treatment, pain response, and ≥30% PSA decline (P =.009). Conclusions: In men with metastatic CRPC and measurable disease receiving chemotherapy, objective tumor response was prognostic for OS and appeared to complement PSA assessment.

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KW - WHO response

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