New Prognostic Imaging Biomarker in Metastatic Prostate Cancer
Posted: Thursday, August 30, 2018
The automated Bone Scan Index (aBSI), a software tool, was “significantly better” than manual calculation at predicting survival in men with metastatic castration-resistant prostate cancer, regardless of the extent of their bone metastases, according to a study published in JAMA Oncology. Andrew J. Armstrong, MD, of the Duke Cancer Institute’s Prostate and Urologic Cancer Center, Durham, North Carolina, and colleagues noted that, just as important, the data support “the prognostic utility of the aBSI as an objective imaging biomarker in the design and eligibility of [future] clinical trials of systemic therapies for patients with metastatic castration-resistant prostate cancer.”
Currently, visualizing metastatic castration-resistant prostate cancer–associated bone disease is done with the technetium-99m scan; its data subjectively are interpreted by manually counting metastatic lesion numbers. The aBSI program, however, objectively views computed tomography and magnetic resonance imaging images and, within seconds, tabulates the metastases.
This aBSI research was the prospectively planned analysis of results of a phase III, double-blind, placebo-controlled clinical trial of tasquinimod. The analysis focused on 721 eligible participants with bone-metastatic, chemotherapy-naive metastatic castration-resistant prostate cancer.
“The discriminative ability of the aBSI (C index, 0.63) in prognosticating overall survival was significantly higher than that of the manual lesion counting (C index, 0.60; P = .03),” wrote the team. In a multivariable survival model, aBSI counts were also significantly associated with overall survival (P = .03), time to symptomatic disease progression (P < .001), and time to opiate use for cancer pain (P < .001).