High subcutaneous adipose tissue predicts the prognosis in metastatic castration-resistant prostate cancer patients in post chemotherapy setting |
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| Institution: | 1. Department of Ambulatory Care, Gustave-Roussy Cancer Campus, University of Paris Sud, Villejuif, France;2. Department of Biostatistics and Epidemiology, Gustave-Roussy Cancer Campus, University of Paris Sud, Villejuif, France;3. Department of Cancer Medicine, Gustave-Roussy Cancer Campus, Villejuif, University of Paris Sud, France;1. Sydney Cancer Centre, Concord Repatriation General Hospital, Concord, Australia;2. Sydney Medical School, University of Sydney, Sydney, Australia;3. Department of Oncology, McMaster University and Ontario Clinical Oncology Group, Hamilton, Ontario, Canada;4. Royal North Shore Hospital, St. Leonards, Australia;5. Mt. Sinai Tisch Cancer Institute, New York, NY;6. UAB Cancer Center, Birmingham, AL;1. University of Montreal Hospital Centre, Montreal, QC, Canada;2. Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, UK;3. Carolina Urologic Research Center, Myrtle Beach, SC, USA;4. Gustave Roussy, Cancer Campus Grand Paris, University of Paris Sud, Villejuif, France;5. Medivation, Inc., San Francisco, CA, USA;6. Astellas Global Medical Affairs, Inc., Northbrook, IL, USA;7. Memorial Sloan-Kettering Cancer Center, New York, NY, USA;1. Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Sud, Villejuif, France;2. Department of Urology, Charité—Universitätsmedizin Berlin, Berlin, Germany;3. Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy;4. Drug Development Unit, Royal Marsden Hospital and Institute of Cancer Research, London, UK;5. Department of Urology, Guys and St Thomas'' Hospital, London, UK;6. Department of Medicine, Division of Medical Oncology, University of Washington/Fred Hutchinson Cancer Research Center, Seattle, WA, USA;7. Department of Early Clinical Development, Medivation, San Francisco, CA, USA;8. Department of Medical Affairs, Medivation, San Francisco, CA, USA;9. Health Economics and Outcomes Research, Astellas Pharma Europe, Leiden, Netherlands;10. Astellas Pharma Global Development, Northbrook, IL, USA;11. Consulting, Quintiles, Hoofddorp, Netherlands;12. Consulting, Quintiles, Barcelona, Spain;13. Department of Public Health, University of Barcelona, Barcelona, Spain;14. Division of Hematology and Medical Oncology, OHSU Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA;15. Department of Urology, Cliniques Universitaires Saint-Luc, Brussels, Belgium;1. Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands;2. Janssen Research & Development, Los Angeles, CA, USA;3. Medical University of Vienna, Vienna, Austria;4. University of Montreal, Montreal, QC, Canada;5. University of Washington, Seattle, WA, USA;6. British Columbia Cancer Agency, Vancouver, BC, Canada;7. Janssen Research & Development, Raritan, NJ, USA;8. Institut Gustave Roussy, University of Paris Sud, Villejuif, France |
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| Abstract: | BackgroundCancer studies have shown that body mass index (BMI), skeletal muscle mass (SMM) and adipose tissue indexes are linked to overall survival (OS) and progression-free survival (PFS). New treatments (abiraterone acetate, enzalutamide cabazitaxel, radium-223, sipuleucel-T) have improved patient outcomes in metastatic castration-resistant prostate cancer (mCRPC). Our objective was to analyse whether body composition parameters exert a prognostic role in mCRPC patients treated with next generation of androgen receptor (AR) axis inhibitors (abiraterone and enzalutamide).MethodsAll mCRPC patients from our institution who were enrolled in two prospective trials, assessing the efficacy of abiraterone acetate and the efficacy of enzalutamide, were selected. SMM, visceral and subcutaneous adipose tissue (SAT) indexes were assessed with computed tomography imaging by measuring cross-sectional areas of the tissues.ResultsIn the 120 patients with available data, median OS and PFS were respectively: 16 months (95% confidence interval CI] = 12–19) and 4 months (95% CI] = 3–6). OS was associated with the SAT index: median survival was 15 months (95% CI] 9–18) for patients with a SAT index < median value and 18 months (95% CI] 13–30) for patients with a SAT index above (P = 0.008). In multivariate analyses, only the occurrence of visceral metastasis (P = 0.004), pain (P = 0.015) and SAT index (P = 0.036) were statistically significant predictors of OS. From baseline to 3 months, the SMM index loss was 2.49 ± 0.44 cm2/m2 (P < 0.001) corresponding to nearly 3.4 kg of muscle loss.ConclusionsHigh volume of SAT is independently associated with overall survival in mCRPC patients treated with next generation AR axis inhibitors. |
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| Keywords: | Adipose tissue Metastatic castration resistant prostate cancer Overall survival Skeletal muscle loss |
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