title: Time to prostate specific antigen (PSA) nadir may predict rapid relapse in men with metastatic castration-resistant prostate cancer (CRPC) receiving docetaxel chemotherapy.
abstract: Docetaxel has been shown to improve survival in patients with metastatic castrate-resistant prostate cancer (mCRPC). There is no clear consensus regarding the optimum duration of chemotherapy. If patients at greater risk of rapid disease relapse could be identified when on chemotherapy, appropriate follow-up strategies could be put into place. The aim of our study was to find prostate specific antigen (PSA) characteristics that predict a shorter disease response to docetaxel chemotherapy. Data from 41 consecutive mCRPC patients treated with three-weekly docetaxel chemotherapy at a single centre between February 2010 and February 2012 were retrospectively analysed. All patients had ≥50% reduction in their PSA with chemotherapy. The relationship between time to PSA nadir (TTN) and PSA halving time with time to PSA progression and overall chemotherapy response duration was analysed. TTN was a strong predictor of the duration of chemotherapy response and time to PSA progression. When TTN was ≥16 weeks, the mean duration of response to chemotherapy was 37.5 weeks compared to 19.9 weeks when TTN <16 weeks (95% CI, 12.66-22.60; p = 1.239 × 10(-8)). The mean time to PSA progression was 12.8 weeks if TTN was ≥16 weeks and 8.2 weeks TTN was <16 weeks (95% CI 0.63-8.60; p = 0.024). We observed that a TTN from the initiation of chemotherapy of <16 weeks for patients with mCRPC is an independent predictor of shorter duration of response and shorter progression-free survival.
authors.affiliation: Velindre Cancer Centre, Velindre NHS Trust, Velindre Road, Whitchurch, Cardiff, CF14 2TL, UK, betsanthomas@doctors.net.uk.
authors.forename: Betsan M
authors.initials: BM
authors.lastname: Thomas
authors.forename: Christian
authors.initials: C
authors.lastname: Smith
authors.forename: Jessica
authors.initials: J
authors.lastname: Evans
authors.forename: Michael R
authors.initials: MR
authors.lastname: Button
authors.forename: Satish
authors.initials: S
authors.lastname: Kumar
authors.forename: Nachi
authors.initials: N
authors.lastname: Palaniappan
authors.forename: John
authors.initials: J
authors.lastname: Staffurth
authors.forename: Jacob S
authors.initials: JS
authors.lastname: Tanguay
authors.forename: Jason F
authors.initials: JF
authors.lastname: Lester
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002369:Castration / Q000379:methods; D018450:Disease Progression; D018572:Disease-Free Survival; D000077143:Docetaxel; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000235:genetics* / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000235:genetics*; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000235:genetics* / Q000473:pathology; D012189:Retrospective Studies; D043823:Taxoids / Q000627:therapeutic use*
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D017430:Prostate-Specific Antigen
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