TY - JOUR AU - Khalaf, Daniel Joseph AU - Avilés, Claudia M. AU - Azad, Arun A. AU - Sunderland, Katherine AU - Todenhöfer, Tilman AU - Eigl, Berhard J. AU - Finch, Daygen AU - Le, Lyly AU - Atwell, Andrew AU - Keith, Bruce AU - Kollmannsberger, Christian AU - Chi, Kim. N. PY - 2017/12/01 Y2 - 2024/03/28 TI - A prognostic model for stratifying clinical outcomes in chemotherapy-naive metastatic castration-resistant prostate cancer patients treated with abiraterone acetate JF - Canadian Urological Association Journal JA - CUAJ VL - 12 IS - 2 SE - Original Research DO - 10.5489/cuaj.4600 UR - https://cuaj.ca/index.php/journal/article/view/4600 SP - E47-52 AB - <p><strong>Introduction:</strong> Recently, a prognostic index including six risk factors (RFs) (unfavourable Eastern Cooperative Oncology Group performance status [ECOG PS], presence of liver metastases, short response to luteinizing hormone-releasing hormone [LHRH] agonists/ antagonists, low albumin, increased alkaline phosphatase [ALP] and lactate dehydrogenase [LDH]) was developed from the COUAA- 301 trial in post-chemotherapy metastatic castration-resistant prostate cancer (mCRPC) patients treated with abiraterone acetate. Our primary objective was to evaluate this model in a cohort of chemotherapy-naive mCRPC patients receiving abiraterone.</p><p><strong>Methods:</strong> We identified 197 chemotherapy-naive patients who received abiraterone at six BC Cancer Agency centres and who had complete information on all six RFs. Study endpoints were prostate-specific antigen (PSA) response rate (RR), time to PSA progression, time on treatment, and overall survival (OS). PSA RR and survival outcomes were compared using Χ<sup>2</sup> test and log-rank test. Multivariable Cox proportional hazard analysis was performed to identify RFs independently associated with OS.</p><p><strong>Results:</strong> Patients were classified into good (0‒1 RFs), intermediate (2‒3 RFs), and poor (4‒6 RFs) prognostic groups (33%, 52%, and 15%, respectively). For good-, intermediate-, and poor-risk patients, PSA RR (≥50% decline) was 60% vs. 42% vs. 40% (p=0.05); median time to PSA progression was 7.3 vs. 5.3 vs. 5.0 months (p=0.02); and median OS was 29.4 vs. 13.8 vs. 8.7 months (p&lt;0.0001).</p><p><strong>Conclusions:</strong> The six-factor prognostic index model stratifies clinical outcomes in chemotherapy-naive mCRPC patients treated with abiraterone. Identifying patients at risk of poor outcome is important for informing clinical practice and clinical trial design.</p> ER -