Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Bone Scan Index as an Imaging Biomarker in Metastatic Castration-resistant Prostate Cancer : A Multicentre Study Based on Patients Treated with Abiraterone Acetate (Zytiga) in Clinical Practice

Reza Felix, Mariana LU ; Ohlsson, Mattias LU orcid ; Kaboteh, Reza ; Anand, Aseem LU ; Franck Lissbrant, Ingela ; Damber, Jan-Erik ; Widmark, Anders ; Thellenberg-Karlsson, Camilla ; Budäus, Lars and Steuber, Thomas , et al. (2016) In European Urology Focus 2(5). p.540-546
Abstract

Background Abiraterone acetate (AA) prolongs survival in metastatic castration-resistant prostate cancer (mCRPC) patients. To measure treatment response accurately in bone, quantitative methods are needed. The Bone Scan Index (BSI), a prognostic imaging biomarker, reflects the tumour burden in bone as a percentage of the total skeletal mass calculated from bone scintigraphy. Objective To evaluate the value of BSI as a biomarker for outcome evaluation in mCRPC patients on treatment with AA according to clinical routine. Design, setting, and participants We retrospectively studied 104 mCRPC patients who received AA following disease progression after chemotherapy. All patients underwent whole-body bone scintigraphy before and during AA... (More)

Background Abiraterone acetate (AA) prolongs survival in metastatic castration-resistant prostate cancer (mCRPC) patients. To measure treatment response accurately in bone, quantitative methods are needed. The Bone Scan Index (BSI), a prognostic imaging biomarker, reflects the tumour burden in bone as a percentage of the total skeletal mass calculated from bone scintigraphy. Objective To evaluate the value of BSI as a biomarker for outcome evaluation in mCRPC patients on treatment with AA according to clinical routine. Design, setting, and participants We retrospectively studied 104 mCRPC patients who received AA following disease progression after chemotherapy. All patients underwent whole-body bone scintigraphy before and during AA treatment. Baseline and follow-up BSI data were obtained using EXINI BoneBSI software (EXINI Diagnostics AB, Lund, Sweden). Outcome measurements and statistical analysis Associations between change in BSI, clinical parameters at follow-up, and overall survival (OS) were evaluated using the Cox proportional hazards regression models and Kaplan-Meier estimates. Discrimination between variables was assessed using the concordance index (C-index). Results and limitations Patients with an increase in BSI at follow-up of at most 0.30 (n = 54) had a significantly longer median survival time than those with an increase of BSI >0.30 (n = 50) (median: 16 vs 10 mo; p = 0.001). BSI change was also associated with OS in a multivariate Cox analysis including commonly used clinical parameters for prognosis (C-index = 0.7; hazard ratio: 1.1; p = 0.03). The retrospective design was a limitation. Conclusions Change in BSI was significantly associated with OS in mCRPC patients undergoing AA treatment following disease progression in a postchemotherapy setting. BSI may be a useful imaging biomarker for outcome evaluation in this group of patients, and it could be a valuable complementary tool in monitoring patients with mCRPC on second-line therapies. Patient summary Bone Scan Index (BSI) change is related to survival time in metastatic castration-resistant prostate cancer (mCRPC) patients on abiraterone acetate. BSI may be a valuable complementary decision-making tool supporting physicians monitoring patients with mCRPC on second-line therapies.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; ; ; ; ; and (Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Abiraterone acetate, Bone metastasis, Bone Scan Index, Castration-resistant prostate cancer
in
European Urology Focus
volume
2
issue
5
pages
7 pages
publisher
Elsevier
external identifiers
  • pmid:28723520
  • scopus:85013192706
ISSN
2405-4569
DOI
10.1016/j.euf.2016.02.013
language
English
LU publication?
yes
id
9a55bb2a-d1c7-4988-82cd-6de3741ee602
date added to LUP
2017-03-02 12:09:02
date last changed
2024-06-09 12:06:06
@article{9a55bb2a-d1c7-4988-82cd-6de3741ee602,
  abstract     = {{<p>Background Abiraterone acetate (AA) prolongs survival in metastatic castration-resistant prostate cancer (mCRPC) patients. To measure treatment response accurately in bone, quantitative methods are needed. The Bone Scan Index (BSI), a prognostic imaging biomarker, reflects the tumour burden in bone as a percentage of the total skeletal mass calculated from bone scintigraphy. Objective To evaluate the value of BSI as a biomarker for outcome evaluation in mCRPC patients on treatment with AA according to clinical routine. Design, setting, and participants We retrospectively studied 104 mCRPC patients who received AA following disease progression after chemotherapy. All patients underwent whole-body bone scintigraphy before and during AA treatment. Baseline and follow-up BSI data were obtained using EXINI Bone<sup>BSI</sup> software (EXINI Diagnostics AB, Lund, Sweden). Outcome measurements and statistical analysis Associations between change in BSI, clinical parameters at follow-up, and overall survival (OS) were evaluated using the Cox proportional hazards regression models and Kaplan-Meier estimates. Discrimination between variables was assessed using the concordance index (C-index). Results and limitations Patients with an increase in BSI at follow-up of at most 0.30 (n = 54) had a significantly longer median survival time than those with an increase of BSI &gt;0.30 (n = 50) (median: 16 vs 10 mo; p = 0.001). BSI change was also associated with OS in a multivariate Cox analysis including commonly used clinical parameters for prognosis (C-index = 0.7; hazard ratio: 1.1; p = 0.03). The retrospective design was a limitation. Conclusions Change in BSI was significantly associated with OS in mCRPC patients undergoing AA treatment following disease progression in a postchemotherapy setting. BSI may be a useful imaging biomarker for outcome evaluation in this group of patients, and it could be a valuable complementary tool in monitoring patients with mCRPC on second-line therapies. Patient summary Bone Scan Index (BSI) change is related to survival time in metastatic castration-resistant prostate cancer (mCRPC) patients on abiraterone acetate. BSI may be a valuable complementary decision-making tool supporting physicians monitoring patients with mCRPC on second-line therapies.</p>}},
  author       = {{Reza Felix, Mariana and Ohlsson, Mattias and Kaboteh, Reza and Anand, Aseem and Franck Lissbrant, Ingela and Damber, Jan-Erik and Widmark, Anders and Thellenberg-Karlsson, Camilla and Budäus, Lars and Steuber, Thomas and Eichenauer, Till and Wollmer, Per and Edenbrandt, Lars and Trägårdh, Elin and Bjartell, Anders}},
  issn         = {{2405-4569}},
  keywords     = {{Abiraterone acetate; Bone metastasis; Bone Scan Index; Castration-resistant prostate cancer}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{540--546}},
  publisher    = {{Elsevier}},
  series       = {{European Urology Focus}},
  title        = {{Bone Scan Index as an Imaging Biomarker in Metastatic Castration-resistant Prostate Cancer : A Multicentre Study Based on Patients Treated with Abiraterone Acetate (Zytiga) in Clinical Practice}},
  url          = {{http://dx.doi.org/10.1016/j.euf.2016.02.013}},
  doi          = {{10.1016/j.euf.2016.02.013}},
  volume       = {{2}},
  year         = {{2016}},
}