scholarly journals The Effect of Therapeutic Anticoagulation on Overall Survival in Men Receiving First-Line Docetaxel Chemotherapy for Metastatic Castration-Resistant Prostate Cancer

2015 ◽  
Vol 13 (1) ◽  
pp. 32-38 ◽  
Author(s):  
Jong Chul Park ◽  
Caroline F. Pratz ◽  
Anteneh Tesfaye ◽  
Robert A. Brodsky ◽  
Emmanuel S. Antonarakis
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Castration Resistant Prostate Cancer ◽  
First Line ◽  
Castration Resistant ◽  
Therapeutic Anticoagulation ◽  
Docetaxel Chemotherapy

Prognostic impact of prior local therapy in castration-resistant prostate cancer

2021 ◽  
Author(s):  
Mikifumi Koura ◽  
Masaki Shiota ◽  
Shohei Ueda ◽  
Takashi Matsumoto ◽  
Satoshi Kobayashi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Local Therapy ◽  
Progression Free Survival ◽  
Castration Resistant Prostate Cancer ◽  
First Line ◽  
Free Survival ◽  
First Line Therapy ◽  
Castration Resistant ◽  
Line Therapy

Abstract Objective This study aimed to reveal the prognostic values of prior local therapy in first-line therapy using androgen receptor-axis targeting agents (abiraterone or enzalutamide) or docetaxel for castration-resistant prostate cancer (CRPC). Methods The study included 303 patients treated with first-line therapy for non-metastatic and metastatic CRPC. The association between prior local therapy and therapeutic outcome including progression-free survival and overall survival was investigated by univariate and multivariate analyses as well as propensity score-matched analysis. Results In univariate analysis, local prior therapy was associated with a lower risk of all-cause mortality (hazard ratio, 0.56, 95% confidence interval, 0.40–0.79; P = 0.0009). Overall survival, but not progression-free survival, was better among patients with prior local therapy compared with patients without prior local therapy even after multivariate analysis and propensity score-matched analysis. Conclusions This study robustly indicated that prior local treatment was prognostic for overall survival among patients with CRPC. This finding is useful to predict patient prognosis in CRPC.

Use of epirubicin, carboplatin, and 5-fluorouracil (ECarboF) as a second-line treatment in metastatic castration-resistant prostate cancer.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 173-173
Author(s):  
U. B. McGovern ◽  
S. J. Harland
Keyword(s):  
Prostate Cancer ◽  
Metastatic Prostate Cancer ◽  
Performance Status ◽  
Median Number ◽  
Second Line ◽  
Castration Resistant Prostate Cancer ◽  
First Line ◽  
Castration Resistant ◽  
Docetaxel Chemotherapy ◽  
Line Chemotherapy

173 Background: ECarboF chemotherapy is an active first line chemotherapy treatment for metastatic prostate cancer. We have now investigated its efficacy and toxicity in patients who have progressed during or after docetaxel chemotherapy. Methods: 37 patients with metastatic prostate cancer who had received ECarboF chemotherapy were retrospectively reviewed from a five year period (2005-2010). All patients had previously received first-line docetaxel chemotherapy and had either progressed following treatment (n=17) or were docetaxel refractory (n=20). Patients received epirubicin 50mg/m2 iv d1, carboplatin (AUC 5) d1, fluorouracil 440mg/m2 d1, d15 and folinic acid 20mg/m2 d1, d15 on a q4w cycle. 20% dose reductions were made for the first cycle in patients with poorer performance status. PSA was measured before each cycle of treatment and all patients were assessed for toxicity. Results: Patients had a median age of 70 years (range 48-77), median baseline PSA of 226.5 ng/mL (range 9.6-1,580) and the median number of ECarboF chemotherapy cycles received was 6 (range 1-10). 65% (n=24) of patients were ECOG 0-1, the remaining 35% (n=13) were ECOG 2-3. 16% (n=6) patients had a ≥ 30% decline in PSA and 16% (n=6) patients had a ≥ 50% decline in PSA. 35% (n=13) of patients experienced grade 3/4 toxicity, most commonly anaemia (13.5%), neutropenia (13.5%) and thrombocytopenia (8.1%) with one treatment related death (neutropenic sepsis) during the five year period analysed. Median time to PSA progression was 5.1 months. Conclusions: ECarboF has activity with acceptable toxicity post docetaxel in the treatment of metastatic castration resistant prostate cancer. Although PSA response rates are modest, the time to progression is comparable to that of more toxic regimens. ECarboF should be considered as an active second-line chemotherapy regimen. No significant financial relationships to disclose.

