TY - JOUR
T1 - Incidence and survival of castration-resistant prostate cancer patients with visceral metastases
T2 - results from the Dutch CAPRI-registry
AU - van den Bergh, Gijs P. A.
AU - Kuppen, Malou C. P.
AU - Westgeest, Hans M.
AU - Mehra, Niven
AU - Gerritsen, Winald R.
AU - Aben, Katja K. H.
AU - van Oort, Inge M.
AU - van Moorselaar, Reindert J. A.
AU - Somford, Diederik M.
AU - van den Eertwegh, Alfonsus J. M.
AU - Bergman, André M.
AU - van den Bergh, Alphonsus C. M.
AU - Uyl-de Groot, Carin A.
N1 - Funding Information:
This research was funded by Sanofi-Aventis Netherlands B.V., Janssen-Cilag B.V., Astellas Pharma B.V., and Bayer B.V. The funding organizations had no role in the design and conduct of the study, collection, management, analysis, interpretation of the data, and preparation, review, or approval of the abstract.
Funding Information:
GPAvdB and MCPK report no conflict of interest. HMW reports travel expenses from Astellas and Ipsen; honoraria from Astellas and Roche. NM reports advisory role for Astellas, AstraZeneca, Janssen, JNJ, MSD, Pfizer, and Roche; funding (institutional and/or personal) from Astellas, Janssen and Pfizer; research grants (institutional) from AstraZeneca and BMS; coordinating PI (institutional) for BMS and Jansen; and non-financial interests (leadership-role or PI) in Castration-resistant Prostate Cancer Registry, Dutch Uro-Oncology Study Group and Prospective Bladder Cancer Infrastructure (Netherlands). WRG reports speaker fees (institutional and/or personal) from MSD; advisory role (institutional) for Bristol-Myers Squibb and Bayer; research grants (institutional) from Astellas, Bayer, Janssen-Cilag and MSD. KKHA reports no conflict of interest. IMvO reports conflicts of interest for Astellas, Bayer, Jansen, MSD/Astra and AAA Novartis. RJAvM reports conflicts of interest for Astellas, AstraZeneca, Bayer, Janssen, Pantarhei Oncology and Sanofi-Genzyme. DMS reports research grants/funding (institution) from Astellas, Besins and Dutch Cancer Society; Advisory/consultancy role for Astellas, Janssen, Bayer and MSD; contracted research (institution) for Janssen, Eli Lilly, Astellas, Blue Earth Diagnostics, Bayer, SPL medical and QED therapeutics. AJMvdE reports study grants from Sanofi, Roche, Bristol-Myers Squibb, TEVA and Idera; travel expenses from MSD Oncology, Roche, Pfizer and Sanofi; speaker honoraria from Bristol-Myers Squibb and Novartis; advisory role for Bristol-Myers Squibb, MSD Oncology, Amgen, Roche, Novartis, Sanofi, Pfizer, Ipsen, Merck and Pierre Fabre. AMB reports conflicts of interest for Astellas, Sanofi, Bayer and Janssen. ACMvdB and CAUdG report no conflict of interest.
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2023/3
Y1 - 2023/3
N2 - Background: The objective of this real-world population study is to investigate incidence and treatment of visceral metastases (VMs) in castration resistant prostate cancer (CRPC) patients and their survival. Methods: CRPC-patients in the CAPRI-registry between 2010 and 2016 were included in the analyses and followed till 2017. Outcomes were proportion of patients radiologically screened for VMs and proportion of patients with VMs at CRPC-diagnosis and at the start of every treatment line. Groups have been created based on location of VMs (lung, liver, or both) at date of first VM diagnosis. The outcome for these groups was overall survival (OS). Statistics included descriptive analyses, Kaplan-Meier method, and Cox proportional hazard regression analysis for survival analyses. Results: Of 3602 patients from the CAPRI registry, 457 patients (12.7%) were diagnosed with VMs during follow-up: 230 patients with liver, 161 with lung, and 66 with both liver and lung metastases. The proportion of patients radiologically screened for VMs increased per treatment line as did the occurrence rate of VMs. However, 80% of patients at CRPC diagnosis to 40% in the 6th line were not screened for VMs at the start of a systemic treatment. Median OS was 8.6 months for patients with liver, 18.3 with lung and 10.9 with both liver and lung metastases (p < 0.001) from date of first VM diagnosis. After correction for prognostic factors patients with lung metastases had significantly better OS than patients with liver metastases (HR 0.650, p = 0.001). Conclusion: This real-world analysis showed that despite the increased rate of radiological staging during follow-up, still 80% to 40% of the patients (CRPC diagnosis to 6th treatment line respectively) were not screened for VMs at the start of a systemic treatment. VMs and location of VMs are key prognostic patient characteristics, impacts survival and have implications for treatment decisions, so routine staging of CRPC-patients is warranted. Clinical trial identification: The CAPRI study is registered in the Dutch Trial Registry as NL3440 (NTR3591).
AB - Background: The objective of this real-world population study is to investigate incidence and treatment of visceral metastases (VMs) in castration resistant prostate cancer (CRPC) patients and their survival. Methods: CRPC-patients in the CAPRI-registry between 2010 and 2016 were included in the analyses and followed till 2017. Outcomes were proportion of patients radiologically screened for VMs and proportion of patients with VMs at CRPC-diagnosis and at the start of every treatment line. Groups have been created based on location of VMs (lung, liver, or both) at date of first VM diagnosis. The outcome for these groups was overall survival (OS). Statistics included descriptive analyses, Kaplan-Meier method, and Cox proportional hazard regression analysis for survival analyses. Results: Of 3602 patients from the CAPRI registry, 457 patients (12.7%) were diagnosed with VMs during follow-up: 230 patients with liver, 161 with lung, and 66 with both liver and lung metastases. The proportion of patients radiologically screened for VMs increased per treatment line as did the occurrence rate of VMs. However, 80% of patients at CRPC diagnosis to 40% in the 6th line were not screened for VMs at the start of a systemic treatment. Median OS was 8.6 months for patients with liver, 18.3 with lung and 10.9 with both liver and lung metastases (p < 0.001) from date of first VM diagnosis. After correction for prognostic factors patients with lung metastases had significantly better OS than patients with liver metastases (HR 0.650, p = 0.001). Conclusion: This real-world analysis showed that despite the increased rate of radiological staging during follow-up, still 80% to 40% of the patients (CRPC diagnosis to 6th treatment line respectively) were not screened for VMs at the start of a systemic treatment. VMs and location of VMs are key prognostic patient characteristics, impacts survival and have implications for treatment decisions, so routine staging of CRPC-patients is warranted. Clinical trial identification: The CAPRI study is registered in the Dutch Trial Registry as NL3440 (NTR3591).
UR - https://www.scopus.com/pages/publications/85139497105
U2 - 10.1038/s41391-022-00605-7
DO - 10.1038/s41391-022-00605-7
M3 - Article
C2 - 36224377
SN - 1365-7852
VL - 26
SP - 162
EP - 169
JO - Prostate cancer and prostatic diseases
JF - Prostate cancer and prostatic diseases
IS - 1
ER -
SDG 3 Good Health and Well-being