Mariana Reza1, Mattias Ohlsson2, Reza Kaboteh3, Aseem Anand4, Ingela Franck-Lissbrant5, Jan-Erik Damber6, Anders Widmark7, Camilla Thellenberg-Karlsson8, Lars Budäus9, Thomas Steuber10, Till Eichenauer10, Per Wollmer11, Lars Edenbrandt12, Elin Trägårdh11, Anders Bjartell13. 1. Department of Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Malmö, Sweden; Department of Translational Medicine, Centre of Medical Informatics, Lund University, Lund, Sweden. Electronic address: mariana.reza@med.lu.se. 2. Department of Astronomy and Theoretical Physics, Lund University, Lund, Sweden. 3. Department of Molecular and Clinical Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden. 4. Department of Translational Medicine, Division of Urological Cancers, Malmö, Lund University, Lund, Sweden. 5. Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden. 6. Department of Urology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden. 7. Department of Oncology, Norrland University Hospital, Umeå University, Umeå, Sweden. 8. Department of Radiation Sciences, Umeå University, Umeå, Sweden. 9. Martini-Klinik, Prostate Cancer Centre, Hamburg, Germany; Department of Urology, Hamburg University Hospital, Hamburg, Germany. 10. Martini-Klinik, Prostate Cancer Centre, Hamburg, Germany. 11. Department of Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Malmö, Sweden. 12. Department of Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Malmö, Sweden; Department of Molecular and Clinical Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden. 13. Department of Translational Medicine, Division of Urological Cancers, Malmö, Lund University, Lund, Sweden; Department of Urology, Skåne University Hospital, Malmö, Sweden.
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 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.
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.
Authors: Andrew J Armstrong; Aseem Anand; Lars Edenbrandt; Eva Bondesson; Anders Bjartell; Anders Widmark; Cora N Sternberg; Roberto Pili; Helen Tuvesson; Örjan Nordle; Michael A Carducci; Michael J Morris Journal: JAMA Oncol Date: 2018-07-01 Impact factor: 31.777
Authors: Jose Mauricio Mota; Andrew J Armstrong; Steven M Larson; Josef J Fox; Michael J Morris Journal: Prostate Cancer Prostatic Dis Date: 2019-04-29 Impact factor: 5.554
Authors: Matthew S Brown; Grace Hyun J Kim; Gregory H Chu; Bharath Ramakrishna; Martin Allen-Auerbach; Cheryce P Fischer; Benjamin Levine; Pawan K Gupta; Christiaan W Schiepers; Jonathan G Goldin Journal: J Med Imaging (Bellingham) Date: 2018-01-11