Greater subcutaneous adiposity is associated with improved response to chemotherapy combined with maximal androgen ablation among men with metastatic castration-resistant prostate cancer (mCRPC), according to data presented at the European Society for Medical Oncology Virtual Congress 2020.1

In a study of 58 men with mCRPC, Andrew E. Hahn, MD, of The University of Texas MD Anderson Cancer Center in Houston, Texas, and colleagues found patients who had an objective response to chemotherapy plus maximal androgen ablation had a significantly higher subcutaneous adipose tissue (SAT) index than those who had no response (87.9 vs 62.7 cm2/m2; P =.01). Visceral adipose tissue, body mass index, and skeletal muscle mass were not significantly associated with response.

All patients had participated in a clinical trial in which they had received a combination of abiraterone, apalutamide, carboplatin, and cabazitaxel. Investigators assessed body composition at the level of L3 on baseline computed tomography scans at trial registration. Of the 58 patients, 12 had an objective response to treatment and 46 did not.

Dr Hahn and his coauthors cited previous studies suggesting that adiposity may improve clinical outcomes in men with CRPC. These include a study by Jong Soo Lee, MD, and colleagues published in The Journal of Urology in 2018.2 Their evaluation of data from 282 patients found that men with an SAT index of 39.9 cm2/m2 or greater at the diagnosis of CRPC had higher progression-free and cancer-specific survival rates than those with a subcutaneous fat index of less than 39.9 cm2/m2 at diagnosis.


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References

  1. Hahn AW, Tidwell RS, Surasi DS, et al. Body composition and clinical outcomes in men with metastatic castration-resistant prostate cancer. Presented at: ESMO Virtual Congress 2020. Abstract 669P.
  2. Lee JS, Lee HS, Ha JS et al. Subcutaneous fat distribution is a prognostic biomarker for men with castration-resistant prostate cancer. J Urol. 2018;200:114-120. doi:10.1016/j.juro.2018.01.069