(UroToday.com) Men of African ancestry experience higher incidence, including de novo metastatic disease, and death from prostate cancer. This is despite the fact that in certain controlled settings, African ancestry prostate cancers are more responsive to therapy when appropriately deployed. The authors of this poster sought to determine, using clinicopathological data, associative predictors of overall survival (OS) for South African men treated with androgen deprivation therapy (ADT).
To do so, they performed a retrospective analysis of data from patients with metastatic prostate cancer diagnosed at Chris Hani Baragwanath Hospital (CHBH) in Johannesburg, South African between 3/22/2016 and 10/30/2020. Black patients who were treated with ADT (at least one dose of LHRH agonist and/or had surgical castration) were included in analysis. PSA progression was defined according to adapted Prostate Cancer Working Group (PCWG) 3 guidelines. Methods included Cox regression models to nominate predictors of OS.
Among the 200 patients available for query, six were excluded due to not receiving ADT, and 41 were without sufficient data for establishment of PSA progression estimations. Baseline characteristics were summarized as follows:
The rate of PSA progression at one- and two-years was 12.1% [95%CI 5.9-17.8] and 37.5% [95%CI 26.1-47.2], respectively. At a median follow up of 2.75 years OS was 61.9% [95%CI 52.7-72.6]. Cox proportional hazard ratios (HR) were used to model risk factors for overall survival as follows. Among these, PSA with a cut off nadir of >4 ng/mL after ADT initiation had a HR for death of 3.77 [1.82-7.62], demonstrated in Kaplan-Meier curves and in the following table.
The authors conclude that high alkaline phosphatase and anemia at diagnosis, and PSA response, are associated with overall survival in Black South African men treated with ADT for prostate cancer. They suggest that these markers could help to risk stratify patients at diagnosis and to assist in decision making related to addition of chemotherapy for metastatic castration sensitive prostate cancer.
Presented by: Yoanna S Pumpalova, MD, Columbia University Irving Medical Center, New York, NYWritten by: Jones Nauseef, MD, PhD, Assistant Professor of Medicine within the Division of Hematology and Medical Oncology, Sandra and Edward Meyer Cancer Center, and Englander Institute for Precision Medicine Weill Cornell Medicine and Assistant Attending physician at NewYork-Presbyterian Hospital. @DrJonesNauseef on Twitter during the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting, Chicago, IL, Fri, June 3 – Mon, June 7, 2022.