Long-term clinical impact of PSA surge in castration-resistant prostate cancer patients treated with abiraterone

Vincenza Conteduca; Orazio Caffo; Cristian Lolli; Michele Aieta; Emanuela Scarpi; Emanuela Bianchi; Francesca Maines; Giuseppe Schepisi; Samanta Salvi; Francesco Massari; Francesco Carrozza; Antonello Veccia; Vincenzo E Chiuri; Enrico Campadelli; Gaetano Facchini; Ugo De Giorgi

doi:10.1002/pros.23357

Long-term clinical impact of PSA surge in castration-resistant prostate cancer patients treated with abiraterone

Vincenza Conteduca, Orazio Caffo, Cristian Lolli, Michele Aieta, Emanuela Scarpi, Emanuela Bianchi, Francesca Maines, Giuseppe Schepisi, Samanta Salvi, Francesco Massari, Francesco Carrozza, Antonello Veccia, Vincenzo E Chiuri, Enrico Campadelli, Gaetano Facchini, Ugo De Giorgi

Research output: Contribution to journal › Article

Abstract

BACKGROUND: Early changes in PSA have been evaluated in association to treatment outcome. The aim of this study was to assess PSA surge phenomenon in castration-resistant prostate cancer (CRPC) patients treated with abiraterone and to correlate those variations with long-term treatment outcome.

PATIENTS AND METHODS: We retrospectively evaluated 330 CRPC patients in 11 Italian hospitals, monitoring PSA levels at baseline and every 4 weeks. Other clinical, biochemical and molecular parameters were determined at baseline. We considered PSA surge as PSA increase within the first 8 weeks from starting abiraterone more than 1% from baseline followed by a PSA decline. The log-rank test was applied to compare survival between groups of patients according to PSA surge. The impact of PSA surge on survival was evaluated by Cox regression analyses.

RESULTS: A total of 330 patients with CRPC, median age 74 years (range, 45-90), received abiraterone (281 chemotherapy-treated and 49 chemotherapy-naïve). PSA surge was observed in 20 (7%) post-chemotherapy and 2 (4%) chemotherapy-naïve patients. For overall patients presenting PSA surge, timing of PSA peak from baseline was 5 ± 1.8 weeks and PSA rise from baseline was 21 ± 18.4%. The overall median follow-up was 23 months (range 1-62). No significant differences in progression-free survival and overall survival were observed between patients with and without PSA surge (P = 0.16 and =0.86, respectively). In addition, uni- and multivariate analyses showed no baseline factors related to PSA surge.

CONCLUSION: PSA surge occurs in both chemotherapy-treated and chemotherapy-naïve patients treated with abiraterone resulting, however, in no long-term impact on outcome. Physicians and patients should be aware of PSA surge challenge to prevent a premature discontinuation of potentially effective therapy with abiraterone. Further larger and prospective studies are warranted to investigate this not infrequent phenomenon.

Original language	English
Pages (from-to)	1012-1019
Number of pages	8
Journal	Prostate
Volume	77
Issue number	9
DOIs	https://doi.org/10.1002/pros.23357
Publication status	Published - Jun 2017

Keywords

Aged
Androstenes
Antineoplastic Agents
Disease-Free Survival
Drug Monitoring
Humans
Italy
Male
Medication Therapy Management
Prostate-Specific Antigen
Prostatic Neoplasms, Castration-Resistant
Retrospective Studies
Time
Journal Article

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Conteduca, V., Caffo, O., Lolli, C., Aieta, M., Scarpi, E., Bianchi, E., Maines, F., Schepisi, G., Salvi, S., Massari, F., Carrozza, F., Veccia, A., Chiuri, V. E., Campadelli, E., Facchini, G., & De Giorgi, U. (2017). Long-term clinical impact of PSA surge in castration-resistant prostate cancer patients treated with abiraterone. Prostate, 77(9), 1012-1019. https://doi.org/10.1002/pros.23357

Long-term clinical impact of PSA surge in castration-resistant prostate cancer patients treated with abiraterone. / Conteduca, Vincenza; Caffo, Orazio; Lolli, Cristian ; Aieta, Michele ; Scarpi, Emanuela; Bianchi, Emanuela; Maines, Francesca; Schepisi, Giuseppe; Salvi, Samanta; Massari, Francesco; Carrozza, Francesco; Veccia, Antonello; Chiuri, Vincenzo E; Campadelli, Enrico; Facchini, Gaetano ; De Giorgi, Ugo.

