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BMC Cancer
Published in: BMC Cancer 1/2023

Open Access 01-12-2023 | Prostate Cancer | Research

Development and validation of a survival nomogram and calculator for male patients with metastatic castration-resistant prostate cancer treated with abiraterone acetate and/or enzalutamide

Authors: Takashi Kawahara, Yusuke Saigusa, Shuko Yoneyama, Masashi Kato, Ippei Kojima, Hiroshi Yamada, Osamu Kamihira, Kenichi Tabata, Hideyasu Tsumura, Masatsugu Iwamura, Kazuhide Makiyama, Hiroji Uemura, Yasuhide Miyoshi

Published in: BMC Cancer | Issue 1/2023

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Abstract

Background

Despite the widespread availability of medication choices for metastatic castration-resistant prostate cancer (mCRPC), biomarkers to predict the efficacy of each mCRPC treatment have not yet been established. This study developed a prognostic nomogram and a calculator to predict the prognosis of patients with mCRPC who received abiraterone acetate (ABI) and/or enzalutamide (ENZ).

Methods

In total, 568 patients with mCRPC who underwent ABI and/or ENZ between 2012 and 2017 were enrolled. A prognostic nomogram based on the risk factors was developed using the Cox proportional hazards regression model and clinically important factors. The discriminatory ability of the nomogram was assessed according to the concordance index (C-index). A 5-fold cross-validation was repeated 2000 times to estimate the C-index, and the means of the estimated C-index for the training and validation sets were determined. A calculator based on this nomogram was then developed.

Results

The median overall survival (OS) was 24.7 months. Multivariate analysis showed that the time to CRPC, pre-chemotherapy, baseline prostate-specific antigen, baseline alkaline phosphatase, and baseline lactate dehydrogenase levels were independent risk factors for OS (hazard ratio [HR]: 0.521, 1.681, 1.439, 1.827, and 12.123, p = 0.001, 0.001,  < 0.001, 0.019, and  < 0.001, respectively). The C-index was 0.72 in the training cohort and 0.71 in the validation cohort.

