CHICAGO, IL USA (UroToday.com) - Presented by Stephanie Doctor* at the American Society of Clinical Oncology (ASCO) Annual Meeting - May 31 - June 4, 2013 - McCormick Place - Chicago, IL USA
*Icahn School of Medicine at Mount Sinai, New York, NY USA
Click HERE to view the poster from this session
Evolving patterns of metastatic disease in castration-resistant prostate cancer (CRPC) reported in clinical trials from 1990 to 2011
Stephanie Doctor, Che-Kai Tsao, James H. Godbold, Matt D. Galsky, William K. Oh
Division of Hematology and Medical Oncology, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY; Mount Sinai Medical Center, New York, NY; Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY
Background: Bone remains the most common site of metastasis in CRPC. With new therapies extending survival in metastatic CRPC (mCRPC), we hypothesized that the incidence of non-osseous metastases is increasing over time. In this study, we evaluated the pattern of metastatic disease in mCRPC as reported in baseline characteristics of prospective clinical trials over 2 decades.
Methods: We identified all therapeutic studies in patients with mCRPC in Pubmed and ASCO abstracts from 1990-2011. Inclusion criteria included phase 2 or 3 clinical trials in mCRPC with available baseline demographic data and no exclusion of specific site of metastatic disease (except brain). ASCO abstracts were limited to presentations in which data were available online. For each study, demographic data and study-reported sites of non-osseous metastatic disease were recorded (lymph node, visceral, soft tissue, liver). For each type of metastasis, weighted least squares linear regression models were used to evaluate temporal trends.
Results: We identified a total of 290 eligible studies (270 phase II and 20 phase III) involving 19,110 patients. Of these, 127 studies reported data on non-osseous metastases and prior chemotherapy. There was a significant trend over time (p50.001) of increasing proportions of patients with non-osseous metastasis in both chemotherapy- naïve and treated groups (1.4% per year increase). Increased lymph node, visceral, and soft tissue metastases were seen over the study period. However, the proportion of patients with liver metastasis remained relatively stable
Conclusions: In this study, we noted an increasing trend of non-osseous metastatic disease in patients with mCRPC over 20 years. This included lymph node, visceral and soft tissue metastatic disease, and this trend was observed in both chemotherapy-naïve and treated patients. Longer survival and new therapies may be changing the clinical presentation of patients with mCRPC.
Stephanie Doctor is a recent graduate of the University of North Carolina at Chapel Hill, earning a BS in Biology with a minor in chemistry. She earned highest honors for her research on cellulose synthesis in Arabidopsis.
Stephanie spent the summer of 2012 studying the changing patterns of metastasis in castration-resistant prostate cancer under the direction of Dr. William Oh at the Tisch Cancer Institute of Mount Sinai School of Medicine. She is now taking time off to travel through Europe and plans to apply for MD/PhD programs upon returning so that she can continue to fight cancer through research and medicine.