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

Delanoy, Nicolas; Hardy-Bessard, Anne Claire; Efstathiou, Eleni; Moulec, Sylvestre Le; Basso, Umberto; Birtle, Alison; Thomson, Alastair; Krainer, Michael; Guillot, Aline; Giorgi, Ugo De; Hasbini, Ali; Daugaard, Gedske; Bahl, Amit; Caffo, Orazio; Beuzeboc, Philippe; Spaeth, Dominique; Eymard, Jean Christophe; Fléchon, Aude; Alexandre, Jérôme; Hélissey, Carole; Butt, Mohamed; Priou, Frank; Lechevallier, É.; Deville, Jean Laurent; Gross‐Goupil, Marine; Morales, Rafael; Thiery‐Vuillemin, Antoine; Gavrikova, Tatiana; Barthélémy, Philippe; Sella, Avishay; Fizazi, Karim; Ferrero, Jean Marc; Laguerre, Brigitte; Thibault, Constance; Hans, Sophie; Oudard, Stéphane

doi:10.1016/j.ejca.2019.10.030

Cited by 5 publications

(6 citation statements)

References 23 publications

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“…As expected, patients in the present study had more disease-related symptoms at rechallenge than when chemotherapy-naïve, reflecting the more advanced status of their disease, and may explain the reduced PSA response rate (87% vs. 30%) and median PFS (9.5 vs. 4.6 months). In contrast, it is of note that the observed median OS of 24.3 months compared favorably with results of studies in the salvage setting [ 13 14 ]. In a retrospective study evaluating cabazitaxel rechallenge in mCRPC patients [ 14 ], rechallenge cabazitaxel resulted in a PSA response of 24% and a median PFS of 7.8 months.…”

Section: Discussionsupporting

confidence: 61%

Docetaxel rechallenge in metastatic castration-resistant prostate cancer: A retrospective, single-center study

Byeon

Kim

et al. 2020

Investig Clin Urol

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Purpose To assess the efficacy and safety of docetaxel rechallenge in the salvage setting in metastatic castration-resistant prostate cancer (mCRPC) patients. Materials and Methods Clinicopathologic data from patients treated with docetaxel rechallenge were collected from a single-center cancer registry. Among 227 patients who received first-line docetaxel for mCRPC between January 2011 and June 2019, 23 undergo rechallenge docetaxel after failure to androgen receptor targeting agents and/or cabazitaxel treatment. Endpoints included radiologic progression-free survival (PFS), treatment duration, and prostate-specific antigen (PSA) response and safety. Results Overall, 30%, 44%, 13%, and 13% of patients received docetaxel rechallenge as either the third, fourth, fifth, or sixth-line therapy, respectively, at a median of 23.6 months after stopping first-line docetaxel. With first-line docetaxel and rechallenge, median treatment duration was 6.4 and 3.3 months, respectively. With docetaxel rechallenge, PSA response was 35% (95% confidence interval [CI], 15% to 54%) and median PFS was 4.5 months (95% CI, 1.9 to 7.1 months). The median OS was 24.3 months (95% CI, 4.6 to 44.0 months). There were 7 severe adverse events (grade 3 or more) including anemia (8.7%), neutropenia, thrombocytopenia, leukopenia, diarrhea, and nausea (4.3% each). Conclusions Docetaxel rechallenge showed meaningful anti-tumor activity with acceptable toxicity in heavily pretreated patients with mCRPC.

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Section: Discussionsupporting

confidence: 61%

Docetaxel rechallenge in metastatic castration-resistant prostate cancer: A retrospective, single-center study

Byeon

Kim

et al. 2020

Investig Clin Urol

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“…23,24 Since pain progression is consistently associated with aggressive disease and worse overall survival, it is important to adequately manage such patients. 12,28 The present results demonstrate that patients receiving cabazitaxel have a greater pain response and longer 20 time to pain progression compared with patients receiving a second androgen-signalingtargeted inhibitor.…”

Section: Discussionmentioning

confidence: 60%

“…Similar findings were reported in a large retrospective registry of 661 patients with mCRPC treated in clinical practice. 28 This possibly reflects recommendations of international guidelines and consensus conferences to continue androgen-signaling-targeted inhibitors until unequivocal signs of progression (i.e. imaging-based and/or clinical progression) before switching therapy.…”

