Liver metastases and its prognostic significance in men with metastatic prostate cancer

Liver metastases predicts shorter overall survival in men with metastatic castration-refractory prostate cancer (mCRPC), according to data being presented at the 2012 American Society of Clinical Oncology Annual Meeting in Chicago.

In a phase III trial, lead study author 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 that men without liver metastases lived 8.2 months longer compared to men whose cancer did metastasize, despite both groups having similar progression free survival and response to docetaxel based chemotherapy.

The multi-institutional study included 1,050 patients 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.

For the investigation, researchers assessed the prognostic significance of liver metastases in predicting overall survival and progression free survival, adjusting for stratification factors.

Fifty-nine (5.6%) of those patients had documented liver metastases. Patients with liver metastases had higher baseline alkaline phosphatase (ALK) and lactate dehydrogenase (ADH) levels compared to patients without liver metastases. The median overall survival time in patients with liver metastases was 14.4 compared to 22.6 months for patients 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.