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Liver Metastases in Prostate Carcinoma Represent a Relatively Aggressive Subtype Refractory to Hormonal Therapy and
Arsh Singh1, Naga K S Cheedella1, Shams A Shakil1
1Division of Hematology/Oncology, Brookdale University Hospital Medical Center, Brooklyn, NY, USA.
Background:
We report a single institution's experience from a small series of patients suggesting that liver metastasis in metastatic castration-refractory prostate cancer (mCRPC) represents a relatively aggressive subtype that is refractory to hormonal manipulation treatment, including luteinizing hormone-releasing hormone agonist (LA) and abiraterone (Ab) therapy, although docetaxel is briefly effective.
Methods:
Between 2007 and 2013, six patients with prostate cancer with liver metastases were analyzed. Biochemical response was defined as > 50% decrease in prostate-specific antigen (PSA) value.
Results:
Two patients who presented with liver metastases died in less than 3 months after LA therapy. Two out of three patients (one died while receiving chemotherapy) received Ab after chemotherapy did not show any response and died while on therapy. One patient who presented with lung metastases initially received LA therapy and progressed on it with liver metastases in < 6 months. Thus, five of six patients did not respond to hormone therapy including LA and Ab. Three patients who received docetaxel after LA therapy had more than 50% objective PSA response with a mean survival of 4 months.
Conclusions:
No literature addresses the response to hormone treatment in hepatic metastasis in prostate carcinoma. This small series suggests that liver metastases in prostate carcinoma represent a relatively aggressive subset against which hormonal therapy, including the LA and Ab, appears to be ineffective. Although our patients responded to docetaxel chemotherapy, their responses were of short duration. A further clinical trial involving more patients will be necessary to substantiate our findings.
Insights
Liver metastasis in prostate cancer is aggressive and resistant to hormone therapies like luteinizing hormone-releasing hormone agonist (LA) and abiraterone (Ab). Docetaxel offers brief efficacy in these patients.
Area of Science:
- Oncology
- Urology
Background:
- Metastatic castration-refractory prostate cancer (mCRPC) with liver involvement presents unique challenges.
- Liver metastases in mCRPC may indicate a more aggressive disease subtype.
Purpose of the Study:
- To investigate the efficacy of hormonal manipulation treatments in patients with mCRPC and liver metastases.
- To evaluate the response to abiraterone (Ab) and luteinizing hormone-releasing hormone agonist (LA) therapy in this specific patient group.
Main Methods:
- Retrospective analysis of six patients with prostate cancer and liver metastases treated between 2007 and 2013.
- Defined biochemical response as a >50% decrease in prostate-specific antigen (PSA) levels.
Main Results:
- Five out of six patients showed no response to hormonal therapies (LA and Ab).
- Two patients died within 3 months of initiating LA therapy.
- Docetaxel chemotherapy resulted in a >50% PSA response in three patients, but with a short mean survival of 4 months.
Conclusions:
- Hormonal therapies, including LA and Ab, appear ineffective against liver metastases in prostate cancer.
- Docetaxel demonstrated a temporary benefit, but responses were short-lived.
- Further clinical trials are needed to confirm these findings and explore alternative treatments.
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