Effectiveness of Deferred Combined Androgen Blockade Therapy Predicts Efficacy in Abiraterone Acetate Treated Metastatic Castration-Resistant Prostate Cancer Patients after Docetaxel
Introduction: Conventional anti-androgen regimens were widely used as an initiation or combined androgen blockade (CAB) therapy in advanced prostate cancer patients. Currently, new androgen pathway inhibitors such as abiraterone acetate (AA) and enzalutamide had been proven effective in metastatic c...
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Frontiers Media S.A.
2017-11-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fphar.2017.00836/full |
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| author | Jian-Ri Li Jian-Ri Li Jian-Ri Li Kun-Yuan Chiu Kun-Yuan Chiu Shian-Shiang Wang Shian-Shiang Wang Shian-Shiang Wang Cheng-Kuang Yang Chuan-Shu Chen Hao-Chung Ho Chi-Feng Hung Chen-Li Cheng Chen-Li Cheng Chi-Rei Yang Cheng-Che Chen Shu-Chi Wang Chia-Yen Lin Chao-Hsiang Chang Chiann-Yi Hsu Yen-Chuan Ou Yen-Chuan Ou Yen-Chuan Ou Yen-Chuan Ou |
| author_facet | Jian-Ri Li Jian-Ri Li Jian-Ri Li Kun-Yuan Chiu Kun-Yuan Chiu Shian-Shiang Wang Shian-Shiang Wang Shian-Shiang Wang Cheng-Kuang Yang Chuan-Shu Chen Hao-Chung Ho Chi-Feng Hung Chen-Li Cheng Chen-Li Cheng Chi-Rei Yang Cheng-Che Chen Shu-Chi Wang Chia-Yen Lin Chao-Hsiang Chang Chiann-Yi Hsu Yen-Chuan Ou Yen-Chuan Ou Yen-Chuan Ou Yen-Chuan Ou |
| author_sort | Jian-Ri Li |
| collection | DOAJ |
| description | Introduction: Conventional anti-androgen regimens were widely used as an initiation or combined androgen blockade (CAB) therapy in advanced prostate cancer patients. Currently, new androgen pathway inhibitors such as abiraterone acetate (AA) and enzalutamide had been proven effective in metastatic castration resistant prostate cancer. In this study, we attempt to analyze the role of conventional anti-androgen drugs as deferred CAB therapy in castration-resistant prostate cancer patients.Materials and Methods: From 2012 to 2017, 48 metastatic castration-resistant prostate cancer (CRPC) patients who received sequential treatments with primary androgen blockade, oral anti-androgen regimens, and docetaxel followed by AA treatment were included. We defined effective deferred CAB as any decline of PSA after add-on antiandrogen after CRPC. Patients were separated into effective and ineffective deferred CAB. Comparison between two groups in the first line androgen deprivation therapy duration, CRPC PSA level, pre-AA PSA level, chemotherapy dosages, duration, and patients progression free survival and overall survival after AA treatment were analyzed.Results: Twenty-three patients (47.9%) achieved PSA decline after deferred CAB. Among total 48 patients, 24 patients experienced PSA decline more than 50% after AA treatment. The median PSA progression-free survival and overall survival after AA treatment in the total cohort of 48 patients were 4.4 and 24.3 months, respectively. The effective deferred CAB group showed significantly lower PSA level, lower percentage of PSA progression, higher total follow-up duration, higher percentage of surviving patients, better progression free survival, and overall survival estimate after AA treatment. Of the eight variables analyzed, effectiveness in deferred CAB showed positive association to progression free survival (HR 0.29, 95% CI 0.12–0.67, p = 0.004) and overall survival (HR 0.24, 95% CI 0.07–0.81, p = 0.022). First line androgen deprivation therapy (ADT) duration also showed positive association to overall survival (HR 0.95, 95% CI 0.91–0.99, p = 0.023).Conclusions: Effectiveness of deferred CAB therapy was positively associated with progression free survival and overall survival of AA treatment after docetaxel. It can be used as a pre-treatment predictor. |
| first_indexed | 2024-12-11T07:39:23Z |
| format | Article |
| id | doaj.art-867e99e149984fc5b50854ce11048474 |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-12-11T07:39:23Z |
| publishDate | 2017-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-867e99e149984fc5b50854ce110484742022-12-22T01:15:37ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122017-11-01810.3389/fphar.2017.00836297519Effectiveness of Deferred Combined Androgen Blockade Therapy Predicts Efficacy in Abiraterone Acetate Treated Metastatic Castration-Resistant Prostate Cancer Patients after DocetaxelJian-Ri Li0Jian-Ri Li1Jian-Ri Li2Kun-Yuan Chiu3Kun-Yuan Chiu4Shian-Shiang Wang5Shian-Shiang Wang6Shian-Shiang Wang7Cheng-Kuang Yang8Chuan-Shu Chen9Hao-Chung Ho10Chi-Feng Hung11Chen-Li Cheng12Chen-Li Cheng13Chi-Rei Yang14Cheng-Che Chen15Shu-Chi Wang16Chia-Yen Lin17Chao-Hsiang Chang18Chiann-Yi Hsu19Yen-Chuan Ou20Yen-Chuan Ou21Yen-Chuan Ou22Yen-Chuan Ou23Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, TaiwanInstitute of Medicine, Chung Sang Medical University, Taichung, TaiwanDepartment of Medicine and Nursing, Hungkuang University, Taichung, TaiwanDivision of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Applied Chemistry, National Chi Nan University, Nantou, TaiwanDivision of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, TaiwanInstitute of Medicine, Chung Sang Medical University, Taichung, TaiwanDepartment of Applied Chemistry, National Chi Nan University, Nantou, TaiwanDivision of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, TaiwanDivision of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, TaiwanDivision of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, TaiwanDivision of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, TaiwanDivision