INTRODUCTION: Docetaxel chemotherapy prolongs survival in metastatic hormone-refractory prostate cancer (mHRPC), but many patients fail to respond to this therapy and there is potential for serious toxicity. Patients differ in their percent prostate-specific antigen (PSA) decline and rate of PSA decline following treatment. We propose that patients who achieve a rapid rate of PSA decline, measured as a shorter PSA half-life (PSAHL), may experience a longer overall survival (OS) than those who achieve a slower rate of PSA decline. METHODS: A chart review of patients treated with docetaxel for mHRPC in Alberta from January 2000 to May 2006 was performed. At 42 days (after 2 cycles) and 84 days (after 4 cycles) following chemotherapy, PSA response and PSAHL were determined. PSAHL could only be determined in patients with a PSA drop from baseline. Optimal PSAHL values for OS stratification were determined using the log-rank chi-square statistic. Survival analysis was carried out using Kaplan-Meier curves and regression analysis. RESULTS: There were 154 patients who fulfilled the inclusion criteria. Using 42-day postdocetaxel data, no associations with OS could be demonstrated. Using 84-day postdocetaxel data, patients stratified by PSAHL demonstrated a significant difference in OS (15 months vs. 25 months) and this relationship remained following multivariate analysis (hazard ratio 0.08 [0.021-0.34]). CONCLUSION: A more rapid rate of PSA decline (PSAHL <70 days) measured after 4 cycles of chemotherapy was associated with a longer OS. This result was independent of other known markers of survival and allowed for a greater survival differentiation than PSA response.
INTRODUCTION:Docetaxel chemotherapy prolongs survival in metastatic hormone-refractory prostate cancer (mHRPC), but many patients fail to respond to this therapy and there is potential for serious toxicity. Patients differ in their percent prostate-specific antigen (PSA) decline and rate of PSA decline following treatment. We propose that patients who achieve a rapid rate of PSA decline, measured as a shorter PSA half-life (PSAHL), may experience a longer overall survival (OS) than those who achieve a slower rate of PSA decline. METHODS: A chart review of patients treated with docetaxel for mHRPC in Alberta from January 2000 to May 2006 was performed. At 42 days (after 2 cycles) and 84 days (after 4 cycles) following chemotherapy, PSA response and PSAHL were determined. PSAHL could only be determined in patients with a PSA drop from baseline. Optimal PSAHL values for OS stratification were determined using the log-rank chi-square statistic. Survival analysis was carried out using Kaplan-Meier curves and regression analysis. RESULTS: There were 154 patients who fulfilled the inclusion criteria. Using 42-day postdocetaxel data, no associations with OS could be demonstrated. Using 84-day postdocetaxel data, patients stratified by PSAHL demonstrated a significant difference in OS (15 months vs. 25 months) and this relationship remained following multivariate analysis (hazard ratio 0.08 [0.021-0.34]). CONCLUSION: A more rapid rate of PSA decline (PSAHL <70 days) measured after 4 cycles of chemotherapy was associated with a longer OS. This result was independent of other known markers of survival and allowed for a greater survival differentiation than PSA response.
Authors: Andrew J Armstrong; Elizabeth Garrett-Mayer; Yi-Chun Ou Yang; Michael A Carducci; Ian Tannock; Ronald de Wit; Mario Eisenberger Journal: J Clin Oncol Date: 2007-09-01 Impact factor: 44.544
Authors: Daniel P Petrylak; Catherine M Tangen; Maha H A Hussain; Primo N Lara; Jeffrey A Jones; Mary Ellen Taplin; Patrick A Burch; Donna Berry; Carol Moinpour; Manish Kohli; Mitchell C Benson; Eric J Small; Derek Raghavan; E David Crawford Journal: N Engl J Med Date: 2004-10-07 Impact factor: 91.245
Authors: Gintaras Zaleskis; Paulius Bosas; Albertas Ulys; Daiva Dabkevičiene; Neringa Dobrovolskiene; Bret Andrew Hudson; Vita Pašukoniene Journal: Med Princ Pract Date: 2021-03-19 Impact factor: 1.927
Authors: J G C van Hasselt; A Gupta; Z Hussein; J H Beijnen; J H M Schellens; A D R Huitema Journal: CPT Pharmacometrics Syst Pharmacol Date: 2015-06-30
Authors: Luis Daverede; Christy Ralph; Satinder P Jagdev; Ioannis Trigonis; Sebastian Trainor; Patricia Harnden; Michael Weston; Alan Paul; Naveen S Vasudev Journal: J Med Case Rep Date: 2014-04-09
Authors: Derek J Rosario; Patrick Davey; James Green; Damien Greene; Bruce Turner; Heather Payne; Mike Kirby Journal: World J Urol Date: 2016-04-20 Impact factor: 4.226