Development of castration resistance in prostate cancer patients treated with luteinizing hormone-releasing hormone analogues (LHRHa): results of the ANARESISTANCE study
Angulo, J.C.; Ciria Santos, J.P.; Gómez Caamaño, Antonio; Poza de Celis, R.; González Sala, J.L.; García Garzón, J.M.; Galán-Llopis, J.A.; Pérez Sampietro, M.; Perrot, V.; Planas Morin, J.; Abascal, J.M.; Barrond, V.; Benedicto, A.; Carballo Castro, Ana María; Cortiñas, J.R.; Fernández, M.; Ferrer, E.; Guzmán, P.L.; López, M.Á.; Martínez, J.C.; Olivier, C.; Peleteiro Higuero, Paula; Pérez, P.J.; Pesqueira, D.; Ponce, J.; Ruibal, M.; Segarra, J.; Solsona, E.; Suárez, J.F.; Rosa, J.; Tabernero, Á.; Vesga, F.; Zapatero, A.

Identificadores
Identificadores
Visualización o descarga de ficheros
Visualización o descarga de ficheros
Fecha de publicación
2022Título de revista
World Journal of Urology
Tipo de contenido
Article
Resumen
Purpose: Evaluate the percentage of patients with prostate cancer treated with luteinizing hormone-releasing hormone analogues (LHRHa) that develop castration resistance after a follow-up period of 3 years. The secondary objective is to evaluate the variables potentially related to the progression to castration resistant prostate cancer (CRPC). Methods: A post-authorization, nation-wide, multicenter, prospective, observational, and longitudinal study that included 416 patients treated with LHRHa between 2012 and 2017 is presented. Patients were followed for 3 years or until development of CRPC, thus completing a per-protocol population of 350 patients. A Cox regression analysis was carried out to evaluate factors involved in progression to CRPC. Results: After 3 years of treatment with LHRHa 18.2% of patients developed CRPC. In contrast, in the subgroup analysis, 39.6% of the metastatic patients developed CRPC, compared with 8.8% of the non-metastatic patients. The patients with the highest risk of developing CRPC were those with a nadir prostate-specific antigen (PSA) > 2 ng/ml (HR 21.6; 95% CI 11.7-39.8; p < 0.001) and those receiving concomitant medication, most commonly bicalutamide (HR 1.8; 95% CI 1-3.1, p = 0.0431). Conclusions: The proportion of metastatic patients developing CRPC after 3 years of treatment with LHRHa is consistent with what has been previously described in the literature. In addition, this study provides new findings on CRPC in non-metastatic patients. Concomitant medication and nadir PSA are statistically significant predictive factors for the time to diagnosis of CRPC, the nadir PSA being the strongest predictor.
