Phase II study of satraplatin and prednisone in patients with metastatic castration-resistant prostate cancer: a pharmacogenetic assessment of outcome and toxicity

Clin Genitourin Cancer. 2013 Sep;11(3):229-37. doi: 10.1016/j.clgc.2013.04.007. Epub 2013 May 17.

Abstract

Background: We assessed the effect of excision repair cross-complementing group 1 (ERCC1) and x-ray cross-complementing group 1 (XRCC1) gene polymorphisms on treatment outcomes with satraplatin and prednisone in patients with metastatic castration-resistant prostate cancer previously treated with docetaxel-based therapy.

Patients and methods: Twenty-four patients were enrolled in this single arm study. The primary objective was to determine if the presence of ERCC1 Asn118Asn (N118N, 500C>T, rs11615) and XRCC1 Arg399Gln (R399Q, 1301G>A, rs25487) genetic variants might be associated with an impact on progression-free survival (PFS); secondary objectives included overall response, survival, and toxicity.

Results: After population stratification by race, white patients carrying heterozygous or variant genotypes at the ERCC1 C>T locus had a >3-fold longer median PFS (5.8 vs. 1.8 months; 2P = .18, adjusted) and 5-fold longer median overall survival (OS) (15.7 vs. 3.2 months; 2P = .010, adjusted) than did patients carrying only wild-type alleles. For the XRCC1 G>A variant, without regard to race, patients carrying the wild-type GG alleles had a longer PFS (9.3 months) than those carrying GA or AA alleles (2.7 months; 2P = .02). Similarly, those carrying GG alleles did not reach median OS, whereas those carrying GA or AA alleles had a median OS of 9.6 months (2P = .12, adjusted). Multivariable analysis by using Cox proportional hazards modeling demonstrated that only XRCC1 was associated with PFS.

Conclusions: To our knowledge, this is the first prospective study to date in patients with metastatic castration-resistant prostate cancer that describes predictive germline polymorphisms of ERCC1 and XRCC1 for assessing the clinical activity of satraplatin.

Keywords: ERCC1; Genotyping; Prostate cancer; Satraplatin; XRCC1.

Publication types

  • Clinical Trial, Phase II
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / genetics
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / pharmacology
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • DNA-Binding Proteins / genetics*
  • Disease-Free Survival
  • Docetaxel
  • Drug Resistance, Neoplasm / genetics
  • Endonucleases / genetics*
  • Genotype
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Metastasis / drug therapy
  • Organoplatinum Compounds / adverse effects
  • Organoplatinum Compounds / pharmacology
  • Organoplatinum Compounds / therapeutic use*
  • Polymorphism, Single Nucleotide
  • Prednisone / adverse effects
  • Prednisone / pharmacology
  • Prednisone / therapeutic use*
  • Prostatic Neoplasms, Castration-Resistant / drug therapy*
  • Prostatic Neoplasms, Castration-Resistant / genetics
  • Taxoids / therapeutic use
  • Treatment Outcome
  • X-ray Repair Cross Complementing Protein 1

Substances

  • DNA-Binding Proteins
  • Organoplatinum Compounds
  • Taxoids
  • X-ray Repair Cross Complementing Protein 1
  • XRCC1 protein, human
  • Docetaxel
  • satraplatin
  • ERCC1 protein, human
  • Endonucleases
  • Prednisone