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Prognostic and predictive analyses of circulating plasma biomarkers in men with metastatic castration resistant prostate cancer treated with docetaxel/prednisone with or without bevacizumab

Abstract

Background

CALGB 90401 (Alliance) was a phase III trial of 1050 patients with metastatic castration-resistant prostate cancer (mCRPC) comparing docetaxel, prednisone, bevacizumab (DP+B) versus DP alone. While this trial did not show an improvement in overall survival (OS), there were improved intermediate outcomes suggesting that subsets of men may derive benefit from this combination. The purpose of this analysis was to identify prognostic and predictive biomarkers associated with OS and progression-free survival (PFS) benefit from DP+B.

Methods

Baseline EDTA plasma samples from 650 consenting patients were analyzed for 24 biomarkers. The proportional hazards model was utilized to test for the prognostic and predictive importance of the biomarkers for OS. The statistically significant biomarkers of OS were further investigated for prognostic and predictive importance for other secondary outcomes.

Results

15 markers [ICAM-1, VEGF-R3, TIMP-1, TSP-2, Ang-2, Her-3, Osteopontin (OPN), PlGF, VCAM-1, HGF, VEGF, Chromogranin A, IL-6, VEGF-R1, BMP-9] were prognostic of OS, while 9 markers (ICAM-1, VEGF-R3, Her-3, TIMP-1, Ang-2, OPN, PlGF, HGF, and VEGF) were also prognostic of PFS. All markers were statistically significant in univariate analyses after adjustment for multiplicity (FDR < 0.1). In multivariable analyses of OS adjusting for risk score, seven markers had FDR < 0.1, including ICAM-1, VEGF-R3, TIMP-1, Ang-2, VEGF, TSP-2 and HGF. In unadjusted analysis, OPN was predictive of PFS improvement with DP+B, in both univariate and multivariable analysis. However, none of the biomarkers tested were predictive of clinical outcomes after adjusting for multiple comparisons.

Conclusions

Multiple biomarkers were identified in CALGB 90401 as prognostic of clinical outcomes but not predictive of OS. While OPN may have promise as a potential biomarker for anti-angiogenic therapies, further mechanistic and clinical studies are needed to determine the underlying biology and potential clinical application.

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Fig. 1: Kaplan-Meier.

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Data availability

The clinical data are available from the NCI data Archive. The laboratory data are available from the first author.

References

  1. Teo MY, Rathkopf DE, Kantoff P. Treatment of advanced prostate cancer. Annu Rev Med. 2019;70:479–99. https://doi.org/10.1146/annurev-med-051517-011947.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Gourdin T. Recent progress in treating advanced prostate cancer. Curr Opin Oncol. 2020;32:210–5. https://doi.org/10.1097/CCO.0000000000000624.

    Article  CAS  PubMed  Google Scholar 

  3. Petrylak DP, Tangen CM, Hussain MH, Lara PN,Jr., Jones JA, Taplin ME. et al. Docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer. N Engl J Med. 2004;351:1513–20. https://doi.org/10.1056/NEJMoa041318.

    Article  CAS  PubMed  Google Scholar 

  4. Tannock IF, de Wit R, Berry WR, Horti J, Pluzanska A, Chi KN. et al. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med. 2004;351:1502–12. https://doi.org/10.1056/NEJMoa040720.

    Article  CAS  PubMed  Google Scholar 

  5. de Bono JS, Oudard S, Ozguroglu M, Hansen S, Machiels JP, Kocak I. et al. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. Lancet. 2010;376:1147–54. https://doi.org/10.1016/S0140-6736(10)61389-X.

    Article  CAS  PubMed  Google Scholar 

  6. Kantoff PW, Higano CS, Shore ND, Berger ER, Small EJ, Penson DF. et al. Sipuleucel-T immunotherapy for castration-resistant prostate cancer. N Engl J Med. 2010;363:411–22. https://doi.org/10.1056/NEJMoa1001294.

    Article  CAS  PubMed  Google Scholar 

  7. Smith MR, Saad F, Chowdhury S, Oudard S, Hadaschik BA, Graff JN, et al. Apalutamide treatment and metastasis-free survival in prostate cancer. N Engl J Med. 2018;378:1408–18. https://doi.org/10.1056/NEJMoa1715546.

