Duke Comprehensive Cancer Center, and the Duke Prostate Center, Duke University, Durham, NC, USA.

Division of Medical Oncology, Department of Medicine, Duke Comprehensive Cancer Center, Duke University, Durham, NC, USA; Division of Medical Oncology, Department of Medicine, Duke Prostate Center, Duke University, Durham, NC, USA; 4Division of Urology, Department of Surgery, Duke Comprehensive Cancer Center, Duke University, Durham, NC, USA; Division of Urology, Department of Surgery, Duke Prostate Center, Duke University, Durham, NC, USA.

The purpose of this study was to evaluate the relationship of baseline body mass index (BMI) and serum testosterone level with prostate cancer outcomes in men with castration-resistant metastatic prostate cancer (CRPC). BMI and testosterone levels were evaluated for their ability to predict overall survival (OS) and prostate-specific antigen (PSA) declines in the TAX327 clinical trial, an international phase III randomized trial of one of the two schedules of docetaxel and prednisone compared with mitoxantrone and prednisone. In this study of 1006 men with CRPC, the median serum testosterone level was 14.5 ng per 100 ml (range 0-270), the median BMI was 27 kg m(-2) (range 15.7-46.5), and 26% of men were obese or morbidly obese (BMI>/=30). Obesity was associated with younger age, lower PSA and alkaline phosphatase levels, and higher performance status, primary Gleason sum, testosterone and hemoglobin compared to absence of obesity. In multivariate analysis, neither BMI, presence of obesity, nor baseline testosterone was significantly associated with OS or PSA declines. Higher testosterone levels among obese men suggest incomplete gonadal suppression with current therapies, but these differences may not be clinically relevant in men with CRPC. There was evidence of potential hemodilution of PSA and alkaline phosphatase levels in obese men.

Written by
Armstrong AJ, Halabi S, de Wit R, Tannock IF, Eisenberger M.

Reference
Prostate Cancer Prostatic Dis. 2008 Jun 24. Epub ahead of print.
doi:10.1038/pcan.2008.36

PubMed Abstract
PMID:18574490

UroToday.com Prostate Cancer Section

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