https://doi.org/10.4081/aiua.2023.11052

Prostate-specific antigen response after Abiraterone treatment in mCRPC: PSA as a predictor of overall survival

Vol. 95 No. 1 (2023)
Submitted: December 2, 2022
Accepted: December 31, 2022
Published: February 22, 2023
Abiraterone, mCRPC, PSA, Overall survival, Progression free survival
Abstract Views: 1016
PDF: 603
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Authors

Alexandre Mendonça Macedo
alex.m.macedo89@gmail.com
https://orcid.org/0000-0003-3907-7753
Urology Department, Hospital Garcia de Orta EPE, Almada; Oncology Department, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal.
Rita Gameiro Marques
https://orcid.org/0000-0002-4292-6552
Oncology Department, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal.
Margarida Cunha André
https://orcid.org/0000-0002-5918-8621
Urology Department, Hospital Garcia de Orta EPE, Almada, Portugal.
Nuno Silva Figueira
Urology Department, Hospital Garcia de Orta EPE, Almada, Portugal.
Miguel Leal Carvalho
https://orcid.org/0000-0001-9087-2109
Urology Department, Hospital Garcia de Orta EPE, Almada, Portugal.

Objectives: Abiraterone Acetate (AA) is an important agent in the treatment of advanced prostate cancer. It was primarily approved for the treatment of metastatic castration-resistant prostate cancer (mCRPC) after failure of androgen deprivation therapy. There is still no available strong data regarding the impact of early decline of prostate-specific antigen (PSA) in the overall survival. The aim of this study was to evaluate the clinical efficacy of an early prostate-specific antigen response as a predictor of overall survival (OS) in metastatic castration-resistant prostate cancer when treated with Abiraterone Acetate.

Materials and methods: A dual center, retrospective, cohort study on patients diagnosed with mCRPC treated with abiraterone between 2013 and 2020 was performed. Primary end-point was to demonstrate the efficacy of AA, with the analysis of PSA decline, and the correlation with overall survival.

Results: The cohort analysis consisted of 84 patients with a median age of 71 ± 9 years. A PSA response of > 30% and > 50% at 60 and 90 days was associated with improved OS. Multivariate analysis revealed that a 60 day PSA decline of > 30% was predictive of overall survival. Median OS of diag-nosed mCRPC patients was 28 months. Docetaxel pre-treatment was not associated with longer OS. The median duration of drug exposure for patients submitted to AA was found to be 14 months.

Conclusions: Early PSA response rate can offer clinically meaningful information and can be considered a surrogate of longer OS. A > 30% or > 50% prostate-specific antigen decline at 60 and 90 days provided an important low-cost clinical tool to predict subsequent events in mCRPC patients treated with abiraterone.

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Crossref
Scopus
Google Scholar
Europe PMC
Torre LA, et al. Global cancer statistics, 2012. CA Cancer J Clin. 2015; 65:87-108. DOI: https://doi.org/10.3322/caac.21262
Sartor O, de Bono JS. Metastatic prostate cancer. N Engl J Med. 2018; 378:645-657. DOI: https://doi.org/10.1056/NEJMra1701695
Ryan CJ, Smith MR, de Bono JS, et al. Abiraterone in metastatic prostate cancer without previous chemotherapy. N Engl J Med. 2013; 368:138-148. DOI: https://doi.org/10.1056/NEJMx130004
Beer TM, Armstrong AJ, Rathkopf DE, et al. Enzalutamide in metastatic prostate cancer before chemotherapy. N Engl J Med. 2014; 371:424-33. DOI: https://doi.org/10.1056/NEJMoa1405095
Fizazi K, Scher HL, Molina A et al. Abiraterone acetate for treat-ment of metastatic castration-resistant prostate cancer: final overall survival analysis of the COU-AA 301 randomised, double-blind, placebo-controlled Phase III study. Lancet Oncol. 2012; 13:983-925. DOI: https://doi.org/10.1016/S1470-2045(12)70379-0
Schlack K, Krabbe LM, Fobker M, et al. Early Prediction of Therapy Response to Abiraterone Acetate Using PSA Subforms in Patients with Castration Resistant Prostate Cancer. Int J Mol Sci. 2016; 17:1520. DOI: https://doi.org/10.3390/ijms17091520
Facchini Halabi A, Armstrong AJ, Sartor O, et al. Prostate-specif-ic antigen changes as surrogate for overall survival in men with metastatic castration-resistant prostate cancer treated with second-line chemotherapy. J Clin Oncol. 2013; 31:3944-3950. DOI: https://doi.org/10.1200/JCO.2013.50.3201
Verzoni E, de Giorgi U, Derosa L, et al. Predictors of long-term response to abiraterone in patients with metastatic castration-resist-ant prostate cancer: a retrospective cohort study. Oncotarget. 2016; 7:40085-40094. DOI: https://doi.org/10.18632/oncotarget.9485
Izumi K, Mizokami A, Namiki M, et al. Enzalutamide versus abi-raterone as a first-line endocrine therapy for castration-resistant prostate cancer (ENABLE study for PCa): a study protocol for a mul-ticenter randomized phase III trial. BMC Cancer. 2017; 17:677. DOI: https://doi.org/10.1186/s12885-017-3661-2
Jarimba RS, Eliseu MN, Pedroso Lima J, et al. Novel hormonal agents for metastatic Castration-Resistant Prostate Cancer: compar-ing outcomes. A single-center retrospective study. Arch Ital Urol Androl. 2021; 93:393-8. DOI: https://doi.org/10.4081/aiua.2021.4.393
Gomella LG, Oliver Sartor A. The current role and limitations of surrogate endpoints in advanced prostate cancer. Urol Oncol. 2014; 32:28.e1-9. DOI: https://doi.org/10.1016/j.urolonc.2012.10.001
Rescigno P, Lorente D, Bianchini D, et al. Prostate-specific anti-gen decline after 4 weeks of treatment with abiraterone acetate and overall survival in patients with metastatic castration-resistant prostate cancer. Eur Urol. 2016; 70:724-731. DOI: https://doi.org/10.1016/j.eururo.2016.02.055

How to Cite

Mendonça Macedo, A., Gameiro Marques, R., Cunha André, M., Silva Figueira, N., & Leal Carvalho, M. (2023). Prostate-specific antigen response after Abiraterone treatment in mCRPC: PSA as a predictor of overall survival. Archivio Italiano Di Urologia E Andrologia, 95(1). https://doi.org/10.4081/aiua.2023.11052
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