778 INTERMITTENT DOCETAXEL THERAPY FOR CASTRATION RESISTANT PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Advanced (II)1 Apr 2013778 INTERMITTENT DOCETAXEL THERAPY FOR CASTRATION RESISTANT PROSTATE CANCER Haruki Kume, Masayoshi Nagata, Yasuhiko Igawa, Hiroaki Nishimatsu, Yutaka Enomoto, Tohru Nakagawa, Tetsuya Fujimura, Motofumi Suzuki, and Yukio Homma Haruki KumeHaruki Kume Tokyo, Japan More articles by this author , Masayoshi NagataMasayoshi Nagata Tokyo, Japan More articles by this author , Yasuhiko IgawaYasuhiko Igawa Tokyo, Japan More articles by this author , Hiroaki NishimatsuHiroaki Nishimatsu Tokyo, Japan More articles by this author , Yutaka EnomotoYutaka Enomoto Tokyo, Japan More articles by this author , Tohru NakagawaTohru Nakagawa Tokyo, Japan More articles by this author , Tetsuya FujimuraTetsuya Fujimura Tokyo, Japan More articles by this author , Motofumi SuzukiMotofumi Suzuki Tokyo, Japan More articles by this author , and Yukio HommaYukio Homma Tokyo, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.342AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Docetaxel chemotherapy (75 mg/m2, every three weeks, up to 10 cycles) has been one of the standard therapies for castration resistant prostate cancer (CRPC). However, adverse events cannot be underestimated. To reduce them we conducted an intermittent treatment. METHODS CRPC cases were given docetaxel at 75 mg/m2 every three weeks with oral dexamethasone 1.0 mg/day. PSA was monitored every 3 weeks. Chemotherapy was suspended if serum PSA level was reduced by more than 50% and reached a level below 4 ng/mL. Treatment was resumed when serum PSA rose by more than 50% and was over 2 ng/mL. RESULTS Fifty CRPC cases were enrolled to this study. Among them 25 (50%) qualified for intermittent treatment: 10 cases received the second and two cases received the third intermittent therapies. The median first chemotherapy-free interval was 251 days, and second was 140 days. During the chemotherapy-free period appetite loss, fatigue, diarrhea, alopecia, and nail change were fully recovered in 5 of 6 (83.3%), 4 of 8 (50%), 3 of 5 (60%), 13 of 17 (76.5%), and 10 of 14 (41.4%), respectively, while motor neuropathy and sensory neuropathy were fully recovered only in 1of 4 (25%) and 1 of 11 (9.1%). Multivariate analysis demonstrated that lower PSA at the start of docetaxel therapy (<31.03 ng/mL (median), p=0.015, Hazard ratio=6.45) and absence of previous steroid therapy (p=0.041, Hazard ratio=4.77) were significant factors for ensuring intermittent therapy. The overall survival was significantly better in the intermittent cases (Figure, log rank test, p=0.010, Hazard ratio 3.50). CONCLUSIONS This intermittent regimen may result in reduction of adverse events in about half of CRPC patients without impairing oncological outcome during a chemotherapy-free period. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e320-e321 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Haruki Kume Tokyo, Japan More articles by this author Masayoshi Nagata Tokyo, Japan More articles by this author Yasuhiko Igawa Tokyo, Japan More articles by this author Hiroaki Nishimatsu Tokyo, Japan More articles by this author Yutaka Enomoto Tokyo, Japan More articles by this author Tohru Nakagawa Tokyo, Japan More articles by this author Tetsuya Fujimura Tokyo, Japan More articles by this author Motofumi Suzuki Tokyo, Japan More articles by this author Yukio Homma Tokyo, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...