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- Title
Development of castration resistance in prostate cancer patients treated with luteinizing hormone-releasing hormone analogues (LHRHa): results of the ANARESISTANCE study.
- Authors
Angulo, J. C.; Ciria Santos, J. P.; Gómez-Caamaño, A.; Poza de Celis, R.; González Sala, J. L.; García Garzón, J. M.; Galán-Llopis, J. A.; Pérez Sampietro, M.; Perrot, V.; Planas Morin, J.; on behalf of ANARESISTANCE study group; Abascal, José Manuel; Barrond, Víctor; Benedicto, Antonio; Carballo, Ana; Cortiñas, José Ramón; Fernández, Manuel; Ferrer, Eduardo; Guzmán, Pablo Luís; López, Miguel Ángel
- Abstract
Purpose: Evaluate the percentage of patients with prostate cancer treated with luteinizing hormone-releasing hormone analogues (LHRHa) that develop castration resistance after a follow-up period of 3 years. The secondary objective is to evaluate the variables potentially related to the progression to castration resistant prostate cancer (CRPC). Methods: A post-authorization, nation-wide, multicenter, prospective, observational, and longitudinal study that included 416 patients treated with LHRHa between 2012 and 2017 is presented. Patients were followed for 3 years or until development of CRPC, thus completing a per-protocol population of 350 patients. A Cox regression analysis was carried out to evaluate factors involved in progression to CRPC. Results: After 3 years of treatment with LHRHa 18.2% of patients developed CRPC. In contrast, in the subgroup analysis, 39.6% of the metastatic patients developed CRPC, compared with 8.8% of the non-metastatic patients. The patients with the highest risk of developing CRPC were those with a nadir prostate-specific antigen (PSA) > 2 ng/ml (HR 21.6; 95% CI 11.7–39.8; p < 0.001) and those receiving concomitant medication, most commonly bicalutamide (HR 1.8; 95% CI 1–3.1, p = 0.0431). Conclusions: The proportion of metastatic patients developing CRPC after 3 years of treatment with LHRHa is consistent with what has been previously described in the literature. In addition, this study provides new findings on CRPC in non-metastatic patients. Concomitant medication and nadir PSA are statistically significant predictive factors for the time to diagnosis of CRPC, the nadir PSA being the strongest predictor.
- Subjects
PROSTATE cancer patients; CASTRATION-resistant prostate cancer; LUTEINIZING hormone; CASTRATION; PROSTATE-specific antigen
- Publication
World Journal of Urology, 2022, Vol 40, Issue 10, p2459
- ISSN
0724-4983
- Publication type
Article
- DOI
10.1007/s00345-022-04108-x