Efficacy of docetaxel in castration-resistant prostate cancer patients with intraductal carcinoma of the prostate

2018 ◽  
Vol 23 (3) ◽  
pp. 584-590 ◽  
Author(s):  
Akiyuki Yamamoto ◽  
Masashi Kato ◽  
Hirotaka Matsui ◽  
Ryo Ishida ◽  
Tohru Kimura ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Intraductal Carcinoma ◽  
Castration Resistant Prostate Cancer ◽  
Carcinoma Of The Prostate ◽  
Castration Resistant

Efficacy of docetaxel and androgen receptor axis-targeted agents in castration-resistant prostate cancer patients with intraductal carcinoma of the prostate.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 150-150
Author(s):  
Akiyuki Yamamoto ◽  
Masashi Kato ◽  
Toyonori Tsuzuki ◽  
Momokazu Gotoh
Keyword(s):  
Prostate Cancer ◽  
Androgen Receptor ◽  
Primary Outcome ◽  
Progression Free Survival ◽  
Intraductal Carcinoma ◽  
Castration Resistant Prostate Cancer ◽  
Free Survival ◽  
Carcinoma Of The Prostate ◽  
Castration Resistant ◽  
Time Of Administration

150 Background: This study aimed to investigate the efficacy of docetaxel and androgen receptor axis-targeted (ARAT) agents in castration-resistant prostate cancer (CRPC) patients with intraductal carcinoma of the prostate (IDC-P). Methods: We retrospectively identified 311 CRPC patients from June 2002 to February 2016. All patients were initially administered with androgen deprivation therapy (ADT), followed by docetaxel or ARAT (abiraterone or enzalutamide) after progressing to CRPC. The primary outcome of interest was overall survival (OS) from the time of CRPC diagnosis and progression-free survival (PFS) from the time of administration of docetaxel or ARAT. Results: IDC-P was found in 180 of 311 patients. The median OS was 33.4 and 64.0 months with and without IDC-P, respectively (hazards ratio [HR], 2.14; P < 0.001). For the first treatment for CRPC, docetaxel was administered to 71 and 50 patients with and without IDC-P, respectively, with a median OS of 30.4 and 64.0 months, respectively (HR, 2.62; P < 0.001). ARAT was administered to 109 and 81 patients with and without IDC-P, respectively, with a median OS of 45.0 and 69.9 months, respectively (HR, 1.84; P = 0.017). Regarding patients with IDC-P, the OS in patients who were administered with ARAT was longer than that in those administered with docetaxel (HR, 0.58; P = 0.008). The median PFS was 7.5 and 12.1 months with and without IDC-P, respectively (HR, 1.36; P = 0.03). Multivariate analysis showed that the prognostic factors for OS were the presence of IDC-P (HR, 1.91; P < 0.001), and administration of ARAT (HR, 0.66; P = 0.02). Conclusions: The presence of IDC-P is an independent prognostic factor for OS and PFS in CRPC patients. ARAT may prolong OS in CRPC patients with IDC-P.

Propensity score matched comparison of docetaxel and androgen receptor axis-targeted (ARAT) agents in castration-resistant prostate cancer patients with intraductal carcinoma of the prostate (IDC-P).

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 80-80
Author(s):  
Akiyuki Yamamoto ◽  
Masashi Kato ◽  
Toyonori Tsuzuki ◽  
Momokazu Gotoh
Keyword(s):  
Prostate Cancer ◽  
Androgen Receptor ◽  
Propensity Score ◽  
Patient Characteristics ◽  
Intraductal Carcinoma ◽  
Castration Resistant Prostate Cancer ◽  
Carcinoma Of The Prostate ◽  
Castration Resistant ◽  
Significant Difference ◽  
Docetaxel Group

