Prognostic and predictive value of plasma testosterone levels in patients receiving first-line chemotherapy for metastatic castrate-resistant prostate cancer.

Abstract

BACKGROUND:

Biomarkers for metastatic castration-resistant prostatic cancer (mCRPC) are an unmet medical need.

METHODS:

The prognostic and predictive value for survival and response to salvage hormonal therapy (SHT) of baseline testosterone level (TL) was analysed in a cohort of 101 mCRPC patients participating in 9 non-hormonal first-line chemotherapy phase II-III trials. Inclusion criteria in all trials required a TL of <50 ng dl(-1).

RESULTS:

Median age: 70 years; visceral metastases: 19.8%; median prostate-specific antigen (PSA): 50.7 ng ml(-1); median TL: 11.5 ng dl(-1). Median overall survival (OS; 24.5 months) was significantly longer if baseline TL was above (High TL; n=52) than under (Low TL; n=49) the TL median value (32.7 vs 22.4 months, respectively; P=0.0162, hazard ratio (HR)=0.6). The presence of anaemia was an unfavourable prognostic factor (median OS: 20.6 vs 28.4 months; P=0.0025, HR=1.88 (CI95%: 1.01-3.48)). Patients presenting both anaemia and low testosterone had a worse outcome compared to those with one or none of them (median OS: 17.9 vs 22.4 vs 38.1 months; P=0.0024). High vs Low TL was associated with PSA response rate (55.6% vs 21.7%) in 41 patients receiving SHT.

CONCLUSION:

Testosterone level under castration range was a prognostic factor for survival mCRPC patients. The PSA response to SHT differed depending on TLs. Testosterone levels might help in treatment decision.

• Authors: A G de Liaño, O Reig, B Mellado, C Martin, E U Rull, J P Maroto
• Journal: British journal of cancer (Br J Cancer) Vol. 110 Issue 9 Pg. 2201-8 (Apr 29 2014) ISSN: 1532-1827 [Electronic] England
• PMID: 24722180 (Publication Type: Clinical Trial, Phase II, Clinical Trial, Phase III, Journal Article)

Chemical References

• Testosterone

Topics

• Aged
• Aged, 80 and over
• Humans
• Male
• Middle Aged
• Neoplasm Metastasis
• Predictive Value of Tests
• Prognosis
• Prostatic Neoplasms, Castration-Resistant (blood, drug therapy, mortality)
• Testosterone (blood)