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KMID : 1037120200380020226
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The World Journal of Men′s Health
2020 Volume.38 No. 2 p.226 ~ p.235
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Efficacy of Androgen Deprivation Therapy in Patients with Metastatic Castration-Resistant Prostate Cancer Receiving Docetaxel-Based Chemotherapy
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Min Kyung-Chan
Chung Jae-Wook
Ha Yun-Sok
Lee Jun-Nyung
Kim Bum-Soo
Kim Hyun-Tae
Kim Tae-Hwan
Yoo Eun-Sang
Kwon Tae-Gyun
Chung Sung-Kwang
Tanaka Masatoshi
Egawa Shin
Kimura Takahiro
Choi Seock-Hwan
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Abstract
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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-naive metastatic CRPC patients in terms of the PFS, but not the OS.
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KEYWORD
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Antineoplastic hormonal drugs, Docetaxel, Progression-free survival, Prostate cancer
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