    Article  CAS  PubMed  Google Scholar 

  8. Beer TM, Armstrong AJ, Rathkopf DE, Loriot Y, Sternberg CN, Higano CS, et al. Enzalutamide in metastatic prostate cancer before chemotherapy. N Engl J Med. 2014;371:424–33. https://doi.org/10.1056/NEJMoa1405095.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Scher HI, Fizazi K, Saad F, Taplin ME, Sternberg CN, Miller K, et al. Increased survival with enzalutamide in prostate cancer after chemotherapy. N Engl J Med. 2012;367:1187–97. https://doi.org/10.1056/NEJMoa1207506.

    Article  CAS  PubMed  Google Scholar 

  10. Mateo J, Carreira S, Sandhu S, Miranda S, Mossop H, Perez-Lopez R, et al. DNA-Repair Defects and Olaparib in Metastatic Prostate Cancer. N Engl J Med. 2015;373:1697–708. https://doi.org/10.1056/NEJMoa1506859.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Parker C, Nilsson S, Heinrich D, Helle SI, O’Sullivan JM, Fossa SD, et al. Alpha emitter radium-223 and survival in metastatic prostate cancer. N Engl J Med. 2013;369:213–23. https://doi.org/10.1056/NEJMoa1213755.

    Article  CAS  PubMed  Google Scholar 

  12. McBean R, O’Kane B, Parsons R, Wong D. Lu177-PSMA therapy for men with advanced prostate cancer: initial 18 months experience at a single Australian tertiary institution. J Med Imaging Radiat Oncol. 2019;63:538–45. https://doi.org/10.1111/1754-9485.12891.

    Article  PubMed  Google Scholar 

  13. Beer TM, Kwon ED, Drake CG, Fizazi K, Logothetis C, Gravis G, et al. Randomized, double-blind, phase III trial of ipilimumab versus placebo in asymptomatic or minimally symptomatic patients with metastatic chemotherapy-naive castration-resistant prostate cancer. J Clin Oncol. 2017;35:40–7. https://doi.org/10.1200/JCO.2016.69.1584.

    Article  CAS  PubMed  Google Scholar 

  14. Graff JN, Alumkal JJ, Drake CG, Thomas GV, Redmond WL, Farhad M, et al. Early evidence of anti-PD-1 activity in enzalutamide-resistant prostate cancer. Oncotarget. 2016;7:52810–7. https://doi.org/10.18632/oncotarget.10547.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Antonarakis ES, Piulats JM, Gross-Goupil M, Goh J, Ojamaa K, Hoimes CJ, et al. Pembrolizumab for treatment-refractory metastatic castration-resistant prostate cancer: multicohort, open-label phase II KEYNOTE-199 study. J Clin Oncol. 2020;38 https://doi.org/10.1200/JCO.19.01638.

  16. O’Shaughnessy MJ, McBride SM, Vargas HA, Touijer KA, Morris MJ, Danila DC, et al. A pilot study of a multimodal treatment paradigm to accelerate drug evaluations in early-stage metastatic prostate cancer. Urology. 2017;102:164–2. https://doi.org/10.1016/j.urology.2016.10.044.

    Article  PubMed  Google Scholar 

  17. Ferrer FA, Miller LJ, Lindquist R, Kowalczyk P, Laudone VP, Albertsen PC, et al. Expression of vascular endothelial growth factor receptors in human prostate cancer. Urology. 1999;54:567–2. https://doi.org/10.1016/s0090-4295(99)00156-9.

    Article  CAS  PubMed  Google Scholar 

  18. Duque JL, Loughlin KR, Adam RM, Kantoff PW, Zurakowski D, Freeman MR. Plasma levels of vascular endothelial growth factor are increased in patients with metastatic prostate cancer. Urology. 1999;54:523–7. https://doi.org/10.1016/s0090-4295(99)00167-3.

    Article  CAS  PubMed  Google Scholar 

  19. Duque JL, Loughlin KR, Adam RM, Kantoff P, Mazzucchi E, Freeman MR. Measurement of plasma levels of vascular endothelial growth factor in prostate cancer patients: relationship with clinical stage, Gleason score, prostate volume, and serum prostate-specific antigen. Clin (Sao Paulo). 2006;61:401–8. https://doi.org/10.1590/s1807-59322006000500006.

