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

Affiliations
  • 1Department of Urology, Kyungpook National University Chilgok Hospital, Daegu, Korea.
  • 2Department of Urology, Kyungpook National University Hospital, Daegu, Korea. skhwan@gmail.com
  • 3Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea.
  • 4Department of Urology, Jikei University School of Medicine, Tokyo, Japan.

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.

  • 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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