title: Docetaxel followed by abiraterone in metastatic castration-resistant prostate cancer: efficacy and predictive parameters in a large single center cohort.
abstract: OBJECTIVE
  To report the outcome and course of disease in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with first-line docetaxel followed by abiraterone acetate in a single center.
  
  
  METHODS
  In this retrospective observational study, we reviewed the course of disease of all applicable patients with mCRPC treated with docetaxel followed by abiraterone at our center. We analyzed progression-free survival (PFS) of docetaxel and abiraterone treatments. We further searched for predictive factors for the duration of treatment response.
  
  
  RESULTS
  Median PFS between initiation of androgen deprivation therapy and the diagnosis of mCRPC was 32 months. Median PFS on docetaxel treatment was 9 months. Median PFS on abiraterone treatment was 11 months. Patients with higher Gleason scores (GS) (8-10) at initial diagnosis had a significantly longer median PFS on docetaxel as compared to patients with GS 6-7, p = 0.01. We demonstrate a significant correlation between the PFS on docetaxel and PFS on abiraterone in the post-docetaxel setting (Kendall tau r = 0.32, p = 0.019) as well as a significant negative correlation between the PSA nadir under abiraterone treatment and the time to progression under abiraterone (Kendall tau r = -0.43, p = 0.007).
  
  
  CONCLUSIONS
  High Gleason score appears to be predictive of duration of response to docetaxel. Interestingly, progression-free survival with abiraterone appears to be correlated with the duration of response with docetaxel, whereas PSA decline and low nadir appear to be predictive of response to abiraterone.
authors.affiliation: Department of Urology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Im Neuenheimer Feld 110, Heidelberg, Germany, kontakt@thomashoefner.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Höfner
authors.forename: Sonia
authors.initials: S
authors.lastname: Vallet
authors.forename: Boris A
authors.initials: BA
authors.lastname: Hadaschik
authors.forename: Sascha
authors.initials: S
authors.lastname: Pahernik
authors.forename: Stefan
authors.initials: S
authors.lastname: Duensing
authors.forename: Markus
authors.initials: M
authors.lastname: Hohenfellner
authors.forename: Dirk
authors.initials: D
authors.lastname: Jäger
authors.forename: Carsten
authors.initials: C
authors.lastname: Grüllich
mesh_terms: D000368:Aged; D000726:Androgen Antagonists / Q000008:administration & dosage; D000736:Androstenes / Q000008:administration & dosage; D000813:Anilides / Q000008:administration & dosage; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary; D002064:Buserelin / Q000008:administration & dosage; D015331:Cohort Studies; D018572:Disease-Free Survival; D000077143:Docetaxel; D005485:Flutamide / Q000008:administration & dosage; D006801:Humans; D016729:Leuprolide / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009570:Nitriles / Q000008:administration & dosage; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy* / Q000473:pathology; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage; D014105:Tosyl Compounds / Q000008:administration & dosage; D016896:Treatment Outcome; D017329:Triptorelin Pamoate / Q000008:administration & dosage
chemical_list: D000726:Androgen Antagonists; D000736:Androstenes; D000813:Anilides; D018931:Antineoplastic Agents, Hormonal; D009570:Nitriles; D043823:Taxoids; D014105:Tosyl Compounds; D017329:Triptorelin Pamoate; D000077143:Docetaxel; D005485:Flutamide; C053541:bicalutamide; D016729:Leuprolide; C089740:abiraterone; D002064:Buserelin
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