Obesity Linked With Improved Survival in mCRPC

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Obese men treated with docetaxel for metastatic castration-resistant prostate cancer have longer cancer-specific and overall survival, a study found.
Obese men treated with docetaxel for metastatic castration-resistant prostate cancer have longer cancer-specific and overall survival, a study found.

SAN FRANCISCO—Obesity is associated with improved cancer-specific and overall survival among men with metastatic castration-resistant prostate cancer (mCRPC) treated with docetaxel, investigators reported at the 2019 Genitourinary Cancers Symposium.

Alberto Martini, MD, of Icahn School of Medicine at Mount Sinai in New York, and collaborators identified 1577 patients with mCRPC from the control arms of 3 randomized trials (ASCENT2, MAINSAL, and VENICE). Study patients had a median age of 69 years and a median BMI of 28 kg/m2. Of these patients, 655 died during follow-up. The median follow-up for survivors was 12 months.

Obesity, defined as a body mass index (BMI) greater than 30 kg/m2, was associated with a significant 35% decreased risk of CSM and 29% decreased risk of death from any cause compared with patients who had a BMI of 25-30 kg/m2 (reference), in adjusted analyses. Each 1 kg/m2 increment in BMI was associated with a significant 6% decreased risk of cancer-specific mortality and 4% decreased risk of death from any cause. The patients found no interaction between BMI categories and docetaxel dose.

The investigators adjusted analyses for age, PSA level, number of metastases, prior treatment, and ECOG (Eastern Cooperative Oncology Group) performance status.

In a previous study published in 2018 in BJU International, investigators found that obesity was associated with a significant 21% decreased risk of all-cause mortality among men with non-metastatic CRPC compared with normal weight.

Reference

Martini A, Waingankar N, Brown NM et al. Obesity and metastatic castration resistant prostate cancer: Results from the control arms of ASCENT2, MAINSAL and VENICE trials. Data presented at the 2019 Genitourinary Cancers Symposium held in San Francisco, February 14-16. Abstract 287.

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