Document Detail

Rational indication for docetaxel rechallenge in metastatic castration-resistant prostate cancer.
MedLine Citation:
PMID:  22889368     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: •  To determine whether prostate-specific antigen (PSA) response at first-line chemotherapy with docetaxel correlates with PSA response and survival at docetaxel rechallenge in patients with metastatic castration-resistant prostate cancer (mCRPC).
PATIENTS AND METHODS: •  We retrospectively evaluated the oncological outcomes of patients with mCRPC, who were treated with full-dose (75 mg/m(2) ), 3-weekly docetaxel plus prednisone/prednisolone at first-line chemotherapy and rechallenge, between 1999 and 2011, at our institution. •  The endpoints were PSA-progression-free survival (PSA-PFS) and overall survival (OS) at docetaxel rechallenge. •  Statistical analyses included Kaplan-Meier curves and log-rank tests to evaluate the effect of PSA response at first-line chemotherapy on PSA-PFS and OS at rechallenge.
RESULTS: •  Fourty-four patients were included in the analysis. •  At a median (range) follow-up of 26.4 (9.8-89.8) months after the first administration of docetaxel, 24 (55%) patients had died. At first-line chemotherapy, 36 (82%) patients achieved a reduction in PSA level of ≥50%. At rechallenge, 10 (28%) patients responded with a reduction of ≥50% for a second time. •  The median (95% confidence interval [CI]) PSA-PFS was 5.9 (95% CI 3.5-6.8) months and the median OS was 21.8 (95% CI 19.9-23.7) months at docetaxel rechallenge. •  Of the PSA response variables evaluated, only a PSA level reduction of ≥50% at first-line chemotherapy correlated significantly with prolonged PSA-PFS (5.8 vs. 4.5 months; P= 0.01) and OS (22.1 vs. 7.2 months; P= 0.03) at rechallenge.
CONCLUSION: •  In the present single-institution study, a reduction in PSA level of ≥50% at first-line chemotherapy with docetaxel correlated with superior PSA-PFS and OS in the rechallenge setting and might, therefore, present a rational indication for docetaxel rechallenge.
Matthias M Heck; Mark Thalgott; Margitta Retz; Petra Wolf; Tobias Maurer; Roman Nawroth; Georgios Hatzichristodoulou; Jürgen E Gschwend; Hubert Kübler
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2012-08-13
Journal Detail:
Title:  BJU international     Volume:  110     ISSN:  1464-410X     ISO Abbreviation:  BJU Int.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2013-03-07     Completed Date:  2013-04-23     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  E635-40     Citation Subset:  IM    
Copyright Information:
Department of Urology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
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MeSH Terms
Adenocarcinoma / blood,  secondary,  therapy*
Antineoplastic Agents / administration & dosage
Disease Progression
Dose-Response Relationship, Drug
Follow-Up Studies
Middle Aged
Prostate-Specific Antigen / blood
Prostatic Neoplasms / blood,  secondary,  therapy*
Radiation-Sensitizing Agents
Retrospective Studies
Taxoids / administration & dosage*
Treatment Outcome
Reg. No./Substance:
0/Antineoplastic Agents; 0/Radiation-Sensitizing Agents; 0/Taxoids; 15H5577CQD/docetaxel; EC Antigen

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