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. 2020 Apr;38(2):226-235.
doi: 10.5534/wjmh.190029. Epub 2019 Jun 4.

Efficacy of Androgen Deprivation Therapy in Patients with Metastatic Castration-Resistant Prostate Cancer Receiving Docetaxel-Based Chemotherapy

Kyungchan Min  1 , Jae Wook Chung  1 , Yun Sok Ha  2 , Jun Nyung Lee  1   3 , Bum Soo Kim  2   3 , Hyun Tae Kim  1   3 , Tae Hwan Kim  1   3 , Eun Sang Yoo  2   3 , Tae Gyun Kwon  1   3 , Sung Kwang Chung  2   3 , Masatoshi Tanaka  4 , Shin Egawa  4 , Takahiro Kimura #  4 , Seock Hwan Choi #  2   5
Affiliations

Efficacy of Androgen Deprivation Therapy in Patients with Metastatic Castration-Resistant Prostate Cancer Receiving Docetaxel-Based Chemotherapy

Kyungchan Min et al. World J Mens Health. 2020 Apr.

Abstract

Purpose: The purpose of this study was to determine the comparative effectiveness of androgen deprivation therapy (ADT) combined with docetaxel (DTX)-based chemotherapy in Korean and Japanese castration-resistant prostate cancer (CRPC) patient cohorts.

Materials and methods: Metastatic CRPC patients who underwent more than three DTX-based chemotherapy cycles in Korea and Japan between 2002 and 2017 were retrospectively analyzed and divided into the DTX-only (DTX, n=30) and combination (DTX+ADT, n=46) groups. Progression-free survival (PFS) was calculated as the time from the start of chemotherapy to the occurrence of either disease progression (prostate-specific antigen [PSA] progression or radiographic progression) or death. The primary end point was PFS and the secondary end point was overall survival (OS).

Results: In the DTX and DTX+ADT groups, the median PFS was 6.0 and 11.0 months (log-rank p=0.053). The multivariate Cox regression analysis revealed that the significant predicting factors of PFS were ADT administration (hazard ratio [HR], 0.478; 95% confidence interval [CI], 0.284-0.804; p=0.005) and number of DTX-based chemotherapy cycles (HR, 0.934; 95% CI, 0.899-0.970; p<0.001). In the DTX and DTX+ADT groups, the median OS was 16.0 and 19.5 months (log-rank p=0.825). Through multiple Cox regression analysis, we found that the significant predicting factors of OS were the PSA nadir level (HR, 1.001; 95% CI, 1.000-1.002; p<0.001) and number of DTX-based chemotherapy cycles (HR, 0.932; 95% CI, 0.876-0.991; p=0.024).

Conclusions: Concurrent DTX-based chemotherapy and ADT may be beneficial compared with DTX-based chemotherapy alone in chemotherapy-naïve metastatic CRPC patients in terms of the PFS, but not the OS.

Keywords: Antineoplastic hormonal drugs; Docetaxel; Progression-free survival; Prostate cancer.

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Conflict of interest statement

The authors have nothing to disclose.

Figures

Fig. 1
Fig. 1. The dotted line shows the PFS of the DTX group, and the linear line shows the PFS of the DTX+ADT group. PFS: progression-free survival, DTX: docetaxel, ADT: androgen deprivation therapy.
Fig. 2
Fig. 2. The dotted line shows the OS of the DTX group, and the linear line shows the OS of the DTX+ADT group. OS: overall survival, DTX: docetaxel, ADT: androgen deprivation therapy.
See this image and copyright information in PMC

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