Markers of bone metabolism and overall survival in men with bone-metastatic hormone sensitive prostate cancer (HSPC): A subset analysis of SWOG S1216, a phase III trial of androgen deprivation with or without orteronel

Primo N Lara ¹, Edward Mayerson ², Erik Gertz ³

⁰University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA. pnlara@ucdavis.edu.

Prostate Cancer and Prostatic Diseases +

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February 29, 2024

View abstract on PubMed

Summary

Elevated bone biomarkers in men with metastatic hormone-sensitive prostate cancer (HSPC) significantly predict overall survival (OS). These markers help identify distinct risk groups with varying prognoses, aiding in personalized treatment strategies.

Area Of Science

Oncology
Biochemistry
Clinical Trials

Background

Circulating bone metabolism biomarkers correlate with overall survival (OS) in advanced prostate cancer.
Previous SWOG S1216 trial data indicated elevated bone biomarkers increase mortality risk in hormone-sensitive prostate cancer (HSPC).
This analysis focuses on the association between bone biomarkers and OS in HSPC patients with documented bone metastases.

Purpose Of The Study

To investigate the prognostic value of bone biomarkers for overall survival (OS) in men with bone metastatic hormone-sensitive prostate cancer (HSPC).
To identify patient subgroups with differential OS outcomes based on bone biomarker levels.
To validate findings from previous analyses within a specific subset of the SWOG S1216 trial.

Main Methods

Assessed bone resorption markers (C-telopeptide [CTx], Pyridinoline [PYD]) and bone formation markers (C-terminal collagen propeptide [CICP], bone alkaline phosphatase [BAP]) in blood samples.
Utilized recursive partitioning in a training set to define cut-points for biomarkers and prognostic groups.
Employed Cox proportional hazards models in a validation set to evaluate biomarker impact on OS, adjusting for clinical variables.

Main Results

Elevated CICP, CTX, and PYD levels were strongly prognostic for OS in men with bone metastatic HSPC.
Hazard ratios indicated significant associations between elevated CICP, CTX, and PYD and worse OS.
Prognostic models identified four patient groups with distinct median OS, ranging from 2.3 to 7.5 years, based on bone biomarker levels.

Conclusions

Elevated serum bone metabolism markers are significantly associated with poorer OS in men with HSPC and bone metastases.
Bone biomarker levels, individually and combined with clinical factors, effectively stratify patients into unique prognostic subsets.
These findings support the use of bone biomarkers for risk stratification and personalized management in bone metastatic HSPC.

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