Study protocol and preliminary results from a mono-centric cohort within a trial testing stereotactic body radiotherapy and abiraterone (ARTO-NCT03449719).


Journal

La Radiologia medica
ISSN: 1826-6983
Titre abrégé: Radiol Med
Pays: Italy
ID NLM: 0177625

Informations de publication

Date de publication:
Aug 2022
Historique:
received: 31 12 2021
accepted: 30 05 2022
pubmed: 29 6 2022
medline: 6 8 2022
entrez: 28 6 2022
Statut: ppublish

Résumé

ARTO trial was designed to evaluate the difference in terms of outcomes between patients affected by oligo metastatic castrate resistant prostate cancer (mCRPC) treated with Abiraterone acetate and randomized to receive or not SBRT on all sites of disease. Here, we present a preliminary analysis conducted on patients enrolled at promoting institution. To present a preliminary overview about population features, clinical outcomes, adverse events, quality of life and explorative translational research. ARTO (NCT03449719) is a phase II trial including patients affected by oligo mCRPC, randomized to receive standard of care (GnRH agonist or antagonist plus abiraterone acetate 1000 mg and oral prednisone 10 mg daily) with or without SBRT on all metastatic sites of disease. All subjects have < 3 bone or nodal metastases. All patients are treated in I line mCRPC setting, no previous lines of treatment for mCRPC are allowed. Data about a mono-centric cohort of 42 patients enrolled are presented in the current analysis, with focus on baseline population features, PSA drop at 3 months, biochemical response, and quality of life outcomes. Descriptive statistics regarding translational research are also presented. Significant difference in terms of PSA drop at three months was not detected (p = 0.68). Biochemical response (PSA reduction > 50%) was reported in 73.7 versus 76.5% of patients in control vs SBRT arm, respectively (p = 0.84). All patients are alive. Progression occurred in 1 versus 0 patients in the control versus SBRT arm, respectively. After 3 months, an average decrease of 13 points in terms of Global Health Score was reported for the overall population. However, complete recovery was noticed at 6 months. Circulating tumor cells detection rate was 40%. SBRT + Abiraterone treatment was safe and well tolerated, non-significant trend in terms of PSA drop and biochemical response at 3 months was detected in SBRT arm. Interestingly, CTCs detection in this selected cohort of oligo-mCRPC was lower if compared to historical data of unselected mCRPC patients.

Sections du résumé

BACKGROUND BACKGROUND
ARTO trial was designed to evaluate the difference in terms of outcomes between patients affected by oligo metastatic castrate resistant prostate cancer (mCRPC) treated with Abiraterone acetate and randomized to receive or not SBRT on all sites of disease. Here, we present a preliminary analysis conducted on patients enrolled at promoting institution.
OBJECTIVE OBJECTIVE
To present a preliminary overview about population features, clinical outcomes, adverse events, quality of life and explorative translational research.
DESIGN, SETTING, AND PARTICIPANTS METHODS
ARTO (NCT03449719) is a phase II trial including patients affected by oligo mCRPC, randomized to receive standard of care (GnRH agonist or antagonist plus abiraterone acetate 1000 mg and oral prednisone 10 mg daily) with or without SBRT on all metastatic sites of disease. All subjects have < 3 bone or nodal metastases. All patients are treated in I line mCRPC setting, no previous lines of treatment for mCRPC are allowed.
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS METHODS
Data about a mono-centric cohort of 42 patients enrolled are presented in the current analysis, with focus on baseline population features, PSA drop at 3 months, biochemical response, and quality of life outcomes. Descriptive statistics regarding translational research are also presented.
RESULTS AND LIMITATION RESULTS
Significant difference in terms of PSA drop at three months was not detected (p = 0.68). Biochemical response (PSA reduction > 50%) was reported in 73.7 versus 76.5% of patients in control vs SBRT arm, respectively (p = 0.84). All patients are alive. Progression occurred in 1 versus 0 patients in the control versus SBRT arm, respectively. After 3 months, an average decrease of 13 points in terms of Global Health Score was reported for the overall population. However, complete recovery was noticed at 6 months. Circulating tumor cells detection rate was 40%.
CONCLUSIONS CONCLUSIONS
SBRT + Abiraterone treatment was safe and well tolerated, non-significant trend in terms of PSA drop and biochemical response at 3 months was detected in SBRT arm. Interestingly, CTCs detection in this selected cohort of oligo-mCRPC was lower if compared to historical data of unselected mCRPC patients.

Identifiants

pubmed: 35763249
doi: 10.1007/s11547-022-01511-7
pii: 10.1007/s11547-022-01511-7
pmc: PMC9349091
doi:

Substances chimiques

Androstenes 0
Prostate-Specific Antigen EC 3.4.21.77
Abiraterone Acetate EM5OCB9YJ6
abiraterone G819A456D0

Types de publication

Clinical Trial, Phase II Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

912-918

Informations de copyright

© 2022. The Author(s).

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Auteurs

Giulio Francolini (G)

Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Largo Brambilla 3, 50139, Florence, Italy.

Beatrice Detti (B)

Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Largo Brambilla 3, 50139, Florence, Italy. beatrice.detti@aouc.unifi.it.

Vanessa Di Cataldo (V)

Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Largo Brambilla 3, 50139, Florence, Italy.

Pietro Garlatti (P)

Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Largo Brambilla 3, 50139, Florence, Italy.

Michele Aquilano (M)

Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Florence, Italy.

Andrea Allegra (A)

Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Florence, Italy.

Sara Lucidi (S)

Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Florence, Italy.

Cecilia Cerbai (C)

Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Florence, Italy.

Lucia Pia Ciccone (LP)

Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Florence, Italy.

Viola Salvestrini (V)

Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Florence, Italy.

Giulia Stocchi (G)

Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Florence, Italy.

Barbara Guerrieri (B)

Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Florence, Italy.

Luca Visani (L)

CyberKnife Center, Istituto Fiorentino di Cura ed Assistenza, Florence, Italy.

Mauro Loi (M)

Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Largo Brambilla 3, 50139, Florence, Italy.

Isacco Desideri (I)

Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Florence, Italy.

Monica Mangoni (M)

Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Florence, Italy.

Icro Meattini (I)

Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Florence, Italy.

Lorenzo Livi (L)

Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Florence, Italy.

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Classifications MeSH