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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
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2016 (English)In: European Urology Focus, ISSN 2405-4569, Vol. 2, no 5, p. 540-546Article in journal (Refereed) Published
Abstract [en]

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(BSI) 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.

Place, publisher, year, edition, pages
Elsevier, 2016. Vol. 2, no 5, p. 540-546
Keywords [en]
Abiraterone acetate, Castration-resistant prostate cancer, Bone metastasis, Bone Scan Index
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:umu:diva-166403DOI: 10.1016/j.euf.2016.02.013ISI: 000485927900015PubMedID: 28723520OAI: oai:DiVA.org:umu-166403DiVA, id: diva2:1379685
Available from: 2019-12-17 Created: 2019-12-17 Last updated: 2019-12-17Bibliographically approved

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Thellenberg-Karlsson, Camilla

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Ohlsson, MattiasThellenberg-Karlsson, Camilla
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