All Title Author
Keywords Abstract

PLOS ONE  2012 

Risk Factors for Metastatic Castration-Resistant Prostate Cancer (CRPC) Predict Long-Term Treatment with Docetaxel

DOI: 10.1371/journal.pone.0048186

Full-Text   Cite this paper   Add to My Lib


Purpose For patients with metastatic castration-resistant prostatic cancer (mCRPC), docetaxel plus prednisone leads to superior survival and a higher response rate compared with mitoxantrone plus prednisone. We analyzed the efficacy of long-term treatment with ≥10 cycles of docetaxel, and validated the risk group classification in predicting overall survival (OS) in Japanese patients with mCRPC. Patients and Methods Fifty-two patients with mCRPC were administered 55 mg/m2 docetaxel and 8 mg dexamethasone, every 3 or 4 weeks, simultaneously with hormonal therapy and daily oral dexamethasone. They were divided into two groups, short-term (9 or fewer cycles) and long-term (10 or more cycles). Four risk factors including the presence of anemia, bone metastases, significant pain and visceral metastases were utilized for the risk group classification. Results Fourteen patients (27%) had an elevation of PSA in spite of docetaxel treatment, while 23 patients (44%) had a decline in PSA level, including 9 patients (17%) whose PSA level declined by ≥50%. The median duration of OS after the initiation of this therapy was 11.2 months in the short-term group and 28.5 months in the long-term group. The good risk group showed a significant difference in OS compared with the intermediate and poor risk groups (P<0.001). The median number of cycles of treatment was 14, 4 and 3 for each risk group, respectively (p<0.01). Conclusions The present study indicated that ≥10 cycles of this docetaxel therapy can significantly prolong survival in Japanese men with CRPC. This risk group classification for men with mCRPC at the initiation of this chemotherapy is useful.


[1]  Tannock IF, de Wit R, Berry WR, Horti J, Pluzanska A, et al. (2004) Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med 351: 1502–1512.
[2]  Cooperberg MR, Hinotsu S, Namiki M, Ito K, Broering J, et al. (2009) Risk assessment among prostate cancer patients receiving primary androgen deprivation therapy. J Clin Oncol 27: 4306–4313.
[3]  Huggins C, Hodges CV (1972) Studies on prostatic cancer. I. The effect of castration, of estrogen and androgen injection on serum phosphatases in metastatic carcinoma of the prostate. CA Cancer J Clin 22: 232–240.
[4]  Millikan RE (1999) Chemotherapy of advanced prostatic carcinoma. Semin Oncol 26: 185–191.
[5]  Tabernero J, Climent MA, Lluch A, Albanell J, Vermorken JB, et al. (2004) A multicentre, randomised phase II study of weekly or 3-weekly docetaxel in patients with metastatic breast cancer. Ann Oncol 15: 1358–1365.
[6]  Camps C, Massuti B, Jimenez A, Maestu I, Gomez RG, et al. (2006) Randomized phase III study of 3-weekly versus weekly docetaxel in pretreated advanced non-small-cell lung cancer: a Spanish Lung Cancer Group trial. Ann Oncol 17: 467–472.
[7]  Gridelli C, Gallo C, Di Maio M, Barletta E, Illiano A, et al. (2004) A randomised clinical trial of two docetaxel regimens (weekly vs 3 week) in the second-line treatment of non-small-cell lung cancer. The DISTAL 01 study. Br J Cancer 91: 1996–2004.
[8]  Gervais R, Ducolone A, Breton JL, Braun D, Lebeau B, et al. (2005) Phase II randomised trial comparing docetaxel given every 3 weeks with weekly schedule as second-line therapy in patients with advanced non-small-cell lung cancer (NSCLC). Ann Oncol 16: 90–96.
[9]  Armstrong AJ, Tannock IF, de Wit R, George DJ, Eisenberger M, et al. The development of risk groups in men with metastatic castration-resistant prostate cancer based on risk factors for PSA decline and survival. Eur J Cancer 46: 517–525.
[10]  Miyoshi Y, Uemura H, Nakamura M, Hasumi H, Sugiura S, et al. (2005) Treatment of androgen-independent, hormone-refractory prostate cancer with docetaxel in Japanese patients. Int J Clin Oncol 10: 182–186.
[11]  Pond GR, Armstrong AJ, Wood BA, Brookes M, Leopold L, et al. (2012) Evaluating the value of number of cycles of docetaxel and prednisone in men with metastatic castration-resistant prostate cancer. Eur Urol 61: 363–369.
[12]  Halabi S, Small EJ, Kantoff PW, Kattan MW, Kaplan EB, et al. (2003) Prognostic model for predicting survival in men with hormone-refractory metastatic prostate cancer. J Clin Oncol 21: 1232–1237.
[13]  Kamiya N, Suzuki H, Endo T, Yano M, Naoi M, et al.. (2012) Clinical usefulness of bone markers in prostate cancer with bone metastasis. Int J Urol.
[14]  Shimazui T, Kawai K, Miyanaga N, Kojima T, Sekido N, et al. (2007) Three-weekly docetaxel with prednisone is feasible for Japanese patients with hormone-refractory prostate cancer: a retrospective comparative study with weekly docetaxel alone. Jpn J Clin Oncol 37: 603–608.
[15]  Naito S, Tsukamoto T, Koga H, Harabayashi T, Sumiyoshi Y, et al. (2008) Docetaxel plus prednisolone for the treatment of metastatic hormone-refractory prostate cancer: a multicenter Phase II trial in Japan. Jpn J Clin Oncol 38: 365–372.
[16]  Chevalier-Larsen ES, O’Brien CJ, Wang H, Jenkins SC, Holder L, et al. (2004) Castration restores function and neurofilament alterations of aged symptomatic males in a transgenic mouse model of spinal and bulbar muscular atrophy. J Neurosci 24: 4778–4786.


comments powered by Disqus

Contact Us


微信:OALib Journal