In: Prostate, Vol. 77, No. 9, 06.2017, p. 1012-1019.

Research output: Contribution to journal › Article

Conteduca, V, Caffo, O, Lolli, C , Aieta, M , Scarpi, E, Bianchi, E, Maines, F, Schepisi, G, Salvi, S, Massari, F, Carrozza, F, Veccia, A, Chiuri, VE, Campadelli, E, Facchini, G & De Giorgi, U 2017, 'Long-term clinical impact of PSA surge in castration-resistant prostate cancer patients treated with abiraterone', Prostate, vol. 77, no. 9, pp. 1012-1019. https://doi.org/10.1002/pros.23357

Conteduca, Vincenza ; Caffo, Orazio ; Lolli, Cristian ; Aieta, Michele ; Scarpi, Emanuela ; Bianchi, Emanuela ; Maines, Francesca ; Schepisi, Giuseppe ; Salvi, Samanta ; Massari, Francesco ; Carrozza, Francesco ; Veccia, Antonello ; Chiuri, Vincenzo E ; Campadelli, Enrico ; Facchini, Gaetano ; De Giorgi, Ugo. / Long-term clinical impact of PSA surge in castration-resistant prostate cancer patients treated with abiraterone. In: Prostate. 2017 ; Vol. 77, No. 9. pp. 1012-1019.

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title = "Long-term clinical impact of PSA surge in castration-resistant prostate cancer patients treated with abiraterone",

abstract = "BACKGROUND: Early changes in PSA have been evaluated in association to treatment outcome. The aim of this study was to assess PSA surge phenomenon in castration-resistant prostate cancer (CRPC) patients treated with abiraterone and to correlate those variations with long-term treatment outcome.PATIENTS AND METHODS: We retrospectively evaluated 330 CRPC patients in 11 Italian hospitals, monitoring PSA levels at baseline and every 4 weeks. Other clinical, biochemical and molecular parameters were determined at baseline. We considered PSA surge as PSA increase within the first 8 weeks from starting abiraterone more than 1% from baseline followed by a PSA decline. The log-rank test was applied to compare survival between groups of patients according to PSA surge. The impact of PSA surge on survival was evaluated by Cox regression analyses.RESULTS: A total of 330 patients with CRPC, median age 74 years (range, 45-90), received abiraterone (281 chemotherapy-treated and 49 chemotherapy-na{\"i}ve). PSA surge was observed in 20 (7%) post-chemotherapy and 2 (4%) chemotherapy-na{\"i}ve patients. For overall patients presenting PSA surge, timing of PSA peak from baseline was 5 ± 1.8 weeks and PSA rise from baseline was 21 ± 18.4%. The overall median follow-up was 23 months (range 1-62). No significant differences in progression-free survival and overall survival were observed between patients with and without PSA surge (P = 0.16 and =0.86, respectively). In addition, uni- and multivariate analyses showed no baseline factors related to PSA surge.CONCLUSION: PSA surge occurs in both chemotherapy-treated and chemotherapy-na{\"i}ve patients treated with abiraterone resulting, however, in no long-term impact on outcome. Physicians and patients should be aware of PSA surge challenge to prevent a premature discontinuation of potentially effective therapy with abiraterone. Further larger and prospective studies are warranted to investigate this not infrequent phenomenon.",

keywords = "Aged, Androstenes, Antineoplastic Agents, Disease-Free Survival, Drug Monitoring, Humans, Italy, Male, Medication Therapy Management, Prostate-Specific Antigen, Prostatic Neoplasms, Castration-Resistant, Retrospective Studies, Time, Journal Article",

author = "Vincenza Conteduca and Orazio Caffo and Cristian Lolli and Michele Aieta and Emanuela Scarpi and Emanuela Bianchi and Francesca Maines and Giuseppe Schepisi and Samanta Salvi and Francesco Massari and Francesco Carrozza and Antonello Veccia and Chiuri, {Vincenzo E} and Enrico Campadelli and Gaetano Facchini and {De Giorgi}, Ugo",

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TY - JOUR

T1 - Long-term clinical impact of PSA surge in castration-resistant prostate cancer patients treated with abiraterone

