Incidence and survival of castration-resistant prostate cancer patients with visceral metastases: results from the Dutch CAPRI-registry

Gijs P.A. van den Bergh*, Malou C.P. Kuppen, Hans M. Westgeest, Niven Mehra, Winald R. Gerritsen, Katja K.H. Aben, Inge M. van Oort, Reindert J.A. van Moorselaar, Diederik M. Somford, Alfonsus J.M. van den Eertwegh, André M. Bergman, Alphonsus C.M. van den Bergh, Carin A. Uyl-de Groot

*Corresponding author for this work

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Abstract

Background: The objective of this real-world population study is to investigate incidence and treatment of visceral metastases (VMs) in castration resistant prostate cancer (CRPC) patients and their survival. Methods: CRPC-patients in the CAPRI-registry between 2010 and 2016 were included in the analyses and followed till 2017. Outcomes were proportion of patients radiologically screened for VMs and proportion of patients with VMs at CRPC-diagnosis and at the start of every treatment line. Groups have been created based on location of VMs (lung, liver, or both) at date of first VM diagnosis. The outcome for these groups was overall survival (OS). Statistics included descriptive analyses, Kaplan-Meier method, and Cox proportional hazard regression analysis for survival analyses. Results: Of 3602 patients from the CAPRI registry, 457 patients (12.7%) were diagnosed with VMs during follow-up: 230 patients with liver, 161 with lung, and 66 with both liver and lung metastases. The proportion of patients radiologically screened for VMs increased per treatment line as did the occurrence rate of VMs. However, 80% of patients at CRPC diagnosis to 40% in the 6th line were not screened for VMs at the start of a systemic treatment. Median OS was 8.6 months for patients with liver, 18.3 with lung and 10.9 with both liver and lung metastases (p < 0.001) from date of first VM diagnosis. After correction for prognostic factors patients with lung metastases had significantly better OS than patients with liver metastases (HR 0.650, p = 0.001). Conclusion: This real-world analysis showed that despite the increased rate of radiological staging during follow-up, still 80% to 40% of the patients (CRPC diagnosis to 6th treatment line respectively) were not screened for VMs at the start of a systemic treatment. VMs and location of VMs are key prognostic patient characteristics, impacts survival and have implications for treatment decisions, so routine staging of CRPC-patients is warranted. Clinical trial identification: The CAPRI study is registered in the Dutch Trial Registry as NL3440 (NTR3591).

Original languageEnglish
Pages (from-to)162-169
Number of pages8
JournalProstate Cancer and Prostatic Diseases
Volume26
Issue number1
Early online date12 Oct 2022
DOIs
Publication statusPublished - Mar 2023

Bibliographical note

Funding Information:
This research was funded by Sanofi-Aventis Netherlands B.V., Janssen-Cilag B.V., Astellas Pharma B.V., and Bayer B.V. The funding organizations had no role in the design and conduct of the study, collection, management, analysis, interpretation of the data, and preparation, review, or approval of the abstract.

Publisher Copyright: © 2022, The Author(s), under exclusive licence to Springer Nature Limited.

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