Section: Discussionmentioning

confidence: 84%

Quality of life in patients with metastatic prostate cancer following treatment with cabazitaxel versus abiraterone or enzalutamide (CARD): an analysis of a randomised, multicentre, open-label, phase 4 study

Fizazi

Kramer

Eymard

et al. 2020

The Lancet Oncology

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“…In a post hoc analysis of three randomized phase III studies in first-line mCRPC (TAX-327, VENICE, FIRSTANA), we recently reported that pain progression at chemotherapy initiation was associated with worse outcome [20]. These findings were supported by the large international CATS registry, suggesting that clinical progression at the initiation of a life-extending therapy was associated with a shorter OS, not only in first-line mCRPC, but also in second and third-line settings, whatever the therapy (DOC, CABA, or ARTA) [21]. Moreover, clinical progression seemed to be associated with a shorter duration of therapy with ARTA compared with taxanes.…”

Section: Introductionmentioning

confidence: 67%

“…Although phase III studies cannot be compared between each other, it is likely that pain severity at baseline contributed to the~1-year difference in survival outcomes observed in chemotherapy studies in first-line mCRPC patients [3,22,27], and in phase III studies with abiraterone [28] and enzalutamide [2,29] in chemo-naïve patients. The poor prognostic value of clinical progression has also been observed at initiation of each therapy line in the large retrospective CATS registry [21,30] that enrolled 661 patients treated with 3 lifeextending therapies (DOC, CABA, and one ARTA) in any order. Clinical progression defined by alteration of ECOG-PS or pain progression was the most common progression type, regardless the therapy line and its prevalence increased with the number of lines (from 43.1% at initiation of first-line therapy to 67.9% at initiation of third-line therapy).…”

Section: Discussionmentioning

confidence: 93%

Pain Progression at Initiation of Cabazitaxel in Metastatic Castration-Resistant Prostate Cancer (mCRPC): A Post Hoc Analysis of the PROSELICA Study

Delanoy

Robbrecht

Eisenberger

et al. 2021

Cancers

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Background: In the PROSELICA phase III trial (NCT01308580), cabazitaxel 20 mg/m2 (CABA20) was non-inferior to cabazitaxel 25 mg/m2 (CABA25) in mCRPC patients previously treated with docetaxel (DOC). The present post hoc analysis evaluates how the type of progression at randomization affected outcomes. Methods: Progression type at randomization was defined as follows: PSA progression only (PSA-p; no radiological progression (RADIO-p), no pain), RADIO-p (±PSA-p, no pain), or pain progression (PAIN-p, ±PSA-p, ±RADIO-p). Relationships between progression type and overall survival (OS), radiological progression-free survival (rPFS), and PSA response (confirmed PSA decrease ≥ 50%) were analyzed. Results: All randomized patients (n = 1200) had received prior DOC, and 25.7% had received prior abiraterone or enzalutamide. Progression type at randomization was evaluable in 1075 patients (PSA-p = 24.4%, RADIO-p = 20.8%, PAIN-p = 54.8%). Pain progression was associated with clinical and biological features of aggressive disease. Median OS from CABA initiation or date of mCRPC diagnosis, all arms combined, was shorter in the PAIN-p group than in the RADIO-p or the PSA-p groups (12.0 versus 16.8 and 18.4 months, respectively, p < 0.001). In multivariate analysis, all arms combined, PAIN-p was an independent predictor of poor OS (HR = 1.44, p < 0.001). PSA response, rPFS, and OS were numerically higher with CABA25 versus CABA20 in patients with PAIN-p. Conclusions: This post hoc analysis of the PROSELICA phase III study shows that pain progression at initiation of CABA in mCRPC patients previously treated with DOC is associated with a poor prognosis. Disease progression should be carefully monitored, even in the absence of PSA rise.

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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

Cited by 5 publications

References 23 publications

Docetaxel rechallenge in metastatic castration-resistant prostate cancer: A retrospective, single-center study

Docetaxel rechallenge in metastatic castration-resistant prostate cancer: A retrospective, single-center study

Quality of life in patients with metastatic prostate cancer following treatment with cabazitaxel versus abiraterone or enzalutamide (CARD): an analysis of a randomised, multicentre, open-label, phase 4 study

Pain Progression at Initiation of Cabazitaxel in Metastatic Castration-Resistant Prostate Cancer (mCRPC): A Post Hoc Analysis of the PROSELICA Study

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