Incident diabetes after hormone therapy ups risk of progression to CRPC

In prostate cancer (PC) patients undergoing hormone therapy, the development of lifestyle-related disorders, particularly diabetes mellitus (DM), predicts an earlier progression to castration-resistant PC (CRPC) and poor prognosis, a recent study has found.

Researchers conducted a retrospective analysis of 230 PC patients on hormone therapy (median age 76 years). DM was reported in 53 participants (23 percent), 45 cases of which had been present even before hormone therapy, while eight diagnoses were detected after initiation of therapy. Other pre-existing or incident lifestyle-related disorders detected included hypertension (59.1 percent), dyslipidaemia (28.7 percent), and hyperuricaemia (23 percent).

Forty-eight patients (20.9 percent) eventually progressed to CRPC. Unadjusted analyses found that such progression was significantly more likely to occur in patients who had developed DM after initiation of hormone therapy, but not in those who had pre-existing DM. There was also a tendency toward higher progression risk in those with post-treatment hypertension. No such interaction was reported for dyslipidaemia and hyperuricaemia.

Multivariate adjustment confirmed the link between post-treatment DM with CRPC progression risk (adjusted hazard ratio [HR], 3.381, 95 percent confidence interval [CI], 1.26–9.11; p=0.016), whereas hypertension, dyslipidaemia, and hyperuricaemia remained unrelated. A prostate specific antigen level ≥18 ng/mL was also identified as a significant risk factor for CRPC progression (adjusted HR, 2.342, 95 percent CI, 1.15–4.77; p=0.019).

“To the best of our knowledge, this study provides the first clinical evidence that the development of lifestyle-related diseases, especially DM, is associated with early progression to CRPC,” the researchers said.