Serum testosterone level and overall survival in first-line abiraterone and enzalutamide for metastatic castration-resistant prostate cancer patients.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e17545-e17545
Author(s):  
Maysa Tamara Silveira Vilbert ◽  
Marcelle Goldner Cesca ◽  
Natasha Carvalho Pandolfi ◽  
Vinicius Fernando Calsavara ◽  
Bruno Cezar de Mendonça Uchôa ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Testosterone Level ◽  
Serum Testosterone ◽  
Serum Testosterone Level ◽  
Castration Resistant Prostate Cancer ◽  
First Line ◽  
Testosterone Levels ◽  
Castration Resistant ◽  
Low Serum

e17545 Background: Androgen receptor-targeted agents Abiraterone and Enzalutamide (Abi/Ez) prolonged overall survival in metastatic castration resistant prostate cancer (mCRPC). Patients with very-low serum testosterone levels seem to have less benefit from these therapies as well as more aggressive prostate cancer. Methods: A retrospective observational cohort study was conducted to evaluate whether a serum testosterone measured at time of start first-line therapy with Abi/Ez is related to overall survival (OS) and time-to-treatment failure (TTF) in mCRPC patients. Kaplan-Meier survival estimates and Cox-regression models were used for time-to-event analyses. The best cut-off for testosterone was defined using Log-rank statistics (Lausen and Schumacher). X² test and Mann-Whitney U-test were applied to compare categorical and continuous variables, respectively. Logistic regression was used to assess characteristics related to serum testosterone levels. Statistical significance was fixed at 0.05. Results: From May 2012 to February 2017, 100 patients were assessed. Median follow-up was 27.8 months (range 2.23 to 68.26). Pts with a high testosterone level ( > 28.2; n = 20) achieved a significantly higher OS (median 66.0 vs 31.9 mo, testosterone > 28.2 HR: 0.206, 95% CI 0.074 to 0.571, p = 0.002) and TTF (median 30.6 vs 11.8 mo, testosterone > 28.2 HR: 0.408, 95%CI 0.219 to 0.762, p = 0.005) than pts with a low serum testosterone level ( < 28.2; n = 80), regardless of receiving therapy with either Abi (n = 69) or Ez (n = 31). Pts with a higher testosterone level were younger (median 67.7 vs 73.6 years; p = 0.026), had a higher body mass index (BMI) (28.5 vs 25.9, p = 0.023) and a lower PSA at start Abi/Ez (12 vs 26, p = 0.031) than pts with lower values. Age (OR 0.93, 95%CI 0.8 to 0.9, p = 0.021), BMI (OR 1.21, 95%CI 1.1 to 1.4, p = 0.006) and baseline PSA (OR 1.2, 95%CI 1.03 to 1.4, p = 0.020) were significantly associated with testosterone > 28.2. After 4 months of Abi/Ez treatment, PSA decrease > 50% of baseline was seen more frequently in high testosterone levels group than in low testosterone levels pts (90% vs 57.5% of pts, respectively, p = 0.007). Conclusions: Pts with high levels of testosterone ( > 28.2) achieved a better OS and TTF when treated with Abi/Ez in first-line mCRPC than those with low levels. Testosterone can be considered a prognostic and predictive biomarker in this scenario, and could be used in treatment decision for this population.

Analysis of docetaxel therapy in elderly (≥70yrs) castration resistant prostate cancer (CRPC) patients enrolled in the Netherlands Prostate Study (NePro).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e16059-e16059
Author(s):  
Maartje Los ◽  
Frank L. Gerritse ◽  
Hielke Jodie Meulenbeld ◽  
Jeanine M.L. Roodhart ◽  
Ankie M.T. van der Velden ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Clinical Trials ◽  
The Netherlands ◽  
Cancer Patients ◽  
Exclusion Criterion ◽  
Castration Resistant Prostate Cancer ◽  
Castration Resistant ◽  
Younger Men ◽  
Docetaxel Chemotherapy

e16059 Background: Prostate cancer truly is an age-associated disease, approximately half of prostate cancer patients in the Netherlands are aged 70 years or older at the time of diagnosis. However, age above 70 years has been an exclusion criterion in many clinical trials. Hence the knowledge about chemotherapy tolerance and toxicity in patients aged 70 years and above is limited. In this study we evaluated the influence of age on docetaxel chemotherapy in elderly (≥70yrs) castration resistant prostate cancer (CRPC) patients. Methods: Prostate cancer truly is an age-associated disease, approximately half of prostate cancer patients in the Netherlands are aged 70 years or older at the time of diagnosis. However, age above 70 years has been an exclusion criterion in many clinical trials. Hence the knowledge about chemotherapy tolerance and toxicity in patients aged 70 years and above is limited. In this study we evaluated the influence of age on docetaxel chemotherapy in elderly (≥70yrs) castration resistant prostate cancer (CRPC) patients. Results: We analyzed 568 patients (median age 68.1yrs, range 46-89yrs, 44.5% aged ≥70yrs). There was no relation between dosage and age (p=0.60). We found no significant differences between the number of dose reductions, TTP, overall survival, chemotherapy tolerance and toxicity up to the age of 80 years. However, when compared to younger men, men aged 80 years or above more frequently experienced grade 3/4 toxicity, were five times less likely to complete the first three treatment cycles at the intended dose (OR5.34, p=0.0052) and showed decreased overall survival (15.3mos versus 24.5mos in <80yrs group, p=0.020). Conclusions: In mCRPC, and possibly other cancer patients, up to the age of 80 years docetaxel chemotherapy is well tolerated with toxicity levels, tolerance and TTP comparable to that of younger patients. However, for chemotherapeutic treatment of patients aged 80 years and above an individual assessment should be made.

