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.
Written by:
de Liaño AG, Reig O, Mellado B, Martin C, Rull EU, Maroto JP. Are you the author?
Medical Oncology and Biochemistry Departments, Hospital de la Santa Creu i Sant Pau, Mas Casanovas s/n, 08025 Barcelona, Spain; Medical Oncology Department, Hospital Clinic, Carrer Villarroel 170, 08036 Barcelona, Spain.
Reference: Br J Cancer. 2014 Apr 29;110(9):2201-8.
doi: 10.1038/bjc.2014.189
PubMed Abstract
PMID: 24722180
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