This retrospective analysis represents the first attempt to integrate the findings on BS and CT to estimate bony metastatic disease progression and evaluate the association of this composite metric with over survival (OS) in men with mCRPC.
The integration of CT and BS can be performed without excessive burdens to the healthcare system. This small study analyzed 28 patients with mCRPC receiving docetaxel or post-docetaxel therapy in prospective trials.
Central radiology review of both CT and BS was conducted by a single radiologist, which was considered critical to optimally integrate the findings of CT and BS.
This hypothesis-generating study suggests that the integration of ≥1 new lesion on CT and/or BS within 90 days captures bone progression and predicts OS.
The external validation and comparison of this composite metric at a single time point within 90 days versus the currently used Prostate Cancer Working Group (PCWG) criteria, which advocate ≥2 new lesions on BS followed by ≥2 new lesions in a subsequent BS in ≥6 weeks, should be investigated.
Thus, the integration of both BS and CT findings may be complementary. In contrast, use of the PCWG guidelines requires a repeat BS, which may subject patients to many weeks of ineffective therapy if the new lesions represent true progression.
Written by: Guru Sonpavde, MD, Department of Medicine, Section of Medical Oncology, University of Alabama at Birmingham (UAB) Comprehensive Cancer Center, Birmingham, AL.
Read the Abstract
Parker SJ, Pond GR, Agarwal N, Alex A, Heilbrun ME, Sonpavde G., "Integration of Bone and Computed Tomography Scans to Assess Bone Metastasis in Metastatic Castration-Resistant Prostate Cancer," Clin Genitourin Cancer. 2016 May 27. pii: S1558-7673(16)30135-5. doi: 10.1016/j.clgc.2016.05.009. [Epub ahead of print].