First Line Androgen Deprivation Therapy Duration Is Associated with the Efficacy of Abiraterone Acetate Treated Metastatic Castration-Resistant Prostate Cancer after Docetaxel

Introduction: We performed a chart review study in our castration-resistant prostate cancer (CRPC) patients who received Abiraterone acetate (AA) treatment after docetaxel and identified clinical markers which can predict treatment outcome. Materials and Methods: From 2012 to 2016, 64 patients who received docetaxel after CRPC followed by AA treatment were included. Clinical parameters were recorded and analysis was performed to identify associations between pre-treatment variables and treatment outcome. Results: Thirty three patients (51.6%) achieved a decrease in PSA of 50%. The median PSA progression-free survival and overall survival in the total cohort of 64 patients were 6.6 and 24 months, respectively. Adverse events (AEs) in all grades developed in 35.9% (23/64) patients and mostly were grade 1 or 2. The most common AEs were gastric upset, hypokalemia and elevated liver function tests. Of the eight variables analyzed, first line androgen deprivation therapy (ADT) duration showed positive association to progression free survival (HR 0.98, 95% CI [0.96-0.99], p = 0.012) and overall survival (HR 0.97, 95% CI [0.94-0.99], p = 0.019). Pre-AA PSA and PSA progression ratio showed negative association only to progression free survival (HR 1.0, 95% CI [1.000-1.002], p = 0.025, HR 1.01, 95% CI [1.00-1.01], p < 0.001, respectively). Conclusion: First line ADT duration was positively associated with AA treatment efficacy in progression free survival and overall survival. It can be used as a pre-treatment predictor.

Frontiers in pharmacology. 2017 Feb 13*** epublish ***

Jian-Ri Li, Shian-Shiang Wang, Cheng-Kuang Yang, Chuan-Su Chen, Hao-Chung Ho, Kun-Yuan Chiu, Chi-Feng Hung, Chen-Li Cheng, Chi-Rei Yang, Cheng-Che Chen, Shu-Chi Wang, Chia-Yen Lin, Yen-Chuan Ou

Division of Urology, Department of Surgery, Taichung Veterans General HospitalTaichung, Taiwan; Institute of Medicine, Chung Shan Medical UniversityTaichung, Taiwan; Department of Medicine and Nursing, Hungkuang UniversityTaichung, Taiwan., Division of Urology, Department of Surgery, Taichung Veterans General HospitalTaichung, Taiwan; Institute of Medicine, Chung Shan Medical UniversityTaichung, Taiwan; Department of Applied Chemistry, National Chi Nan UniversityNantou, Taiwan., Division of Urology, Department of Surgery, Taichung Veterans General Hospital Taichung, Taiwan., Division of Urology, Department of Surgery, Taichung Veterans General HospitalTaichung, Taiwan; Institute of Medicine, Chung Shan Medical UniversityTaichung, Taiwan., Division of Urology, Department of Surgery, Taichung Veterans General HospitalTaichung, Taiwan; Department of Applied Chemistry, National Chi Nan UniversityNantou, Taiwan., Department of Urology, China Medical University Hospital Taichung, Taiwan., Division of Urology, Department of Surgery, Taichung Veterans General HospitalTaichung, Taiwan; Institute of Medicine, Chung Shan Medical UniversityTaichung, Taiwan; Department of Medical Research, Taichung Veterans General HospitalTaichung, Taiwan.

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