of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, TaiwanInstitute of Medicine, Chung Sang Medical University, Taichung, TaiwanDepartment of Urology, China Medical University Hospital, Taichung, TaiwanDivision of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, TaiwanDivision of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, TaiwanDivision of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Urology, China Medical University Hospital, Taichung, TaiwanDepartment of Medical Research, Taichung Veterans General Hospital, Taichung, TaiwanDivision of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, TaiwanInstitute of Medicine, Chung Sang Medical University, Taichung, TaiwanDepartment of Medical Research, Taichung Veterans General Hospital, Taichung, TaiwanTung's Taichung MetroHarbor Hospital, Taichung, TaiwanIntroduction: Conventional anti-androgen regimens were widely used as an initiation or combined androgen blockade (CAB) therapy in advanced prostate cancer patients. Currently, new androgen pathway inhibitors such as abiraterone acetate (AA) and enzalutamide had been proven effective in metastatic castration resistant prostate cancer. In this study, we attempt to analyze the role of conventional anti-androgen drugs as deferred CAB therapy in castration-resistant prostate cancer patients.Materials and Methods: From 2012 to 2017, 48 metastatic castration-resistant prostate cancer (CRPC) patients who received sequential treatments with primary androgen blockade, oral anti-androgen regimens, and docetaxel followed by AA treatment were included. We defined effective deferred CAB as any decline of PSA after add-on antiandrogen after CRPC. Patients were separated into effective and ineffective deferred CAB. Comparison between two groups in the first line androgen deprivation therapy duration, CRPC PSA level, pre-AA PSA level, chemotherapy dosages, duration, and patients progression free survival and overall survival after AA treatment were analyzed.Results: Twenty-three patients (47.9%) achieved PSA decline after deferred CAB. Among total 48 patients, 24 patients experienced PSA decline more than 50% after AA treatment. The median PSA progression-free survival and overall survival after AA treatment in the total cohort of 48 patients were 4.4 and 24.3 months, respectively. The effective deferred CAB group showed significantly lower PSA level, lower percentage of PSA progression, higher total follow-up duration, higher percentage of surviving patients, better progression free survival, and overall survival estimate after AA treatment. Of the eight variables analyzed, effectiveness in deferred CAB showed positive association to progression free survival (HR 0.29, 95% CI 0.12–0.67, p = 0.004) and overall survival (HR 0.24, 95% CI 0.07–0.81, p = 0.022). First line androgen deprivation therapy (ADT) duration also showed positive association to overall survival (HR 0.95, 95% CI 0.91–0.99, p = 0.023).Conclusions: Effectiveness of deferred CAB therapy was positively associated with progression free survival and overall survival of AA treatment after docetaxel. It can be used as a pre-treatment predictor.http://journal.frontiersin.org/article/10.3389/fphar.2017.00836/fullabiraterone acetateandrogen deprivation therapycastration-resistant prostate cancerdeferred combined androgen blockadedocetaxel |
| spellingShingle | Jian-Ri Li Jian-Ri Li Jian-Ri Li Kun-Yuan Chiu Kun-Yuan Chiu Shian-Shiang Wang Shian-Shiang Wang Shian-Shiang Wang Cheng-Kuang Yang Chuan-Shu Chen Hao-Chung Ho Chi-Feng Hung Chen-Li Cheng Chen-Li Cheng Chi-Rei Yang Cheng-Che Chen Shu-Chi Wang Chia-Yen Lin Chao-Hsiang Chang Chiann-Yi Hsu Yen-Chuan Ou Yen-Chuan Ou Yen-Chuan Ou Yen-Chuan Ou Effectiveness of Deferred Combined Androgen Blockade Therapy Predicts Efficacy in Abiraterone Acetate Treated Metastatic Castration-Resistant Prostate Cancer Patients after Docetaxel Frontiers in Pharmacology abiraterone acetate androgen deprivation therapy castration-resistant prostate cancer deferred combined androgen blockade docetaxel |
| title | Effectiveness of Deferred Combined Androgen Blockade Therapy Predicts Efficacy in Abiraterone Acetate Treated Metastatic Castration-Resistant Prostate Cancer Patients after Docetaxel |
| title_full | Effectiveness of Deferred Combined Androgen Blockade Therapy Predicts Efficacy in Abiraterone Acetate Treated Metastatic Castration-Resistant Prostate Cancer Patients after Docetaxel |
| title_fullStr | Effectiveness of Deferred Combined Androgen Blockade Therapy Predicts Efficacy in Abiraterone Acetate Treated Metastatic Castration-Resistant Prostate Cancer Patients after Docetaxel |
| title_full_unstemmed | Effectiveness of Deferred Combined Androgen Blockade Therapy Predicts Efficacy in Abiraterone Acetate Treated Metastatic Castration-Resistant Prostate Cancer Patients after Docetaxel |
| title_short | Effectiveness of Deferred Combined Androgen Blockade Therapy Predicts Efficacy in Abiraterone Acetate Treated Metastatic Castration-Resistant Prostate Cancer Patients after Docetaxel |
| title_sort | effectiveness of deferred combined androgen blockade therapy predicts efficacy in abiraterone acetate treated metastatic castration resistant prostate cancer patients after docetaxel |
| topic | abiraterone acetate androgen deprivation therapy castration-resistant prostate cancer deferred combined androgen blockade docetaxel |
| url | http://journal.frontiersin.org/article/10.3389/fphar.2017.00836/full |
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