80 Background: Several studies have reported that intraductal carcinoma of the prostate (IDC-P) is a pathological adverse prognostic factor in patients with prostate cancer. However, the optimal treatment has not been established. The present study aimed to evaluate the efficacy of docetaxel and androgen receptor axis-targeted (ARAT) agents in patients with castration-resistant prostate cancer (CRPC) with IDC-P using a propensity score-matched analysis. Methods: We retrospectively identified 309 patients with CRPC from February 2007 to February 2016. They received initial androgen deprivation therapy (ADT) and after progression to CRPC, they received docetaxel or ARAT (abiraterone or enzalutamide) as the first-line life-prolonging therapy. The primary outcome of interest was OS from the time of CRPC diagnosis. We also investigated PFS from the time of docetaxel or ARAT initiation. Results: Propensity score-matching identified 85 patients in each group. There were no significant differences in patient characteristics between the groups. The median OS in the docetaxel group was 38.2 months versus 58.3 months in the ARAT group (HR 0.57; 95% CI 0.37–0.89; P =.01). Regarding patients with IDC-P, OS was significantly longer in the ARAT group than the docetaxel group (HR 0.48; 95% CI 0.26–0.86; P =.01), and there was no significant difference in each group, as in patients without IDC-P (HR 0.75; 95% CI 0.37–1.52; P =.43). The median PFS in the docetaxel group was 6.7 versus 7.8 months in the ARAT group (HR 0.65; 95% CI 0.45–0.94; P =.02). A multivariate analysis demonstrated that the presence of IDC-P, duration of primary ADT, visceral metastasis, and administration of ARAT as the first treatment for CRPC were independent prognostic factors for OS. Conclusions: Administration of ARAT as the first treatment for CRPC may prolong OS more than that of docetaxel, especially in patients with IDC-P.

Effect of chemotherapy on survival for intraductal carcinoma of the prostate (IDC-P) in patients with castration-resistant prostate cancer.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. e601-e601 ◽  
Author(s):  
Akiyuki Yamamoto ◽  
Masashi Kato ◽  
Toyonori Tsuzuki ◽  
Momokazu Gotoh ◽  
Yoshihisa Matsukawa ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Local Treatment ◽  
Specific Antigen ◽  
Intraductal Carcinoma ◽  
Survival Duration ◽  
Rank Test ◽  
Castration Resistant Prostate Cancer ◽  
Cancer Specific Survival ◽  
Carcinoma Of The Prostate ◽  
Castration Resistant

e601 Background: Several studies have reported that intraductal carcinoma of the prostate (IDC-P) was a pathological adverse prognostic factor in patients with prostate cancer; however, there have been no reports regarding the effect of chemotherapy on survival for this group of patients. This study assessed the effect of chemotherapy on survival in patients with IDC-P. Methods: We retrospectively evaluated 150 prostate cancer patients who were initially diagnosed with distant metastases from June 2002 to January 2014 at the authors’ affiliated hospitals. All needle biopsy slides were reviewed by a single genitourinary pathologist according to the 2014 International Society of Urological Pathology (ISUP) grading system. Exclusion criteria were patients with missing data and those receiving local treatment. Seventy-nine patients with castration-resistant prostate cancer (CRPC) were analyzed. Study endpoints included cancer-specific survival after starting chemotherapy and survival duration from diagnosis of CRPC to cancer-related death. Log-rank test and the Cox proportional hazard model were used for statistical analysis. Results: The patients’ median age was 70 years (range 50–85 years). The median serum prostate-specific antigen level at initial diagnosis was 495.0 ng/mL (range 12.6–10,000). IDC-P was found in 62 out of 79 cases. Forty-six patients received docetaxel-based chemotherapy. Patients received a median of seven chemotherapy courses (range 1–55 courses). The cancer-specific survival duration after starting chemotherapy was 16.7 months in patients with IDC-P and 23.4 months in patients without IDC-P (P = 0.068). Chemotherapy could significantly extend survival duration from diagnosis of CRPC in patients with IDC-P (18.4 months vs. 4.4 months, P = 0.001) Conclusions: Although the effect of chemotherapy may be limited in patients with IDC-P, it significantly extended the time from diagnosis of castration-resistant disease to cancer-related death.

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