Lorente D, Llacer C, Lozano R, et al. - In patients treated with first-line androgen receptor signaling inhibitors, researchers confirm the prognostic value of the Armstrong risk model. In low-risk patients with less aggressive diseases, abiraterone provided a greater benefit. There is a need for future research to establish the role of Armstrong risk groups for treatment selection in metastatic castration-resistant prostate cancer (mCRPC) patients.

• Researchers examined a total of 1,088 patients.

• It was shown that the risk score was correlated with overall survival (OS; tAUC 0.733).

• The data indicated that most patients were at a low (49%) or intermediate (41%) risk.

• The results showed that the risk category was significantly correlated with OS (hazard ratio [HR]: 2.3; 95% confidence interval [CI]: 1.9–2.4; p < 0.001), radiographic progression-free survival (rPFS; HR: 1.7; 95% CI: 1.5–1.8; p < 0.001), and prostate-specific antigen progression-free survival (HR: 1.7; 95% CI: 1.5–1.9; p < 0.001).

• They found a significant interaction between the risk group and OS (p = 0.007) and rPFS (p = 0.009).

• In low-risk patients, survival was superior (HR: 0.73; 95% CI: 0.59–0.89; p = 0.009), but similar in intermediate-risk (HR: 0.97; 95% CI: 0.79–1.21; p = 0.9) and high-risk (HR: 1.35; 95% CI: 0.80–2.28; p = 0.5) patients.

• The results revealed that two-year OS rates in abiraterone vs placebo were 82% vs 74% in low-risk, 55% vs 52% in intermediate-risk, and 28% vs 31% in high-risk patients.