    Article  Google Scholar 

  20. Bok RA, Halabi S, Fei DT, Rodriquez CR, Hayes DF, Vogelzang NJ, et al. Vascular endothelial growth factor and basic fibroblast growth factor urine levels as predictors of outcome in hormone-refractory prostate cancer patients: a cancer and leukemia group B study. Cancer Res. 2001;61:2533–6.

    CAS  PubMed  Google Scholar 

  21. George DJ, Halabi S, Shepard TF, Sanford B, Vogelzang NJ, Small EJ, et al. The prognostic significance of plasma interleukin-6 levels in patients with metastatic hormone-refractory prostate cancer: results from cancer and leukemia group B 9480. Clin Cancer Res. 2005;11:1815–20. https://doi.org/10.1158/1078-0432.CCR-04-1560.

    Article  CAS  PubMed  Google Scholar 

  22. Kelly WK, Halabi S, Carducci M, George D, Mahoney JF, Stadler WM, et al. Randomized, double-blind, placebo-controlled phase III trial comparing docetaxel and prednisone with or without bevacizumab in men with metastatic castration-resistant prostate cancer: CALGB 90401. J Clin Oncol. 2012;30:1534–40. https://doi.org/10.1200/JCO.2011.39.4767.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Liu Y, Lyu J, Bell Burdett K, Sibley AB, Hatch AJ, Starr MD, et al. Prognostic and predictive biomarkers in patients with metastatic colorectal cancer receiving regorafenib. Mol Cancer Ther. 2020;19:2146–54. https://doi.org/10.1158/1535-7163.MCT-20-0249.

    Article  CAS  PubMed  Google Scholar 

  24. Nixon AB, Pang H, Starr MD, Friedman PN, Bertagnolli MM, Kindler HL. et al. Prognostic and predictive blood-based biomarkers in patients with advanced pancreatic cancer: results from CALGB80303 (Alliance). Clin Cancer Res. 2003;19:6957–66. https://doi.org/10.1158/1078-0432.CCR-13-0926.

    Article  CAS  Google Scholar 

  25. Hatch AJ, Sibley AB, Starr MD, Brady JC, Jiang C, Jia J, et al. Blood-based markers of efficacy and resistance to cetuximab treatment in metastatic colorectal cancer: results from CALGB 80203 (Alliance). Cancer Med. 2016;5:2249–60. https://doi.org/10.1002/cam4.806.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Alvarez Secord A, Bell Burdett K, Owzar K, Tritchler D, Sibley AB, Liu Y, et al. Predictive blood-based biomarkers in patients with epithelial ovarian cancer treated with carboplatin and paclitaxel with or without bevacizumab: results from GOG-0218. Clin Cancer Res. 2020;26:1288–96. https://doi.org/10.1158/1078-0432.CCR-19-0226.

    Article  PubMed  Google Scholar 

  27. Nixon AB, Sibley AB, Liu Y, Hatch AJ, Jiang C, Mulkey F. et al. Plasma protein biomarkers in advanced or metastatic colorectal cancer patients receiving chemotherapy with bevacizumab or cetuximab: results from CALGB 80405 (Alliance). Clin Cancer Res. 2022;28:2779–88. https://doi.org/10.1158/1078-0432.CCR-21-2389.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Nixon AB, Halabi S, Liu Y, Starr MD, Brady JC, Shterev I, et al. Predictive biomarkers of overall survival in patients with metastatic renal cell carcinoma treated with IFNalpha ± bevacizumab: results from CALGB 90206 (Alliance). Clin Cancer Res. 2022;28:2771–8. https://doi.org/10.1158/1078-0432.CCR-21-2386.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Armstrong AJ, Nixon AB, Carmack A, Yang Q, Eisen T, Stadler WM, et al. Angiokines associated with targeted therapy outcomes in patients with non-clear cell renal cell carcinoma. Clin Cancer Res. 2021;27:3317–28. https://doi.org/10.1158/1078-0432.CCR-20-4504.

