MP87-07 PROGNOSTIC FACTORS FOR OVERALL SURVIVAL IN PATIENTS WITH CASTRATION-RESISTANT PROSTATE CANCER TREATED BY INTERMITTENT CHEMOTHERAPY WITH DOCETAXEL AND PREDNISOLONE

Abstract

You have accessJournal of UrologyProstate Cancer: Advanced III1 Apr 2015MP87-07 PROGNOSTIC FACTORS FOR OVERALL SURVIVAL IN PATIENTS WITH CASTRATION-RESISTANT PROSTATE CANCER TREATED BY INTERMITTENT CHEMOTHERAPY WITH DOCETAXEL AND PREDNISOLONE Shintaro Narita, Takuya Koie, Shigeyuki Yamada, Kazuhiko Orikasa, Shigeki Matsuo, Hiroshi Aoki, Shigeto Ishidoya, Senji Hoshi, Norihiko Tsuchiya, Chikara Ohyama, Yoichi Arai, and Tomonori Habuchi Shintaro NaritaShintaro Narita More articles by this author , Takuya KoieTakuya Koie More articles by this author , Shigeyuki YamadaShigeyuki Yamada More articles by this author , Kazuhiko OrikasaKazuhiko Orikasa More articles by this author , Shigeki MatsuoShigeki Matsuo More articles by this author , Hiroshi AokiHiroshi Aoki More articles by this author , Shigeto IshidoyaShigeto Ishidoya More articles by this author , Senji HoshiSenji Hoshi More articles by this author , Norihiko TsuchiyaNorihiko Tsuchiya More articles by this author , Chikara OhyamaChikara Ohyama More articles by this author , Yoichi AraiYoichi Arai More articles by this author , and Tomonori HabuchiTomonori Habuchi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1952AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Optimal schedule of docetaxel chemotherapy for castration-resistant prostate cancer (CRPC) is unknown, although the continuous administration has been accepted as a standard. Here, we conducted a phase II trial to evaluate the outcome of intermittent docetaxel and prednisolone (DP) in CRPC and assessed the feasibility of intermittent chemotherapy in patients having various prognostic factors. METHODS The patients were treated with a 28-day cycle of docetaxel (70 mg/m2 on day 1) and oral prednisolone (10 mg/day). After 3 consecutive administration of docetaxel, the holiday was taken until PSA level returned to the baseline. The therapy was continued intermittently until disease progressed, the drug became markedly toxic and the presence of patient's refusal. Adverse events, duration of chemotherapy holidays, overall survival, scores of quality of life (QOL), were statistically assessed. Cox proportional hazards regression was used to identify independent prognostic factors for overall survival. RESULTS A total of 120 patients were enrolled. The median age and pretreatment PSA level were 72 years and 37.5 ng/mL, respectively. 61 (50.8%) patients resumed chemotherapy after the first holiday, and maximally 6 courses (-18 docetaxel administration) were administered in four patients. The mean period of first, second and third to fifth holiday was 5.9, 3.3 and 2.1 months, respectively. Toxicity was moderate except for two fatal adverse events. The median time to treatment failure and overall survival from initiation of DP therapy were 18.4 and 35 months, respectively. All QOL scores were statistically unchanged from the start of DP therapy to the beginning of the second course. In univariate analyses, ECOG-PS, pretreatment PSA level, completion of first cycle, and 50% or greater of PSA decline in first course were significant prognostic factors for overall survival. Multivariate analyses showed that ECOG-PS and pretreatment PSA level was strong prognostic factors for overall survival in CRPC patients treated with the intermittent DP therapy (HR 6.52, 95% CI 1.97 -12.80, p=0.001; HR 2.97, 95% CI 1.08 -5.77, p=0.032, respectively). CONCLUSIONS Intermittent DP therapy may be one of the feasible options for CRPC treatment with comparable outcome, successful chemotherapy holidays and maintaining QOL. Patients with good PS and low pretreatment PSA level may be good candidates for intermittent DP therapy. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1086-e1087 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shintaro Narita More articles by this author Takuya Koie More articles by this author Shigeyuki Yamada More articles by this author Kazuhiko Orikasa More articles by this author Shigeki Matsuo More articles by this author Hiroshi Aoki More articles by this author Shigeto Ishidoya More articles by this author Senji Hoshi More articles by this author Norihiko Tsuchiya More articles by this author Chikara Ohyama More articles by this author Yoichi Arai More articles by this author Tomonori Habuchi More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...