International Urology and Nephrology, 2018, Vol.50(10), pp.1821-1827
To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1007/s11255-018-1963-1 Byline: Christian Thomas (1), Maximilian P. Brandt (1), Stephanie Baldauf (1), Igor Tsaur (1), Sebastian Frees (1), Hendrik Borgmann (1), Wolfgang Jager (1), Georg Bartsch (1), Meike Schneider (1), Robert Dotzauer (1), Andreas Neisius (1), Axel Haferkamp (1) Keywords: Prostate cancer; Docetaxel; Rechallenge Abstract: Purpose The purpose of the study was to define clinical factors for successful treatment response and re-exposure to docetaxel in metastatic castration-resistant prostate cancer (mCRPC). Methods An mCRPC database of patients receiving first-line docetaxel and rechallenge courses was established. Several clinical factors were evaluated for prediction of treatment response. Multivariate cox-regression analysis was used to define pre-treatment and treatment factors for survival. Results Between 2005 and 2013, 94 patients with mCRPC were treated with docetaxel. Full data set and follow-up were available for 62 patients. Median follow-up was 84 m [interquartile range (IQR) 64--104 m]. Median biochemical progression-free survival (bPFS) and overall survival under docetaxel were 9 m (IQR 5--16 m) and 20 m (IQR 16--26 m), respectively. Partial PSA-response at first docetaxel-sequence (n=62), rechallenge (n=32), and third-sequence (n=22) docetaxel was 48.4%, 31.6%, and 34.8%, respectively. Time from start of primary androgen deprivation to CRPC〉47 m was the only independent pre-treatment parameter to predict improved overall survival (Hazard Ratio 0.48, p=0.015). Interestingly, there was a strong trend for improved overall survival in patients with high Gleason Score (Hazard Ratio 0.58 p=0.08). Partial PSA-response at docetaxel-rechallenge (Hazard Ratio 0.31 p=0.008) and treatment-free interval〉3 m (Hazard Ratio 3.49 p=0.014) were the only independent predictive factors under taxane treatment for overall survival. Conclusion Despite novel hormonal drugs, docetaxel still plays an important role in the treatment of mCRPC. Patients with partial-PSA-response at rechallenge or a treatment-free interval〉3 m benefit most from docetaxel re-exposure. Author Affiliation: (1) 0000 0001 1941 7111, grid.5802.f, Department of Urology, University of Mainz, Langenbeckstra[sz]e 1, 55131, Mainz, Germany Article History: Registration Date: 12/08/2018 Received Date: 10/06/2018 Accepted Date: 12/08/2018 Online Date: 17/08/2018 Article note: Christian Thomas and Maximilian P. Brandt have contributed equally to this work and shared first authorship. Andreas Neisius and Axel Haferkamp have contributed equally to this work and shared last authorship.
Prostate cancer ; Docetaxel ; Rechallenge
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