    Article  CAS  PubMed  Google Scholar 

  30. Taplin ME, George DJ, Halabi S, Sanford B, Febbo PG, Hennessy KT, et al. Prognostic significance of plasma chromogranin a levels in patients with hormone-refractory prostate cancer treated in Cancer and Leukemia Group B 9480 study. Urology. 2005;66:386–91. https://doi.org/10.1016/j.urology.2005.03.040.

    Article  PubMed  Google Scholar 

  31. Altman DG, McShane LM, Sauerbrei W, Taube SE. Reporting recommendations for tumor marker prognostic studies (REMARK): explanation and elaboration. PLoS Med. 2012;9:e1001216 https://doi.org/10.1371/journal.pmed.1001216.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Bubley GJ, Carducci M, Dahut W, Dawson N, Daliani D, Eisenberger M, et al. Eligibility and response guidelines for phase II clinical trials in androgen-independent prostate cancer: recommendations from the Prostate-Specific Antigen Working Group. J Clin Oncol. 1999;17:3461–7. https://doi.org/10.1200/JCO.1999.17.11.3461.

    Article  CAS  PubMed  Google Scholar 

  33. Benjamini Y, Drai D, Elmer G, Kafkafi N, Golani I. Controlling the false discovery rate in behavior genetics research. Behav Brain Res. 2001;125:279–84. https://doi.org/10.1016/s0166-4328(01)00297-2.

    Article  CAS  PubMed  Google Scholar 

  34. Halabi S, Lin CY, Kelly WK, Fizazi KS, Moul JW, Kaplan EB, et al. Updated prognostic model for predicting overall survival in first-line chemotherapy for patients with metastatic castration-resistant prostate cancer. J Clin Oncol. 2014;32:671–7. https://doi.org/10.1200/JCO.2013.52.3696.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Li Q, Yuan Z, Cao B. The function of human epidermal growth factor receptor-3 and its role in tumors (Review). Oncol Rep. 2013;30:2563–70. https://doi.org/10.3892/or.2013.2754.

    Article  CAS  PubMed  Google Scholar 

  36. Lunger L, Tauber R, Feuerecker B, Gschwend JE, Eiber M, Heck MM. Narrative review: prostate-specific membrane antigen-radioligand therapy in metastatic castration-resistant prostate cancer. Transl Androl Urol. 2021;10:3963–71. https://doi.org/10.21037/tau-20-1135.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Mirzaei A, Mohammadi S, Ghaffari SH, Yaghmaie M, Vaezi M, Alimoghaddam K, et al. Osteopontin b and c splice isoforms in leukemias and solid tumors: angiogenesis alongside chemoresistance. Asian Pac J Cancer Prev. 2018;19:615–23. https://doi.org/10.22034/APJCP.2018.19.3.615.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Larionova I, Kazakova E, Gerashchenko T, Kzhyshkowska J. New angiogenic regulators produced by TAMs: perspective for targeting tumor angiogenesis. Cancers. 2021;13. https://doi.org/10.3390/cancers13133253.

  39. Zhao H, Chen Q, Alam A, Cui J, Suen KC, Soo AP, et al. The role of osteopontin in the progression of solid organ tumour. Cell Death Dis. 2018;9:356 https://doi.org/10.1038/s41419-018-0391-6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Tan Y, Zhao L, Yang YG, Liu W. The role of osteopontin in tumor progression through tumor-associated macrophages. Front Oncol. 2022;12:953283 https://doi.org/10.3389/fonc.2022.953283.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. McKay RR, Zurita AJ, Werner L, Bruce JY, Carducci MA, Stein MN. et al. A randomized phase ii trial of short-course androgen deprivation therapy with or without bevacizumab for patients with recurrent prostate cancer after definitive local therapy. J Clin Oncol. 2016;34:1913–20. https://doi.org/10.1200/JCO.2015.65.3154.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Humphrey PA, Halabi S, Picus J, Sanford B, Vogelzang NJ, Small EJ. et al. Prognostic significance of plasma scatter factor/hepatocyte growth factor levels in patients with metastatic hormone-refractory prostate cancer: results from cancer and leukemia group B 150005/9480. Clin Genitourin Cancer. 2006;4:269–74. https://doi.org/10.3816/CGC.2006.n.006.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

We gratefully acknowledge the invaluable contributions of the patients, their families, and the staff who participated in this study. The authors would also like to thank the Alliance Biorepository at the Ohio State University and administrative staff. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of National Cancer Institute. ClinicalTrials.gov Identifier: NCT00110214.

