Testosterone plays a significant role in maintaining the tumor microenvironment. The role of the target serum testosterone (TST) level in enzalutamide- (Enza) and abiraterone (Abi)-treated castration-resistant prostate cancer (CRPC) patients was studied. In total, 107 patients treated with Enza and/or Abi at Chiba University Hospital and affiliated hospitals were studied. The relationships between progression-free survival (PFS), overall survival (OS), and clinical factors were studied by Cox proportional hazard and Kaplan-Meier models. In the Abi and Enza groups overall, TST ≥ 13 ng/dL (median) (Hazard Ratio (HR) 0.43, p = 0.0032) remained an independent prognostic factor for PFS. In the Enza group, TST ≥ 13 ng/dL (median) was found to be a significant prognostic factor (HR 0.28, p = 0.0044), while, in the Abi group, TST ≥ 12 ng/dL (median) was not significant (HR 0.40, p = 0.0891). TST showed significant correlation with PFS periods (r = 0. 32, p = 0.0067), whereas, for OS, TST ≥ 13 ng/dL (median) showed no significant difference in the Abi and Enza groups overall. According to Kaplan-Meier analysis, a longer PFS at first-line therapy showed a favorable prognosis in the Enza group (p = 0.0429), while no difference was observed in the Abi group (p = 0.6051). The TST level and PFS of first-line therapy may be considered when determining the treatment strategy for CRPC patients.
Journal of clinical medicine. 2019 Apr 11*** epublish ***
Shinichi Sakamoto, Maihulan Maimaiti, Minhui Xu, Shuhei Kamada, Yasutaka Yamada, Hiroki Kitoh, Hiroaki Matsumoto, Nobuyoshi Takeuchi, Kosuke Higuchi, Haruhito A Uchida, Akira Komiya, Maki Nagata, Hiroomi Nakatsu, Hideyasu Matsuyama, Koichiro Akakura, Tomohiko Ichikawa
Department of Urology, Chiba University Hospital, Chiba 260-8670, Japan. ., Department of Urology, Chiba University Hospital, Chiba 260-8670, Japan. ., Department of Urology, Chiba University Hospital, Chiba 260-8670, Japan. ., Department of Urology, Yokohama Rosai Hospital, Yokohama 222-0036, Japan. ., Department of Urology, Asahi Central Hospital, Aashi 289-2511, Japan. ., Department of Urology, Japan Community Healthcare Organization Tokyo Shinjuku Medical Center, Shinjyuku 162-8543, Japan. ., Department of Urology, Graduate School of Medicine, Yamaguchi University, Ube 755-0046, Japan. ., Department of Urology, Chiba University Hospital, Chiba 260-8670, Japan. ., Department of Urology, Funabashi Medical Center, Funabashi 273-8588, Japan. ., Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-0914, Japan. ., Department of Urology, Chiba University Hospital, Chiba 260-8670, Japan. ., Department of Urology, Yokohama Rosai Hospital, Yokohama 222-0036, Japan. ., Department of Urology, Asahi Central Hospital, Aashi 289-2511, Japan. ., Department of Urology, Graduate School of Medicine, Yamaguchi University, Ube 755-0046, Japan. ., Department of Urology, Japan Community Healthcare Organization Tokyo Shinjuku Medical Center, Shinjyuku 162-8543, Japan. ., Department of Urology, Chiba University Hospital, Chiba 260-8670, Japan. .