Prognostic models for patients with metastatic castration-resistant prostate cancer (mCRPC) that are generalizable, current, and simple to apply are not yet available. Therefore, using information from 5 randomized clinical trials (RCTs), researchers created a nomogram to predict overall survival (OS) of mCRPC patients undergoing conventional treatment.
Five RCTs (ASCENT 2, VENICE, CELGENE/LARGE SAIL, ENTHUSE 14 and ENTHUSE 33) were randomly divided into training and validation cohorts (n=1636, 70%; n=700, 30%). Cox regression assessed the prognostic value of each available variable as a predictor of OS in the training cohort. A unique multivariate model was constructed using independent predictors of OS on multivariate analysis (nomogram). Using the area under the time-dependent curve (tAUC) and calibration curves, the validity of this model was examined in the validation cohort.
The median follow-up time (interquartile range) was 13.9 (8.9-20.2) months and the majority of patients (44.5%) were between 65 and 74 years old. In multivariate analysis: (visceral vs bone metastasis, relative risk [HR]: 1.24), prostate specific antigen (HR: 1.00), aspartate transaminase (HR: 1.01), alkaline phosphatase (HR: 1.00), body mass index (HR: 0.97) and hemoglobin (≥ 13 g/dl versus P
In order to predict the OS of patients with mCRPC receiving first-line chemotherapy, a new prognostic model was created. This could help urologists and oncologists counsel patients and help stratify patients more accurately for future clinical trials.