title: Predictors of long-term response to abiraterone in patients with metastastic castration-resistant prostate cancer: a retrospective cohort study.
abstract: We aimed to identify clinical predictors of long-term response to abiraterone (defined as >12 months drug exposure) in a retrospective cohort of metastatic castration-resistant prostate cancer patients treated in post-docetaxel setting at 24 Italian centers. The Cox proportional hazards model was used to analyze the association between clinical features and the duration of drug exposure. Results were expressed as hazard ratios (HR) with associated 95% confidence intervals (CI). A total of 143 patients met the inclusion criteria. Their median age was 73 years, median Gleason score 8 and median abiraterone exposure 20 months. At the univariate analysis, a significant correlation with the duration of abiraterone exposure was found for Gleason score (HR 0.82, 95% CI 0.71-0.96; p=0.012), PSA (HR 1.10, 95% CI 1.03-1.18; p=0.08) and lactic dehydrogenase levels (HR 1.22, 95% CI 1.02-1.46; p=0.027), while the association between lower alkaline phosphatase levels and treatment duration was marginally significant (HR 1.07, 95% CI 0.99-1.16; p=0.074). Only PSA and Gleason score were predictive of long-term treatment duration in the multivariate analysis. No other clinical factors resulted to be predictive of sustained response to abiraterone, including metastatic disease at diagnosis and visceral disease, suggesting that all subgroups of patients may derive a substantial clinical benefit from abiraterone treatment. These findings need to be validated in prospective, larger studies.
authors.affiliation: Unit of Medical Oncology 1, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Verzoni
authors.affiliation: Department of Medical Oncology, IRST, IRCCS, Meldola, Italy.
authors.forename: Ugo
authors.initials: U
authors.lastname: De Giorgi
authors.affiliation: Unit of Medical Oncology 2, Istituto Toscano Tumori, Pisa, Italy.
authors.forename: Lisa
authors.initials: L
authors.lastname: Derosa
authors.affiliation: Ospedale Santa Chiara, Trento, Italy.
authors.forename: Orazio
authors.initials: O
authors.lastname: Caffo
authors.affiliation: IRCCS AOU San Martino IST and University of Genoa, Genova, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Boccardo
authors.affiliation: Unit of Medical Oncology, Department of Uro-Gynecological Oncology, Istituto Nazionale Tumori, Fondazione G. Pascale IRCCS, Naples, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Facchini
authors.affiliation: Department of Oncology, IRCCS- Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Porcu
authors.affiliation: Istituto Clinico Humanitas, Rozzano, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: De Vincenzo
authors.affiliation: Fondazione Poliambulanza, Brescia, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Zaniboni
authors.affiliation: Ospedale Vito Fazzi, Lecce, Italy.
authors.forename: Vincenzo Emanuele
authors.initials: VE
authors.lastname: Chiuri
authors.affiliation: Istituto Nazionale Tumori CRO, Aviano, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Fratino
authors.affiliation: Policlinico Universitario Campus Biomedico, Roma, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Santini
authors.affiliation: Medical Oncology Unit, AO Papardo, Messina, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Adamo
authors.affiliation: Ospedale San Bortolo, Vicenza, Italy.
authors.forename: Rocco
authors.initials: R
authors.lastname: De Vivo
authors.affiliation: Ospedale San Carlo, Potenza, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Dinota
authors.affiliation: Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Messina
authors.affiliation: Niguarda Cancer Center, Ospedale Niguarda Ca' Granda, Milan, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Ricotta
authors.affiliation: AO Santa Maria, Terni, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Caserta
authors.affiliation: Ospedale S. Cuore di Gesù, Gallipoli, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Scavelli
authors.affiliation: Ospedale Madonna delle Grazie, Matera, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Susi
authors.affiliation: IRCCS Centro di Riferimento Oncologico della Basilicata (CROB), Rionero in Vulture, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Tartarone
authors.affiliation: Ospedale D. Camberlingo, Francavilla Fontana, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Surace
authors.affiliation: AOU Maggiore della Carità, Novara, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Mosca
authors.affiliation: PO San G. Moscati, ASL Taranto, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Bruno
authors.affiliation: AO, Treviglio, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Barni
authors.affiliation: Unit of Medical Oncology 1, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Grassi
authors.affiliation: Unit of Medical Oncology 1, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Procopio
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000736:Androstenes / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood; D000077143:Docetaxel; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D012189:Retrospective Studies; D043823:Taxoids / Q000627:therapeutic use
chemical_list: D000736:Androstenes; D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D043823:Taxoids; D000077143:Docetaxel; D017430:Prostate-Specific Antigen; C089740:abiraterone
keywords: abiraterone acetate; castration-resistant; predictive factors; prostate cancer; retrospective studies