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Impact of baseline serum IL‐8 on metastatic hormone‐sensitive prostate cancer outcomes in the Phase 3 CHAARTED trial (E3805)
Author(s) -
Harshman Lauren C.,
Wang Victoria X.,
Hamid Anis A.,
Santone Gabriella,
Drake Charles G.,
Carducci Michael A.,
DiPaola Robert S.,
Fichorova Rai.,
Sweeney Christopher J.
Publication year - 2020
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.24074
Subject(s) - medicine , prostate cancer , hazard ratio , oncology , docetaxel , androgen deprivation therapy , cohort , proportional hazards model , enzalutamide , metastasis , cancer , confidence interval , androgen receptor
Background The immunosuppressive cytokine interleukin‐ 8 (IL‐8), produced by tumor cells and some myeloid cells, promotes inflammation, angiogenesis, and metastasis. In our discovery work, elevated serum IL‐8 at androgen deprivation therapy (ADT) initiation portended worse overall survival (OS). Leveraging serum samples from the phase 3 CHAARTED trial of patients treated with ADT +/− docetaxel for metastatic hormone‐sensitive prostate cancer (mHSPC), we validated these findings. Methods Two hundred and thirty‐three patients had serum samples drawn within 28 days of ADT initiation. The samples were assayed using the same Mesoscale Multiplex ELISA platform employed in the discovery cohort. After adjusting for performance status, disease volume, and de novo/metachronous metastases, multivariable Cox proportional hazards models assessed associations between IL‐8 as continuous and binary variables on OS and time to castration‐resistant prostate cancer (CRPC). The median IL‐8 level (9.3 pg/ml) was the a priori binary cutpoint. Fixed‐effects meta‐analyses of the discovery and validation sets were performed. Results Higher IL‐8 levels were prognostic for shorter OS (continuous: hazard ratio [HR] 2.2, 95% confidence interval [CI]: 1.4–3.6, p = .001; binary >9.3: HR 1.7, 95% CI: 1.2–2.4, p = .007) and time to CRPC (continuous: HR 2.3, 95% CI: 1.6–3.3, p < .001; binary: HR 1.8, 95% CI: 1.3–2.5, p < .001) and independent of docetaxel use, disease burden, and time of metastases. Meta‐analysis including the discovery cohort, also showed that binary IL‐8 levels >9.3 pg/ml from patients treated with ADT alone was prognostic for poorer OS (HR 1.8, 95% CI: 1.2–2.7, p = .007) and shorter time to CRPC (HR 1.4, 95% CI: 0.99–1.9, p = .057). Conclusions In the phase 3 CHAARTED study of men with mHSPC at ADT initiation, elevated IL‐8 portended worse survival and shorter time to castration‐resistant prostate cancer independent of docetaxel administration, metastatic burden, and metachronous versus de novo metastatic presentation. These findings support targeting IL‐8 as a strategy to improve mHSPC outcomes.