title: Development of nomogram to non-steroidal antiandrogen sequential alternation in prostate cancer for predictive model.
abstract: OBJECTIVE
  To clarify clinical predictors for a prostate-specific antigen decrease ≥50% in response to alternative non-steroidal antiandrogen therapy and to develop a nomogram to predict the prostate-specific antigen decrease ≥50% in response to alternative non-steroidal antiandrogen therapy in patients with advanced prostate cancer that relapsed after initial combined androgen blockade. We previously reported that combined androgen blockade with an alternative non-steroidal antiandrogen is effective for advanced prostate cancer that has relapsed after initial combined androgen blockade.
  
  
  METHODS
  We enrolled 161 patients from 14 medical institutions with histologically confirmed prostate cancer who had been treated with combination therapy and in whom cancer progressed after first-line combined androgen blockade therapy. A nomogram for the prostate-specific antigen decrease ≥50% from baseline prostate-specific antigen in response to alternative non-steroidal antiandrogen therapy was developed based on the final logistic regression model.
  
  
  RESULTS
  Overall prostate-specific antigen decreased ≥50% in 75 of 161 patients (46.6%) in response to alternative non-steroidal antiandrogen therapy. Using five independent risk factors (initial serum level of prostate-specific antigen, hemoglobin, C-reactive protein, prostate-specific antigen nadir to second hormone therapy and Gleason sum), a nomogram was developed for the prediction of prostate-specific antigen decrease ≥50% in response to alternative non-steroidal antiandrogen therapy. The receiver operating characteristic curve showed that the accuracy of the predicted probability was 72.5% for the model.
  
  
  CONCLUSIONS
  This predictive nomogram could predict the prostate-specific antigen decrease ≥50% in response to alternative non-steroidal antiandrogen therapy and might be of benefit to determine the sequential treatment strategy in patients with relapse after first combined androgen blockade.
authors: *Department of Urology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba 285-8741, Japan. hiroyoshi.suzuki@med.toho-u.ac.jp.
authors: Naoto
authors: N
authors: Kamiya
authors: Hiroyoshi
authors: H
authors: Suzuki
authors: Kensaku
authors: K
authors: Nishimura
authors: Motohiro
authors: M
authors: Fujii
authors: Takatsugu
authors: T
authors: Okegawa
authors: Tadashi
authors: T
authors: Matsuda
authors: Tatsuo
authors: T
authors: Morita
authors: Yoshio
authors: Y
authors: Takihana
authors: Seiichiro
authors: S
authors: Ozono
authors: Mikio
authors: M
authors: Namiki
authors: Akio
authors: A
authors: Matsubara
authors: Tomohiko
authors: T
authors: Ichikawa
authors: Tsuneharu
authors: T
authors: Miki
mesh_terms: D000726:Androgen Antagonists / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D014408:Biomarkers, Tumor / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D015331:Cohort Studies; D018450:Disease Progression; D004334:Drug Administration Schedule; D017273:Goserelin / Q000008:administration & dosage; D006801:Humans; D053208:Kaplan-Meier Estimate; D016729:Leuprolide / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D049451:Nomograms; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies
chemical_list: D000726:Androgen Antagonists; D014408:Biomarkers, Tumor; D017273:Goserelin; D002097:C-Reactive Protein; D017430:Prostate-Specific Antigen; D016729:Leuprolide
keywords: alternation; hormone therapy; nomogram; prostate cancer