External Validation of a Prognostic Model Predicting Overall Survival in Metastatic Castrate-resistant Prostate Cancer Patients Treated with Abiraterone

A prognostic model was derived from the population of the COU-AA-301 phase 3 trial for metastatic castrate-resistant prostate cancer patients treated with abiraterone after docetaxel, and it stratifies patients into three risk groups based on clinical parameters. We validated this model in an independent cohort of patients treated with abiraterone after docetaxel outside a clinical trial (group A; n = 94) and explored its utility in patients treated with abiraterone in the prechemotherapy setting (group B; n = 64). For group A, median overall survival (mOS) was significantly different across the three prognostic groups (good: n = 39, mOS: 21.8 mo; intermediate: n = 44, mOS: 10.6 mo; poor: n = 7, mOS: 6.8 mo; p < 0.001; area under the curve [AUC]: 0.71). Analysis of group B confirmed the ability of the model to prognosticate for survival in the prechemotherapy setting: (good: n = 44, mOS: 45.6 mo; intermediate or poor: n = 20, mOS: 34.5 mo; p = 0.042; AUC: 0.61). These results serve to validate the prognostic model in an independent population treated with abiraterone after docetaxel and support clinical implementation of the score. Calibration of the model was poorer in patients receiving abiraterone prechemotherapy. Prospective evaluation of this model in clinical trials is needed.