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Gleason Pattern 5 May Be a Prognostic Factor in Radium-223 Treatment.

Mitsuhisa Nishimoto¹, Kazutoshi Fujita¹, Aritoshi Ri²

¹Department of Urology, Faculty of Medicine, Kindai University, Osaka, Japan.

Cancer Diagnosis & Prognosis

|July 4, 2024

Summary

Prognostic factors for metastatic castration-resistant prostate cancer (CRPC) treated with radium-223 dichloride were analyzed. High PSA levels and Gleason Pattern 5 at treatment initiation indicate a worse overall survival (OS).

Keywords:

Gleason pattern Metastatic castration-resistant prostate cancer radium-223

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Published on: April 24, 2020

Area of Science:

Oncology
Radiopharmaceutical Therapy
Prostate Cancer Research

Background:

Metastatic castration-resistant prostate cancer (CRPC) has limited treatment options.
Radium-223 dichloride is an alpha-emitting radiopharmaceutical used for CRPC.
Identifying prognostic factors can optimize treatment strategies for CRPC patients.

Purpose of the Study:

To analyze prognostic factors influencing overall survival (OS) in patients with CRPC treated with radium-223 dichloride.
To evaluate the impact of baseline prostate-specific antigen (PSA) and Gleason Pattern (GP) on treatment outcomes.
To assess the association between treatment line and OS in CRPC patients receiving radium-223 dichloride.

Main Methods:

Retrospective analysis of 56 patients with CRPC treated with radium-223 dichloride.
Evaluation of prostate-specific antigen (PSA) and alkaline phosphatase (ALP) response rates.
Kaplan-Meier curves for overall survival (OS) and Cox proportional hazards analysis for prognostic factors.

Main Results:

Five-year OS rates were 62.2% post-CRPC diagnosis and 21.3% at radium-223 initiation.
PSA decline >50% observed in 11.1% and ALP decline >50% in 17.9% of patients.
High baseline PSA levels (HR=1.00) and Gleason Pattern 5 (HR=5.42) were significantly associated with worse OS.

Conclusions:

Gleason Pattern 5 and elevated PSA levels at radium-223 initiation are poor prognostic indicators for OS in CRPC.
Treatment timing (first-line vs. later) did not significantly impact OS.
A tailored treatment strategy for CRPC, considering Gleason Pattern, is warranted.