External Validation of a Prognostic Model Predicting Metastatic Castration-Resistant Prostate Cancer Survival in Patients Receiving Post-Docetaxel Second-Line Chemotherapy
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- Blas Leandro
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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- Shiota Masaki
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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- Nakamura Motonobu
- Department of Urology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
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- Yokomizo Akira
- Department of Urology, Harasanshin Hospital, Fukuoka, Japan
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- Tomoda Toshihisa
- Department of Urology, Oita Prefectural Hospital, Oita, Japan
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- Sakamoto Naotaka
- Department of Urology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
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- Seki Narihito
- Department of Urology, Kyushu Central Hospital, Fukuoka, Japan
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- Hasegawa Shuji
- Department of Urology, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
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- Yunoki Takakazu
- Department of Urology, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan
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- Harano Masahiko
- Department of Urology, JCHO Kyushu Hospital, Kitakyushu, Japan
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- Kuroiwa Kentaro
- Department of Urology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan
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- Eto Masatoshi
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Description
<p>Introduction: The Halabi model predicts the overall survival (OS) of patients with metastatic castration-resistant prostate cancer (mCRPC) treated with second-line therapy after docetaxel. We aimed to validate this model externally with an independent cohort, outside the setting of a clinical trial.</p><p>Methods: In a multi-institutional study, we included 66 patients treated with cabazitaxel after docetaxel for mCRPC. Patients were stratified according to the two- and three-risk groups of the Halabi nomogram. Kaplan-Meier and Cox proportional hazard analyses were performed to estimate survival and hazard ratios (HRs). The model performance was assessed using receiver operating characteristic curves, and the associated c-index (area under the curve [AUC]).</p><p>Results: The median OS in the two-risk groups was 5.06 months in the high-risk group (n=22) and 12.9 months in the low-risk group (n=44, p<0.001). High-risk patients had an HR of 9.50 (95% confidence interval (CI) 4.12-21.6, p<0.001) compared to low-risk patients. For the three-risk groups, the median OS was 6.44 months in the high-risk group (n=15), 5.75 months in the intermediate-risk group (n=11), and 13.7 months in the low-risk group (n=40, p=0.84). Compared to low-risk patients, intermediate-risk patients had an HR of 7.49 (95% CI 3.08-20.4, p<0.001), and high-risk patients had an HR of 8.48 (95% CI, 3.39-21.7, p<0.001). The AUC was 0.72 (95% CI 0.64-0.76) for the two-risk stratification. When comparing different risks, the AUCs were 0.48 (high vs intermediate), 0.66 (high vs low), and 0.65 (intermediate vs low).</p><p>Conclusions: The two-risk stratification version but not the three-risk group analysis confirmed the ability of the model to predict survival. These results support the value of the Halabi nomogram in men receiving post-docetaxel second-line chemotherapy for mCRPC.</p>
Journal
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- JMA Journal
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JMA Journal 5 (2), 224-229, 2022-04-15
Japan Medical Association / The Japanese Associaiton of Medical Sciences
