Risk Factors for Prostate Cancer Resistance to First-Line Androgen Deprivation Therapy (ADT)

Introduction: Androgen deprivation therapy is the mainstay of systemic treatment for metastatic prostate. However, the majority of patients progress to CRPC. The aim of this study is to identify factors that predict castration resistance in men with locally advanced or metastatic prostate cancer treated with first line ADT. Methods: This is a retrospective and analytical study including 46 patients treated for advanced or metastatic prostate cancer with first-line ADT at the Military Hospital Mohammed 5 of Rabat (HMMV) between November 2013 and July 2018 (a period of 5 years). The elements analyzed were sociodemographic, clinical, patient history, biological and radiological data. Results: Predictive factors for castration resistance in our sample are: 1) A high-risk stage according to the LATITUDE criteria. 2) High initial PSA. 3) PSA nadir (PSAn) > 1.17 ng/ml. 4) Elevated PAL at diagnosis > 129 IU/L. 5) Short time to reach PSAn ≤ 9 months. Conclusion: The risk factors predictive of early resistance to first-line hormonal therapy in patients with metastatic prostate cancer in our series were similar to those described in the literature. We advocate early treatment with hormonal chemotherapy in any patient with metastatic prostate cancer who has any of the elements identified in our study.