According to data presented at the 2012 American Society of Clinical Oncology Annual Meeting in Chicago. (Abstract # 4655) the presences of liver metastases predicts shorter overall survival in men with metastatic castration-refractory prostate cancer (mCRPC).
William Kevin Kelly, DO, Thomas Jefferson University Hospital and the Kimmel Cancer Center at Jefferson, and colleagues from the Alliance for Clinical Trials in Oncology, found in a phase III trial that men without liver metastases lived 8.2 months longer compared to men who had developed liver metastases. The survival benefit even existed despite both groups having similar progression free survival and response to docetaxel based chemotherapy.
The multi-institutional study included 1,050 men from the CALGB 90401 trial, a randomized, double-blind, placebo-controlled phase III trial comparing docetaxel, prednisone, and placebo with docetaxel, prednisone, and bevacizumab in men with mCRPC.
In their sample, fifty-nine (5.6%) of those men had documented liver metastases. Men with liver metastases had higher baseline alkaline phosphatase (ALK) and lactate dehydrogenase (ADH) levels compared to men without liver metastases. The median overall survival time in men with liver metastases was 14.4 compared to 22.6 months for men without liver metastasis (hazard ratio (HR) 1.4). The HR for treatment effect (docetaxel and prednisone with either bevacizumab or placebo) for liver metastases was not statistically significant for either group.
The Bottom Line
The presence of liver metastasis is a negative prognostic sign for men with castrate resistant prostate cancer.
Joel T. Nowak, M.A., M.S.W.