Bellmunt Risk Score in metastatic hormone-sensitive prostate cancer (mHSPC)

Prostate cancer is one of the most common cancers in men around the world. Some men are diagnosed with prostate cancer that has already spread to other parts of the body (metastatic prostate cancer). In the early stages, this type of cancer often responds to hormone therapy, which lowers or blocks the male hormones that help the cancer grow. This stage is called metastatic hormone-sensitive prostate cancer (mHSPC). Over time, the disease may become more difficult to treat and stop responding to hormone therapy, becoming metastatic castration-resistant prostate cancer (mCRPC).

Doctors need better ways to estimate how long someone with prostate cancer might live or how aggressive their cancer might become. One tool that helps with this is the Bellmunt Risk Score (BRS). This score uses three common clinical measures: (1) how well a person can carry out daily activities, measured by the Eastern Cooperative Oncology Group Performance Status (ECOG PS); (2) the concentration of the oxygen-carrying molecule within the blood, known as hemoglobin; and (3) whether the cancer has spread to the liver (called liver metastases). We have already shown that the BRS is a useful tool for predicting survival in men with mCRPC.

In this project, we will investigate whether the same tool can also help predict outcomes in men at an earlier stage—those with mHSPC. To do this, we will analyze individual participant data from three large clinical trials: ARASENS, TITAN, and LATITUDE. These trials include men with mHSPC and contain the same clinical information used in the BRS.

Our goal is to see if the BRS can help doctors and patients with mHSPC understand their likely outcomes. If successful, this simple tool could be used to guide treatment decisions, provide clearer expectations, and improve communication between doctors and patients.

We will carry out statistical analyses to test how well the BRS predicts outcomes in this earlier stage of disease. We will also explore whether the score works equally well across different trials and patient groups. This research will help determine whether a single, easy-to-use score can be widely used across the full course of advanced prostate cancer.