title: Anti-androgen therapy suspension following prolonged clinical and biochemical response: outcomes in a series of elderly patients with advanced prostate cancer.
abstract: OBJECTIVE
  To describe the outcomes following the suspension of androgen-suppression therapy in a series of elderly patients in an advanced stage of prostate cancer and in prolonged clinical and biochemical response.
  
  
  METHODS
  Of 371 consecutive patients with advanced prostate cancer and treated with androgen-suppression therapy, 44 older patients were defined as in stable response on the basis of the following: absence of noteworthy dysuria, normal prostate findings on digital rectal examination, and prostate-specific antigen values lower than 0.50 ng/ml. After suspending treatment, it was to be re-scheduled in case of onset of dysuria, evidence of a palpable lesion on digital rectal examination, or a rise in prostate-specific antigen above 10 ng/ml. Progression of disease was defined as a prostate-specific antigen level increase at two subsequent measurements, and/or the appearance of new lesions, and/or evidence of progression of disease on digital rectal examination.
  
  
  CONCLUSIONS
  Median age of patients was 78.5 years at the moment of therapy suspension. After a median follow-up of 93.9 months, fourteen patients (31.8%) showed progression of disease, but only 7 (15.9%) of these died. In 7 (15.9%) patients, serum testosterone levels did not exceed 0.5 ng/ml, indicating an absence of gonadal activity. The median time to progression was 138.2 months, and the median cumulative survival from the start and from the suspension of androgen-suppression therapy was 105.5 months and 64.1 months, respectively. The savings in drug costs amounted to 772,267 Euro. Taking into consideration these outcomes of survival and of savings in drug costs, we can conclude that in these selected elderly patients, this treatment option could be of interest.
authors.affiliation: Department of Oncology San Giacomo Hospital, Novi Ligure, Italy. bruno.castagneto@gmail.com
authors.forename: Bruno
authors.initials: B
authors.lastname: Castagneto
authors.forename: Ilaria
authors.initials: I
authors.lastname: Stevani
authors.forename: Valentino
authors.initials: V
authors.lastname: Ferraris
authors.forename: Laura
authors.initials: L
authors.lastname: Giorcellit
authors.forename: Massimo
authors.initials: M
authors.lastname: Perachino
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000401:mortality; D013535:Suspensions; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D013535:Suspensions