Abstract
Introduction
The overall survival (OS) of metastatic castration-resistant prostate cancer (mCRPC)
patients has improved since 2011 with the use of novel hormonal agents (NHAs). The
incidence of brain metastases (mets) has been reported to increase since 2004 with
the use of docetaxel, but not the incidence of visceral mets. Our objective was to
study whether the use of NHAs increases the risk of developing visceral or brain mets
(VBMs).
Patients and Methods
mCRPC patients with mets limited to bone (bmCRPC), treated at Tours University Hospital
between 2007 and 2015, were included retrospectively. The primary endpoint was to
determine whether treatment with NHAs was associated with an increased incidence of
VBMs. Secondary endpoints included the search for putative predictive factors to develop
VBMs.
Results
On 187 bmCRPC patients included, 65 developed VBMs. VBM incidence increased in bmCRPC
patients alive after 2011, compared to patients who died before (39.7 vs. 24.6%, P = .04). Meanwhile, their median OS increased from 16.3 months to 28.5 months (P = .01). The longer was the treatment with NHAs, the lower was the risk of VBMs (HR = 0.96,
95% CI [0.94; 0.99]), whereas age < 70 years (HR = 3.33, 95% CI [1.50; 7.40]) and
low PSA level at diagnosis (HR = 1.58, 95% CI [1.16; 2.15]) increased this risk.
Conclusion
Though retrospective, our results showed an increased incidence of VBMs in bmCRPC
patients after 2011. However, this was not associated with NHA exposure duration.
The role of NHA exposure remains unclear and needs further investigation.
Keywords
Abbreviations:
bmCRPC (Bone metastatic castration resistant prostate cancer), CNIL (« Commission Nationale de l'Informatique et des Libertés »), ISUP (International society of urological pathology), mCRPC (Metastatic castration resistant prostate cancer), mets (Metastases), NHA (Novel hormonal agent), OS (Overall survival), PCWG2 (Prostate cancer clinical trials working group), PSA (Prostate-specific antigen), VBM (Visceral and/or brain metastases), wo (Without)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: April 21, 2022
Accepted:
April 14,
2022
Received in revised form:
April 11,
2022
Received:
December 29,
2021
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
