Overall survival (OS) is worse for men with castration-resistant prostate cancer (CRPC) metastases to the lung and liver compared with metastases to bone and nonvisceral involvement, a study published in the Journal of Clinical Oncology has shown.1
Prior research suggests that site of metastases is an important factor for OS in men with metastatic CRPC (mCRPC). The studies, however, used a limited number of participants; therefore, these researchers sought to investigate this impact using a greater sample of men.
For this study, they combined individual patient data from 8820 men with mCRPC who received docetaxel chemotherapy in 9 phase III trials. Metastatic sites were categorized as lymph node (LN) only, bone with or without LN (with no visceral metastases), any lung metastases (but no liver), and any liver metastases.
Data showed prevalence of metastatic sites were bone with or without LN metastases (72.8%), visceral disease (20.8%), and LN-only disease (6.4%). Median OS was worse for men with liver metastases (13.5 months). Although median OS was better for men with lung metastases (19.4 months) compared with men with liver metastases, median survival duration was significantly worse for those with lung metastases than for those men with nonvisceral bone metastases (21.3 months). Median OS in men with LN-only disease was 31.6 months.
The pooled hazard ratios for death in men with lung metastases compared with men with bone with or without LN metastases was 1.14 (95% CI, 1.04 to 1.25; P=.007), and in men with any liver metastases compared with men with lung metastases was 1.52 (95% CI, 1.35 to 1.73; P<.0001).
“These data may help in treatment decisions, the design of future clinical trials, and understanding the variation in biology of different sites of metastases in men with mCRPC,” conclude the researchers.
1. Halabi S, Kelly WK, Ma H, et al. Meta-analysis evaluating the impact of site of metastasis on overall survival in men with castration-resistant prostate cancer [published online ahead of print March 7, 2016]. J Clin Oncol. doi:10.1200/JCO.2015.65.7270.