Development of castration resistance in prostate cancer patients treated with luteinizing hormone-releasing hormone analogues (LHRHa): results of the ANARESISTANCE study.
Por:
Angulo JC, Ciria Santos JP, Gómez-Caamaño A, Poza de Celis R, González Sala JL, García Garzón JM, Galán-Llopis JA, Pérez Sampietro M, Perrot V and Planas Morin J
Publicada:
1 oct 2022
Ahead of Print:
4 sep 2022
Resumen:
PURPOSE: Evaluate the percentage of patients with prostate cancer treated with luteinizing hormone-releasing hormone analogues (LHRHa) that develop castration resistance after a follow-up period of 3 years. The secondary objective is to evaluate the variables potentially related to the progression to castration resistant prostate cancer (CRPC). METHODS: A post-authorization, nation-wide, multicenter, prospective, observational, and longitudinal study that included 416 patients treated with LHRHa between 2012 and 2017 is presented. Patients were followed for 3 years or until development of CRPC, thus completing a per-protocol population of 350 patients. A Cox regression analysis was carried out to evaluate factors involved in progression to CRPC. RESULTS: After 3 years of treatment with LHRHa 18.2% of patients developed CRPC. In contrast, in the subgroup analysis, 39.6% of the metastatic patients developed CRPC, compared with 8.8% of the non-metastatic patients. The patients with the highest risk of developing CRPC were those with a nadir prostate-specific antigen (PSA) > 2 ng/ml (HR 21.6; 95% CI 11.7-39.8; p < 0.001) and those receiving concomitant medication, most commonly bicalutamide (HR 1.8; 95% CI 1-3.1, p = 0.0431). CONCLUSIONS: The proportion of metastatic patients developing CRPC after 3 years of treatment with LHRHa is consistent with what has been previously described in the literature. In addition, this study provides new findings on CRPC in non-metastatic patients. Concomitant medication and nadir PSA are statistically significant predictive factors for the time to diagnosis of CRPC, the nadir PSA being the strongest predictor.
Filiaciones:
Angulo JC:
Clinical Department, Universidad Europea de Madrid
Hospital Universitario de Getafe, Madrid, Spain.
Ciria Santos JP:
Radiation Oncology Service, Hospital Universitario Donostia, Donostia, Spain
Gómez-Caamaño A:
Department of Radiation Oncology, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
Poza de Celis R:
Department of Radiation Oncology, Hospital Universitario Araba, Gasteiz, Spain
González Sala JL:
Urology Service, Corporació Sanitària Parc Taulí, Sabadell, Spain
García Garzón JM:
Urology Service, Hospital General de Llerena, Llerena, Spain
:
Urology Service, Hospital General Universitario de Alicante, Alicante, Spain
Pérez Sampietro M:
Ipsen Pharma, S.A.U, Barcelona, Spain
Perrot V:
Ipsen Pharma, S.A.U, Barcelona, Spain
Planas Morin J:
Urology Service, Hospital Universitario Vall d'Hebrón, Barcelona, Spain
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