Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

In metastatic hormone-sensitive prostate cancer, prior local therapy is linked to improved survival

Abdel-Rahman O and Cheung W. Clinical Genitourinary Cancer; published online 21 July 2018 https://doi.org/10.1016/j.clgc.2018.07.007

Key clinical point: Patients with metastatic hormone-sensitive prostate cancer (HSPC) and prior local treatment have better overall, progression-free and cancer-specific survivals compared to those without prior local treatment.

Major finding: In a multivariate model adjusted for assigned study treatment arm, age, baseline PSA, and baseline Gleason score, volume of the disease (low risk or high risk) and baseline performance status), patients with prior local treatment had better overall survival (P =0.045), progression-free survival (P= 0.035) and cancer-specific survival (P= 0.010) compared to those without prior local treatment. Moreover, they have a longer time to development of castrate-resistant disease (P=0.025).

Study details: This is a retrospective secondary analysis of the prospectively collected data among 789 patients with metastatic HSPC in the CHAARTED study which is a phase III multicenter study conducted between 2006 and 2014. CHAARTED compared androgen deprivation therapy (ADT) plus docetaxel versus ADT alone among patients with metastatic HSPC. Of the 789 cases, 575 patients did not receive prior local treatment to the prostate. Ofthe 214 patients who had prior local treatment, 154 patients (72%) underwent prostatectomy and 60 patients (28%) underwent radical radiotherapy. Prior adjuvant hormonal treatment following either prostatectomy or radiotherapy was used in 28 patients (13.1%).

Disclosures: The study was not funded and the authors disclosed have no financial conflicts of interest. Data was taken from Datasets [Datasets 192 and 193] from the NCTN Data Archive of the National Cancer Institute’s (NCI’s) National Clinical Trials Network (NCTN).

Source: Abdel-Rahman O and Cheung W. Clinical Genitourinary Cancer; published online 21 July 2018 https://doi.org/10.1016/j.clgc.2018.07.007

Citation:

Abdel-Rahman O and Cheung W. Clinical Genitourinary Cancer; published online 21 July 2018 https://doi.org/10.1016/j.clgc.2018.07.007