World J Mens Health.  2020 Apr;38(2):226-235. 10.5534/wjmh.190029.

Efficacy of Androgen Deprivation Therapy in Patients with Metastatic Castration-Resistant Prostate Cancer Receiving Docetaxel-Based Chemotherapy

• Min K
• Chung JW
• Ha YS
• Lee JN
• Kim BS
• Kim HT
• Kim TH
• Yoo ES
• Kwon TG
• Chung SK
• Tanaka M
• Egawa S
• Kimura T
• Choi SH

• KMID: 2471829
• DOI: http://doi.org/10.5534/wjmh.190029

Abstract

PURPOSE
The purpose of this study was to determine the comparative effectiveness of androgen deprivation therapy (ADT) combined with docetaxel (DTX)-based chemotherapy in Korean and Japanese castration-resistant prostate cancer (CRPC) patient cohorts.
MATERIALS AND METHODS
Metastatic CRPC patients who underwent more than three DTX-based chemotherapy cycles in Korea and Japan between 2002 and 2017 were retrospectively analyzed and divided into the DTX-only (DTX, n=30) and combination (DTX+ADT, n=46) groups. Progression-free survival (PFS) was calculated as the time from the start of chemotherapy to the occurrence of either disease progression (prostate-specific antigen [PSA] progression or radiographic progression) or death. The primary end point was PFS and the secondary end point was overall survival (OS).
RESULTS
In the DTX and DTX+ADT groups, the median PFS was 6.0 and 11.0 months (log-rank p=0.053). The multivariate Cox regression analysis revealed that the significant predicting factors of PFS were ADT administration (hazard ratio [HR], 0.478; 95% confidence interval [CI], 0.284-0.804; p=0.005) and number of DTX-based chemotherapy cycles (HR, 0.934; 95% CI, 0.899-0.970; p<0.001). In the DTX and DTX+ADT groups, the median OS was 16.0 and 19.5 months (log-rank p=0.825). Through multiple Cox regression analysis, we found that the significant predicting factors of OS were the PSA nadir level (HR, 1.001; 95% CI, 1.000-1.002; p<0.001) and number of DTX-based chemotherapy cycles (HR, 0.932; 95% CI, 0.876-0.991; p=0.024).
CONCLUSIONS
Concurrent DTX-based chemotherapy and ADT may be beneficial compared with DTX-based chemotherapy alone in chemotherapy-naïve metastatic CRPC patients in terms of the PFS, but not the OS.

Keyword

Prostate cancer; Progression-free survival; Docetaxel; Antineoplastic hormonal drugs

MeSH Terms

Antineoplastic Agents, Hormonal
Asian Continental Ancestry Group
Cohort Studies
Disease Progression
Disease-Free Survival
Drug Therapy*
Humans
Japan
Korea
Prostate*
Prostatic Neoplasms*
Retrospective Studies
Antineoplastic Agents, Hormonal

Figure

• 

  Fig. 1 The dotted line shows the PFS of the DTX group, and the linear line shows the PFS of the DTX+ADT group. PFS: progression-free survival, DTX: docetaxel, ADT: androgen deprivation therapy.

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  Fig. 2 The dotted line shows the OS of the DTX group, and the linear line shows the OS of the DTX+ADT group. OS: overall survival, DTX: docetaxel, ADT: androgen deprivation therapy.

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