Conclusions

We developed a nomogram and calculator to predict OS in Japanese patients with mCRPC who received ABI and/or ENZ. Reproducible prognostic prediction calculators for mCRPC will facilitate greater accessibility for clinical use.
Appendix
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Literature
1.
Ryan CJ, Smith MR, de Bono JS, Molina A, Logothetis CJ, de Souza P, Fizazi K, Mainwaring P, Piulats JM, Ng S, et al. Abiraterone in metastatic prostate cancer without previous chemotherapy. N Engl J Med. 2013;368(2):138–48.CrossRefPubMed
2.
Scher HI, Fizazi K, Saad F, Taplin ME, Sternberg CN, Miller K, de Wit R, Mulders P, Chi KN, Shore ND, et al. Increased survival with enzalutamide in prostate cancer after chemotherapy. N Engl J Med. 2012;367(13):1187–97.CrossRefPubMed
3.
Ninomiya S, Kawahara T, Tatenuma T, Miyoshi Y, Miyamoto H, Yao M, Uemura H. Preference for enzalutamide capsules versus tablet pills in patients with prostate cancer. Int J Urol. 2019;26(12):1161–2.CrossRefPubMedPubMedCentral
4.
5.
6.
Ohno Y. Role of systemic inflammatory response markers in urological malignancy. Int J Urol. 2019;26(1):31–47.CrossRefPubMed
7.
Partin AW, Yoo J, Carter HB, Pearson JD, Chan DW, Epstein JI, Walsh PC. The use of prostate specific antigen, clinical stage and Gleason score to predict pathological stage in men with localized prostate cancer. J Urol. 1993;150(1):110–4.CrossRefPubMed
8.
Shariat SF, Karakiewicz PI, Suardi N, Kattan MW. Comparison of nomograms with other methods for predicting outcomes in prostate cancer: a critical analysis of the literature. Clin Cancer Res. 2008;14(14):4400–7.CrossRefPubMed
9.
Spreafico A, Chi KN, Sridhar SS, Smith DC, Carducci MA, Kavsak P, Wong TS, Wang L, Ivy SP, Mukherjee SD, et al. A randomized phase II study of cediranib alone versus cediranib in combination with dasatinib in docetaxel resistant, castration resistant prostate cancer patients. Invest New Drugs. 2014;32(5):1005–16.CrossRefPubMedPubMedCentral
10.
Hata A, Fujitani N, Takeshita M, Tanaka C, Matsuda N, Takaishi M, Shimokawa Miyama T, Hoshi F. Comparison of regression for blood ALP levels using methods of the Japan Society of Clinical Chemistry and the International Federation of Clinical Chemistry and Laboratory Medicine in bovine, canine, feline, and human testing. PLoS One. 2021;16(6):e0253396.CrossRefPubMedPubMedCentral
11.
Iasonos A, Keung EZ, Zivanovic O, Mancari R, Peiretti M, Nucci M, George S, Colombo N, Carinelli S, Hensley ML, et al. External validation of a prognostic nomogram for overall survival in women with uterine leiomyosarcoma. Cancer. 2013;119(10):1816–22.CrossRefPubMed
12.
Vickers AJ, Cronin AM, Elkin EB, Gonen M. Extensions to decision curve analysis, a novel method for evaluating diagnostic tests, prediction models and molecular markers. BMC Med Inform Decis Mak. 2008;8:53.CrossRefPubMedPubMedCentral
13.
Hussain M, Fizazi K, Saad F, Rathenborg P, Shore N, Ferreira U, Ivashchenko P, Demirhan E, Modelska K, Phung, et al. Enzalutamide in Men with Nonmetastatic, Castration-Resistant Prostate Cancer. N Engl J Med. 2018;378(26):2465–74.CrossRefPubMedPubMedCentral
14.
Smith MR, Saad F, Chowdhury S, Oudard S, Hadaschik BA, Graff JN, Olmos D, Mainwaring PN, Lee JY, Uemura H, et al. Apalutamide Treatment and Metastasis-free Survival in Prostate Cancer. N Engl J Med. 2018;378(15):1408–18.CrossRefPubMed
15.
Fizazi K, Shore N, Tammela TL, Ulys A, Vjaters E, Polyakov S, Jievaltas M, Luz M, Alekseev B, Kuss I, et al. Darolutamide in Nonmetastatic, Castration-Resistant Prostate Cancer. N Engl J Med. 2019;380(13):1235–46.CrossRefPubMed
16.
17.
Beer TM, Armstrong AJ, Rathkopf DE, Loriot Y, Sternberg CN, Higano CS, Iversen P, Bhattacharya S, Carles J, Chowdhury S, et al. Enzalutamide in metastatic prostate cancer before chemotherapy. N Engl J Med. 2014;371(5):424–33.CrossRefPubMedPubMedCentral
18.
de Bono JS, Logothetis CJ, Molina A, Fizazi K, North S, Chu L, Chi KN, Jones RJ, Goodman OB Jr, Saad F, et al. Abiraterone and increased survival in metastatic prostate cancer. N Engl J Med. 2011;364(21):1995–2005.CrossRefPubMedPubMedCentral
19.
Halabi S, Kelly WK, Ma H, Zhou H, Solomon NC, Fizazi K, Tangen CM, Rosenthal M, Petrylak DP, Hussain M, et al. Meta-Analysis Evaluating the Impact of Site of Metastasis on Overall Survival in Men With Castration-Resistant Prostate Cancer. J Clin Oncol. 2016;34(14):1652–9.CrossRefPubMedPubMedCentral
20.
Potretzke A, Hillman L, Wong K, Shi F, Brower R, Mai S, Cetnar JP, Abel EJ, Downs TM. NLR is predictive of upstaging at the time of radical cystectomy for patients with urothelial carcinoma of the bladder. Urol Oncol. 2014;32(5):631–6.CrossRefPubMed
21.
Tokunaga R, Sakamoto Y, Nakagawa S, Miyamoto Y, Yoshida N, Oki E, Watanabe M, Baba H. Prognostic Nutritional Index Predicts Severe Complications, Recurrence, and Poor Prognosis in Patients With Colorectal Cancer Undergoing Primary Tumor Resection. Dis Colon Rectum. 2015;58(11):1048–57.CrossRefPubMed
22.
23.
Yang YJ, Lin GW, Li GX, Dai B, Ye DW, Wu JL, Xie HY, Zhu Y. External validation and newly development of a nomogram to predict overall survival of abiraterone-treated, castration-resistant patients with metastatic prostate cancer. Asian J Androl. 2018;20(2):184–8.CrossRefPubMed
24.
Lin GW, Ye DW, Jia HX, Dai B, Zhang HL, Zhu Y, Shi GH, Ma CG. Development of a preliminary nomogram to predict progression of bone scan for castration-resistant prostate cancer. Onco Targets Ther. 2015;8:713–9.PubMedPubMedCentral
25.
Khalaf DJ, Aviles CM, Azad AA, Sunderland K, Todenhofer T, Eigl BJ, Finch D, Le L, Atwell A, Keith B, et al. A prognostic model for stratifying clinical outcomes in chemotherapy-naive metastatic castration-resistant prostate cancer patients treated with abiraterone acetate. Can Urol Assoc J. 2018;12(2):E47–52.CrossRefPubMed
26.
Chi KN, Kheoh T, Ryan CJ, Molina A, Bellmunt J, Vogelzang NJ, Rathkopf DE, Fizazi K, Kantoff PW, Li J, et al. A prognostic index model for predicting overall survival in patients with metastatic castration-resistant prostate cancer treated with abiraterone acetate after docetaxel. Ann Oncol. 2016;27(3):454–60.CrossRefPubMed
27.
Kimura T, Egawa S. Epidemiology of prostate cancer in Asian countries. Int J Urol. 2018;25(6):524–31.CrossRefPubMed
28.
Ravi P, Mateo J, Lorente D, Zafeiriou Z, Altavilla A, Ferraldeschi R, Sideris S, Grist E, Smith A, Wong S, et al. External validation of a prognostic model predicting overall survival in metastatic castrate-resistant prostate cancer patients treated with abiraterone. Eur Urol. 2014;66(1):8–11.CrossRefPubMed
Metadata
Title
Development and validation of a survival nomogram and calculator for male patients with metastatic castration-resistant prostate cancer treated with abiraterone acetate and/or enzalutamide
Authors
Takashi Kawahara
Yusuke Saigusa
Shuko Yoneyama
Masashi Kato
Ippei Kojima
Hiroshi Yamada
Osamu Kamihira
Kenichi Tabata
Hideyasu Tsumura
Masatsugu Iwamura
Kazuhide Makiyama
Hiroji Uemura
Yasuhide Miyoshi
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2023
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-023-10700-0

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