Abstract
e15126 Background: ReC with DOC is an option for CRPC pts, who have responded to first-line DOC and have stopped the treatment without progression. The possibility of obtaining a new response by a DOC ReC is usually considered on the basis of the response to the previous treatment. We attempt to identify if there are additional factors able to predict ReC response. Methods: From March, 2002 to December, 2010, a consecutive series of 45 CRPC pts received at least one ReC after first-line DOC, for a total of 91 ReC courses (median 2, range 1-7). ReCs consisted of 4-6 DOC cycles and were proposed until the appearance of a true resistance to DOC: we consider as DOC-resistant pts showing a clinical and/or biochemical progression during DOC treatment. For each ReC course, we recorded the following parameters: treatment schedule (3 wks vs weekly), estramustine use (yes vs no), PSA response (↓ > 50%) at the previous DOC course, baseline parameters (hemoglobin, alkaline phosphatase, pain presence, ECOG), number of previous DOC courses, PSA parameters (slope LOG, doubling time, velocity) during both previous DOC course and treatment holiday, duration of treatment holiday before ReC. A binary logistic regression analysis was applied. Continuous variables were categorized by quartiles and chosen for the initial model after a univariate chi-square analysis. Results: In 67% of 91 ReCs we observed a PSA reduction > 50%. After a median follow-up of 25 mos, the median survival is 32 mos and the projected 2-years overall survival is 77.5%. ReC was well tolerated with no more than grade 1-2 hematological and non-hematological toxicities. Having an interval log-PSA equal to or more than 0.62 [(exp(beta) 8.965; p= 0.020], an interval from the previous cycle equal to or more than 23 weeks [(exp(beta) 8.212; p= 0.002], a response to the previous cycle [(exp(beta) 7.658; p= 0.014], resulted to be independently predictive of a response to ReC. Conclusions: In our experience, for CRPC pts sensitive to DOC, ReC appears to be a good option to obtain further response. Response to the previous cycle, interval log-PSA and interval from the previous cycle are factors able to identify the pts having more probabilities to respond to ReC.
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