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Automated Bone Scan Index to Optimize Prostate Cancer Working Group Radiographic Progression Criteria for Men With Metastatic Castration-Resistant Prostate Cancer

Anand, Aseem LU ; Heller, Glenn ; Fox, Joseph ; Danila, Daniel C. ; Bjartell, Anders LU ; Edenbrandt, Lars LU ; Larson, Steven M. ; Scher, Howard I. and Morris, Michael J. (2022) In Clinical Genitourinary Cancer 20(3). p.270-277
Abstract

Introduction: Radiographic progression-free survival (rPFS) by Prostate Cancer Working Group (PCWG) criteria is a radiographic endpoint. The automated bone scan index (aBSI) quantifies osseous disease burden on bone scintigraphy as a percentage of total skeletal weight. Using the aBSI, we sought to quantify increase in tumor burden represented by PCWG progression criteria, and to determine the interval increase that best associates with overall survival (OS). Patient and Methods: Retrospective analysis of trials using androgen receptor axis–targeted drugs for metastatic castration resistant prostate cancer patients (mCRPC). aBSI increase in bone disease was assessed from baseline scan to time-to-progression (per PCWG criteria).... (More)

Introduction: Radiographic progression-free survival (rPFS) by Prostate Cancer Working Group (PCWG) criteria is a radiographic endpoint. The automated bone scan index (aBSI) quantifies osseous disease burden on bone scintigraphy as a percentage of total skeletal weight. Using the aBSI, we sought to quantify increase in tumor burden represented by PCWG progression criteria, and to determine the interval increase that best associates with overall survival (OS). Patient and Methods: Retrospective analysis of trials using androgen receptor axis–targeted drugs for metastatic castration resistant prostate cancer patients (mCRPC). aBSI increase in bone disease was assessed from baseline scan to time-to-progression (per PCWG criteria). Threshold for time to aBSI increase were explored and the association between each time-to-threshold and OS was computed. Results: A total of 169 mCPRC patients had bone scans available for aBSI analysis. Of these, 90 (53%) had progression in bone meeting PCWG criteria. Total aBSI increase in patients meeting PCWG criteria was 1.22 (interquartile range [IQR]: 0.65-2.49), with a median relative increase of 109% (IQR: 40%-377%). Median aBSI at baseline was 3.1 (IQR: 1.3-7.1). The best association between OS and time-to-progression occurred with an absolute increase in aBSI equal to 0.6 (Kendall's tau 0.52). Conclusion: An absolute increase of 0.6 or more in aBSI from the first follow-up scan results in the highest association with OS in patients with mCRPC. The rPFS by PCWG, identified progression at nearly twice this tumor burden, suggesting that aBSI may be used to further develop the PCWG criteria without degrading its association with OS.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
bone metastases, clinical trials endpoints, Imaging biomarkers
in
Clinical Genitourinary Cancer
volume
20
issue
3
pages
270 - 277
publisher
Elsevier
external identifiers
  • scopus:85126036243
  • pmid:35279418
ISSN
1558-7673
DOI
10.1016/j.clgc.2022.02.002
language
English
LU publication?
yes
id
38a2bf03-e2c3-4971-8e55-493808a01ab4
date added to LUP
2022-04-22 13:41:49
date last changed
2024-06-20 19:01:35
@article{38a2bf03-e2c3-4971-8e55-493808a01ab4,
  abstract     = {{<p>Introduction: Radiographic progression-free survival (rPFS) by Prostate Cancer Working Group (PCWG) criteria is a radiographic endpoint. The automated bone scan index (aBSI) quantifies osseous disease burden on bone scintigraphy as a percentage of total skeletal weight. Using the aBSI, we sought to quantify increase in tumor burden represented by PCWG progression criteria, and to determine the interval increase that best associates with overall survival (OS). Patient and Methods: Retrospective analysis of trials using androgen receptor axis–targeted drugs for metastatic castration resistant prostate cancer patients (mCRPC). aBSI increase in bone disease was assessed from baseline scan to time-to-progression (per PCWG criteria). Threshold for time to aBSI increase were explored and the association between each time-to-threshold and OS was computed. Results: A total of 169 mCPRC patients had bone scans available for aBSI analysis. Of these, 90 (53%) had progression in bone meeting PCWG criteria. Total aBSI increase in patients meeting PCWG criteria was 1.22 (interquartile range [IQR]: 0.65-2.49), with a median relative increase of 109% (IQR: 40%-377%). Median aBSI at baseline was 3.1 (IQR: 1.3-7.1). The best association between OS and time-to-progression occurred with an absolute increase in aBSI equal to 0.6 (Kendall's tau 0.52). Conclusion: An absolute increase of 0.6 or more in aBSI from the first follow-up scan results in the highest association with OS in patients with mCRPC. The rPFS by PCWG, identified progression at nearly twice this tumor burden, suggesting that aBSI may be used to further develop the PCWG criteria without degrading its association with OS.</p>}},
  author       = {{Anand, Aseem and Heller, Glenn and Fox, Joseph and Danila, Daniel C. and Bjartell, Anders and Edenbrandt, Lars and Larson, Steven M. and Scher, Howard I. and Morris, Michael J.}},
  issn         = {{1558-7673}},
  keywords     = {{bone metastases; clinical trials endpoints; Imaging biomarkers}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{270--277}},
  publisher    = {{Elsevier}},
  series       = {{Clinical Genitourinary Cancer}},
  title        = {{Automated Bone Scan Index to Optimize Prostate Cancer Working Group Radiographic Progression Criteria for Men With Metastatic Castration-Resistant Prostate Cancer}},
  url          = {{http://dx.doi.org/10.1016/j.clgc.2022.02.002}},
  doi          = {{10.1016/j.clgc.2022.02.002}},
  volume       = {{20}},
  year         = {{2022}},
}