Funding

Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Numbers U10CA180821, U10CA180882, and U24CA196171 (to the Alliance for Clinical Trials in Oncology), UG1CA233180, UG1CA233253, and UG1CA233341 and NIH grant 5R01-CA256157. This research is supported by the United States Army Medical Research W81XWH-18-1-0278 and the Prostate Cancer Foundation Challenge Award. Detailed information is listed in https://acknowledgments.alliancefound.org. This work is also supported in part by funds from Genentech. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

Authors

Contributions

ABN: Conceptualization, Supervision, data curation, funding acquisition, investigation, visualization, methodology, writing–original draft, writing–review and editing. YL: Data curation, investigation, visualization, methodology, writing–original draft, writing–review and editing. QY: formal analysis, validation, visualization, methodology, writing-original draft, writing-review and editing. BL: formal analysis, writing-review and editing. MDS: Data curation, methodology, writing–review and editing. JCB: Data curation, methodology, writing–review and editing. WKK: Conceptualization, data curation, methodology, writing–review and editing. HB, MJM, AJA: supervision, data curation, funding acquisition, investigation, methodology, writing-original draft, and revision/editing. DJG: Conceptualization, Supervision, data curation, funding acquisition, investigation, methodology, writing–original draft, writing–review and editing. SH: Conceptualization, Supervision, funding acquisition, formal analysis, validation, visualization, methodology, writing–original draft, writing–review and editing.

Corresponding authors

Correspondence to Andrew B. Nixon or Susan Halabi.

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Competing interests

A.B. Nixon has received research funding from Genentech, HTG Molecular Diagnostics, MedImmune/AstraZeneca, Medpacto, Promega Corporation, Seattle Genetics; and has received consultant/advisory compensation from AdjuVolt Therapeutics, Eli Lilly, GSK, Leap Therapeutics, Promega Corporation. D.J. George has received consultant/advisory compensation from Astellas, Astrazeneca, Axess Oncology, Bayer H/C Pharmaceuticals, BMS, Capio Biosciences, Constellation Pharmaceuticals, EMD Serono, Exelixis Inc., Flatiron, Ipsen, Janssen Pharmaceuticals, Merck Sharp & Dohme, Michael J Hennessey Associates, Modra Pharmaceuticals B. V., Myovant Sciences, Nektar Therapeutics, Physician Education Resource LLC, Pfizer, Propella TX, RevHealth LLC, Sanofi, UroGPO; and has received research funding from Astrazeneca, BMS, Calithera, Exelixis Inc., Janssen Pharmaceuticals, Novartis, Pfizer, Sanofi. H. Beltran has served as consultant/advisory board member for Janssen, Sanofi Genzyme, Astellas, Astra Zeneca, Merck, Pfizer, Foundation Medicine, Blue Earth Diagnostics, Amgen, Oncorus and has received research funding (to institution) from Janssen Oncology, AbbVie/Stemcentrx, Eli Lilly, Millennium Pharmaceuticals, Bristol Myers Squibb. A.J. Armstrong is a paid consultant with Pfizer, Astellas, Forma, BMS, Janssen, Bayer, Astrazeneca, Novartis, and Merck and receives research funding (to his institution) from Pfizer, Astellas, Janssen, Bayer, Dendreon, Novartis, Genentech/Roche, Merck, BMS, Astrazeneca, Constellation, Beigene, Forma, and Amgen. S. Halabi was on the DMC for Aveo, BMS, Janssen and Sanofi and receives research funding from Astellas and ASCO (Institution). The other authors declare no potential conflicts of interest.

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Nixon, A.B., Liu, Y., Yang, Q. et al. Prognostic and predictive analyses of circulating plasma biomarkers in men with metastatic castration resistant prostate cancer treated with docetaxel/prednisone with or without bevacizumab. Prostate Cancer Prostatic Dis (2024). https://doi.org/10.1038/s41391-024-00794-3

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