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Incidence and survival of castration-resistant prostate cancer patients with visceral metastases: results from the Dutch CAPRI-registry

Prostate Cancer and Prostatic Diseases volume 26, pages 162–169 (2023)Cite this article

Subjects

Abstract

Background

The objective of this real-world population study is to investigate incidence and treatment of visceral metastases (VMs) in castration resistant prostate cancer (CRPC) patients and their survival.

Methods

CRPC-patients in the CAPRI-registry between 2010 and 2016 were included in the analyses and followed till 2017. Outcomes were proportion of patients radiologically screened for VMs and proportion of patients with VMs at CRPC-diagnosis and at the start of every treatment line. Groups have been created based on location of VMs (lung, liver, or both) at date of first VM diagnosis. The outcome for these groups was overall survival (OS). Statistics included descriptive analyses, Kaplan-Meier method, and Cox proportional hazard regression analysis for survival analyses.

Results

Of 3602 patients from the CAPRI registry, 457 patients (12.7%) were diagnosed with VMs during follow-up: 230 patients with liver, 161 with lung, and 66 with both liver and lung metastases. The proportion of patients radiologically screened for VMs increased per treatment line as did the occurrence rate of VMs. However, 80% of patients at CRPC diagnosis to 40% in the 6th line were not screened for VMs at the start of a systemic treatment. Median OS was 8.6 months for patients with liver, 18.3 with lung and 10.9 with both liver and lung metastases (p < 0.001) from date of first VM diagnosis. After correction for prognostic factors patients with lung metastases had significantly better OS than patients with liver metastases (HR 0.650, p = 0.001).

Conclusion

This real-world analysis showed that despite the increased rate of radiological staging during follow-up, still 80% to 40% of the patients (CRPC diagnosis to 6th treatment line respectively) were not screened for VMs at the start of a systemic treatment. VMs and location of VMs are key prognostic patient characteristics, impacts survival and have implications for treatment decisions, so routine staging of CRPC-patients is warranted.

Clinical trial identification

The CAPRI study is registered in the Dutch Trial Registry as NL3440 (NTR3591).

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

This research was funded by Sanofi-Aventis Netherlands B.V., Janssen-Cilag B.V., Astellas Pharma B.V., and Bayer B.V. The funding organizations had no role in the design and conduct of the study, collection, management, analysis, interpretation of the data, and preparation, review, or approval of the abstract.

Author information

Author notes

  1. These authors contributed equally: Gijs P. A. van den Bergh, Malou C. P. Kuppen.

Authors and Affiliations

  1. Institute for Medical Technology Assessment, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands

    Gijs P. A. van den Bergh, Malou C. P. Kuppen & Carin A. Uyl-de Groot

  2. Department of Radiation Oncology, Maastro, Maastricht, The Netherlands

    Malou C. P. Kuppen

  3. Department of Internal Medicine, Amphia Hospital, Breda, The Netherlands

    Hans M. Westgeest

  4. Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands

    Niven Mehra & Winald R. Gerritsen

  5. Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands

    Katja K. H. Aben

  6. Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands

    Katja K. H. Aben

  7. Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands

    Inge M. van Oort

  8. Department of Urology, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands

    Reindert J. A. van Moorselaar

  9. Department of Urology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands

    Diederik M. Somford

  10. Department of Medical Oncology, Amsterdam UMC location Vrije Universiteit Amsterdam, The Netherlands; Cancer Center Amsterdam, Amsterdam, The Netherlands

    Alfonsus J. M. van den Eertwegh

  11. Division of Internal Medicine (MOD) and Oncogenomics, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands

    André M. Bergman

  12. Department of Radiation Oncology, University Medical Center Groningen, Groningen, The Netherlands

    Alphonsus C. M. van den Bergh

Authors
  1. Gijs P. A. van den Bergh
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Contributions

Study concept and design: GPAvdB and MCPK. Data analysis and/or interpretation: GPAvdB, MCPK, HMW, NM, WRG, KKHA, IMvO, RJAvM, DMS, AJMvdE, AMB, ACMvdB, CAUdG. Drafting of the manuscript: GPAvdB, MCPK, HMW, NM, WRG, ACMvdB, CAUdG. Critical revision and final approval of the manuscript: GPAvdB, MCPK, HMW, NM, WRG, KKHA, IMvO, RJAvM, DMS, AJMvdE, AMB, ACMvdB, CAUdG.

Corresponding authors

Correspondence to Gijs P. A. van den Bergh or Malou C. P. Kuppen.

Ethics declarations

Competing interests

GPAvdB and MCPK report no conflict of interest. HMW reports travel expenses from Astellas and Ipsen; honoraria from Astellas and Roche. NM reports advisory role for Astellas, AstraZeneca, Janssen, JNJ, MSD, Pfizer, and Roche; funding (institutional and/or personal) from Astellas, Janssen and Pfizer; research grants (institutional) from AstraZeneca and BMS; coordinating PI (institutional) for BMS and Jansen; and non-financial interests (leadership-role or PI) in Castration-resistant Prostate Cancer Registry, Dutch Uro-Oncology Study Group and Prospective Bladder Cancer Infrastructure (Netherlands). WRG reports speaker fees (institutional and/or personal) from MSD; advisory role (institutional) for Bristol-Myers Squibb and Bayer; research grants (institutional) from Astellas, Bayer, Janssen-Cilag and MSD. KKHA reports no conflict of interest. IMvO reports conflicts of interest for Astellas, Bayer, Jansen, MSD/Astra and AAA Novartis. RJAvM reports conflicts of interest for Astellas, AstraZeneca, Bayer, Janssen, Pantarhei Oncology and Sanofi-Genzyme. DMS reports research grants/funding (institution) from Astellas, Besins and Dutch Cancer Society; Advisory/consultancy role for Astellas, Janssen, Bayer and MSD; contracted research (institution) for Janssen, Eli Lilly, Astellas, Blue Earth Diagnostics, Bayer, SPL medical and QED therapeutics. AJMvdE reports study grants from Sanofi, Roche, Bristol-Myers Squibb, TEVA and Idera; travel expenses from MSD Oncology, Roche, Pfizer and Sanofi; speaker honoraria from Bristol-Myers Squibb and Novartis; advisory role for Bristol-Myers Squibb, MSD Oncology, Amgen, Roche, Novartis, Sanofi, Pfizer, Ipsen, Merck and Pierre Fabre. AMB reports conflicts of interest for Astellas, Sanofi, Bayer and Janssen. ACMvdB and CAUdG report no conflict of interest.

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van den Bergh, G.P.A., Kuppen, M.C.P., Westgeest, H.M. et al. Incidence and survival of castration-resistant prostate cancer patients with visceral metastases: results from the Dutch CAPRI-registry. Prostate Cancer Prostatic Dis 26, 162–169 (2023). https://doi.org/10.1038/s41391-022-00605-7

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