You have accessJournal of UrologyProstate Cancer: Staging I1 Apr 2014PD15-11 EXPONENTIAL PSA KINETIC PATTERN DURING OFF-TREATMENT PERIOD IS A POOR OUTCOMES RISK FACTOR IN INTERMITENT ANDROGEN DEPRIVATION THERAPY FOR PROSTATE CANCER Alexandre Ingels, Rafael Sanchez-Salas, Fabien Olivier, Dominique Prapotnich, Mehdi Fhima, José Dancausa, Stephane David, Fernando Secin, Eric Barret, Marc Galiano, Francois Rozet, and Xavier Cathelineau Alexandre IngelsAlexandre Ingels More articles by this author , Rafael Sanchez-SalasRafael Sanchez-Salas More articles by this author , Fabien OlivierFabien Olivier More articles by this author , Dominique PrapotnichDominique Prapotnich More articles by this author , Mehdi FhimaMehdi Fhima More articles by this author , José DancausaJosé Dancausa More articles by this author , Stephane DavidStephane David More articles by this author , Fernando SecinFernando Secin More articles by this author , Eric BarretEric Barret More articles by this author , Marc GalianoMarc Galiano More articles by this author , Francois RozetFrancois Rozet More articles by this author , and Xavier CathelineauXavier Cathelineau More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1300AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Significance of PSA kinetics patterns during intermittent androgen deprivation (IAD) therapy off-treatment period for prostate cancer (PC) is not clearly established. To define relevant PSA kinetics patterns, to quantify them and to determine their prognostic value in IAD. METHODS Between 1992 and 2012, 735 patients underwent IAD at our institution. ON-Treatment Period: three months of gonadotropin-releasing hormone (GnRH) agonist combined with daily oral androgen receptor antagonist. Off-treatment Period was indicated when PSA was < 4 ng/ml. Hormonal therapy was restarted when PSA > 20 ng/ml or for clinical symptoms. Follow-up consisted in a 3-month PSA monitoring. Inclusion criteria to implement off-treatment period (OFTP) in analysis: increase between two consecutive PSA measurements >0.3 ng/ml; minimum four consecutive measurements; sequence followed by a treatment. Matching criteria was set ≤10%. Kaplan-Meier curves with Uni- and multivariate Cox regression model to estimate kinetics patterns impact on Time to Continuous Androgen Deprivation (TCAD), Time to Castration-Resistant PC (TCRPC) and Cancer Specific Survival (CSS). RESULTS 493 patients were selected based on inclusion criteria. A set of 1173 OFTPs was analyzed. OFTP PSA kinetics fitted with 3 patterns: exponential (PSA(t)=λ.eα.t), linear (PSA(t)=a.t), power law (PSA(t)= a.tc) or were classified as “other”. Only 45% of OFTPs (33% for 1st OFTP) matched with an exponential pattern. Linear and power law-like PSA kinetics represented respectively 7.5 and 7.7% of selected OFTPs. Remainder of the cohort had more complex kinetics. On multivariate analysis, exponential kinetic pattern on 1st OFTP was related with significantly worse CSS (p<0.0001, HR=2.9), shorter TCAD (p<0.0001, HR=2.3) and TCRPC (p=0.0003, HR=2.0) and happened to be the most robust factor to predict these outcomes. Figure 1: Survival curves for TCAD (a), CRPC (b) and CSS (c) comparing exponential (black) vs non-exponential (red) patterns CONCLUSIONS Although it is assumed to be the general pattern for PSA kinetics in PC, less than 50% of OFTPs analyzed fitted an exponential model, it appeared to be a risk factor for shorter IAD durations, time before castration-resistance PC and CSS. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e420 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Alexandre Ingels More articles by this author Rafael Sanchez-Salas More articles by this author Fabien Olivier More articles by this author Dominique Prapotnich More articles by this author Mehdi Fhima More articles by this author José Dancausa More articles by this author Stephane David More articles by this author Fernando Secin More articles by this author Eric Barret More articles by this author Marc Galiano More articles by this author Francois Rozet More articles by this author Xavier Cathelineau More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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