Improving Survival Predictions for Men with Hormone-Sensitive Metastatic Prostate Cancer Using the Metastasized Prostate Cancer Survival Score (MeProCSS) and Standard Treatments

Prostate cancer is one of the most common cancers among men worldwide. When the disease has spread beyond the prostate (a walnut-sized gland in the male reproductive system) to other parts of the body (metastatic prostate cancer), it becomes more difficult to treat and has a significant impact on life expectancy. The standard treatment for metastatic prostate cancer that still responds to hormone therapy is called androgen deprivation therapy (ADT), which lowers the production of testosterone, a hormone that helps the cancer grow. In recent years, additional treatments, including chemotherapy (a cancer treatment that uses drugs to kill cancer cells or stop them from growing and spreading) with docetaxel and a newer medication called darolutamide, have helped improve the survival of patients.

Although these newer treatments have led to better survival rates, there is still a lot of difference in how long patients live after starting treatment. Some patients respond very well, while others do not. A reliable tool that can predict how long a patient might live could help doctors make better decisions about which treatments to use and how often to monitor their patients. Our research aims to improve a tool called the Metastasized Prostate Cancer Survival Score (MeProCSS), which can help doctors better predict how long a patient might survive when treated with ADT, docetaxel, and darolutamide.

We will analyze patient data from a study called the ARASENS trial, which tested ADT, docetaxel, and darolutamide in patients with metastatic prostate cancer. This data is anonymized, meaning personal information is removed to protect privacy. We will use advanced statistical techniques and computer modeling to examine the factors that impact survival and improve the MeProCSS tool. Our goal is to make this tool more accurate and useful for doctors worldwide, helping them make better treatment decisions.

The primary aim of this study is to externally validate the MeProCSS using data from the ARASENS trial. The trial's rigorously collected, anonymized dataset includes a well-defined population of patients with mHSPC treated with the triplet combination (ADT + docetaxel + darolutamide), offering an ideal opportunity to test the prognostic accuracy and clinical utility of the MeProCSS tool in an independent cohort.

Secondarily, we aim to explore whether additional variables available in the ARASENS dataset (e.g., treatment duration, metastasis distribution patterns) may enhance the model’s performance through minor recalibration or refinement. Any such extensions will be clearly distinguished from the primary validation analysis and noted as hypothesis-generating.

This research is important because many men are diagnosed with metastatic prostate cancer every year. By improving the prediction of survival, doctors will be able to choose the most appropriate treatments for each patient, leading to more personalized care. For patients at higher risk of poor outcomes, doctors could adjust their treatment plans early on to try to improve their chances of survival and overall quality of life.