AU - Conteduca, Vincenza

AU - Caffo, Orazio

AU - Lolli, Cristian

AU - Aieta, Michele

AU - Scarpi, Emanuela

AU - Bianchi, Emanuela

AU - Maines, Francesca

AU - Schepisi, Giuseppe

AU - Salvi, Samanta

AU - Massari, Francesco

AU - Carrozza, Francesco

AU - Veccia, Antonello

AU - Chiuri, Vincenzo E

AU - Campadelli, Enrico

AU - Facchini, Gaetano

AU - De Giorgi, Ugo

PY - 2017/6

Y1 - 2017/6

N2 - BACKGROUND: Early changes in PSA have been evaluated in association to treatment outcome. The aim of this study was to assess PSA surge phenomenon in castration-resistant prostate cancer (CRPC) patients treated with abiraterone and to correlate those variations with long-term treatment outcome.PATIENTS AND METHODS: We retrospectively evaluated 330 CRPC patients in 11 Italian hospitals, monitoring PSA levels at baseline and every 4 weeks. Other clinical, biochemical and molecular parameters were determined at baseline. We considered PSA surge as PSA increase within the first 8 weeks from starting abiraterone more than 1% from baseline followed by a PSA decline. The log-rank test was applied to compare survival between groups of patients according to PSA surge. The impact of PSA surge on survival was evaluated by Cox regression analyses.RESULTS: A total of 330 patients with CRPC, median age 74 years (range, 45-90), received abiraterone (281 chemotherapy-treated and 49 chemotherapy-naïve). PSA surge was observed in 20 (7%) post-chemotherapy and 2 (4%) chemotherapy-naïve patients. For overall patients presenting PSA surge, timing of PSA peak from baseline was 5 ± 1.8 weeks and PSA rise from baseline was 21 ± 18.4%. The overall median follow-up was 23 months (range 1-62). No significant differences in progression-free survival and overall survival were observed between patients with and without PSA surge (P = 0.16 and =0.86, respectively). In addition, uni- and multivariate analyses showed no baseline factors related to PSA surge.CONCLUSION: PSA surge occurs in both chemotherapy-treated and chemotherapy-naïve patients treated with abiraterone resulting, however, in no long-term impact on outcome. Physicians and patients should be aware of PSA surge challenge to prevent a premature discontinuation of potentially effective therapy with abiraterone. Further larger and prospective studies are warranted to investigate this not infrequent phenomenon.

AB - BACKGROUND: Early changes in PSA have been evaluated in association to treatment outcome. The aim of this study was to assess PSA surge phenomenon in castration-resistant prostate cancer (CRPC) patients treated with abiraterone and to correlate those variations with long-term treatment outcome.PATIENTS AND METHODS: We retrospectively evaluated 330 CRPC patients in 11 Italian hospitals, monitoring PSA levels at baseline and every 4 weeks. Other clinical, biochemical and molecular parameters were determined at baseline. We considered PSA surge as PSA increase within the first 8 weeks from starting abiraterone more than 1% from baseline followed by a PSA decline. The log-rank test was applied to compare survival between groups of patients according to PSA surge. The impact of PSA surge on survival was evaluated by Cox regression analyses.RESULTS: A total of 330 patients with CRPC, median age 74 years (range, 45-90), received abiraterone (281 chemotherapy-treated and 49 chemotherapy-naïve). PSA surge was observed in 20 (7%) post-chemotherapy and 2 (4%) chemotherapy-naïve patients. For overall patients presenting PSA surge, timing of PSA peak from baseline was 5 ± 1.8 weeks and PSA rise from baseline was 21 ± 18.4%. The overall median follow-up was 23 months (range 1-62). No significant differences in progression-free survival and overall survival were observed between patients with and without PSA surge (P = 0.16 and =0.86, respectively). In addition, uni- and multivariate analyses showed no baseline factors related to PSA surge.CONCLUSION: PSA surge occurs in both chemotherapy-treated and chemotherapy-naïve patients treated with abiraterone resulting, however, in no long-term impact on outcome. Physicians and patients should be aware of PSA surge challenge to prevent a premature discontinuation of potentially effective therapy with abiraterone. Further larger and prospective studies are warranted to investigate this not infrequent phenomenon.

KW - Aged

KW - Androstenes

KW - Antineoplastic Agents

KW - Disease-Free Survival

KW - Drug Monitoring

KW - Humans

KW - Italy

KW - Male

KW - Medication Therapy Management

KW - Prostate-Specific Antigen

KW - Prostatic Neoplasms, Castration-Resistant

KW - Retrospective Studies

KW - Time

KW - Journal Article

U2 - 10.1002/pros.23357

DO - 10.1002/pros.23357

M3 - Article

C2 - 28429372

VL - 77

SP - 1012

EP - 1019

JO - Prostate

JF - Prostate

SN - 0270-4137

IS - 9

ER -