The effect of therapeutic anticoagulation on overall survival (OS) in men receiving docetaxel chemotherapy for metastatic castration-resistant prostate cancer (mCRPC).

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 28-28
Author(s):  
Caroline F. Pratz ◽  
Robert A. Brodsky ◽  
Emmanuel S. Antonarakis
Keyword(s):  
Proportional Hazards ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
Cox Proportional Hazards ◽  
Castration Resistant Prostate Cancer ◽  
First Line ◽  
Castration Resistant ◽  
Therapeutic Anticoagulation ◽  
Antitumor Potential ◽  
Docetaxel Chemotherapy

28 Background: Anticoagulants have been postulated to possess antitumor activity, although clinical data supporting this claim are conflicting. We sought to examine the effect of therapeutic anticoagulation on OS in men with mCRPC receiving first-line docetaxel chemotherapy. Methods: We retrospectively reviewed the records of 247 consecutive mCRPC patients who received first-line docetaxel chemotherapy between 1/1/1998 and 1/1/2010. Information on anticoagulant use, type of anticoagulant administered, indication for anticoagulation, and duration of anticoagulation were captured. Univariate and multivariable Cox proportional hazards regression models were developed to investigate the effect of anticoagulant use on OS. Results: In all, 29/247 men (11.7%) received anticoagulation (LMW heparin: 17/247; warfarin: 12/247). The indication was DVT in 15/247, PE in 9/247, and both DVT and PE in 5/247 men. In univariate analysis, anticoagulant use was associated with improved OS (any anticoagulant, HR 0.61 [95%CI 0.40–0.94] P=0.024; LMW heparin, HR 0.58 [95%CI 0.34–0.99] P=0.048; warfarin, HR 0.82 [95%CI 0.55–1.28] P=0.23). Median OS was 20.9 mo (with any anticoagulant) versus 17.1 mo (with no anticoagulant). In multivariable analysis, anticoagulant use remained a significant predictor of OS after adjusting for other prognostic factors (Table). Conclusions: Anticoagulant use is an independent predictor of OS in men with mCRPC receiving docetaxel. This finding is surprising given that the occurrence of venous thrombosis might be expected to negatively influence OS. If validated, these data may provide the impetus to explore the antitumor potential of anticoagulants in prospective clinical trials. [Table: see text]

The effect of treatment sequence on overall survival for men with metastatic castration-resistant prostate cancer: A multicenter retrospective study.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 238-238
Author(s):  
Shingo Hatakeyama ◽  
Kazutaka Okita ◽  
Hayato Yamamoto ◽  
Takahiro Yoneyama ◽  
Yasuhiro Hashimoto ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Real World ◽  
Cox Regression ◽  
Sequential Therapy ◽  
Treatment Sequence ◽  
Castration Resistant Prostate Cancer ◽  
First Line ◽  
Castration Resistant ◽  
Significant Difference

238 Background: We aimed to evaluate the treatment sequence for patients with metastatic castration-resistant prostate cancer (mCRPC) in real-world practice and compare overall survival in each sequential therapy. Methods: We retrospectively evaluated 146 patients with mCRPC who were initially treated with androgen deprivation therapy as metastatic hormone-naïve prostate cancer in 14 hospitals between January 2010 and March 2019. The agents for the sequential therapy included new androgen receptor-targeted agents (ART: abiraterone acetate or enzalutamide), docetaxel, and/or cabazitaxel. We evaluated the treatment sequence for mCRPC and the effect of sequence patterns on overall survival. Results: The median age was 71 years. A total of 35 patients received ART-ART, 33 received ART-docetaxel, 68 received docetaxel-ART, and 10 received docetaxel-cabazitaxel sequences. The most prescribed treatment sequence was docetaxel-ART (47%), followed by ART-ART (24%). Overall survival calculated from the initial diagnosis reached 83, 57, 79, 37 months in the ART-ART, ART-docetaxel, docetaxel-ART, and docetaxel-cabazitaxel, respectively. Multivariate Cox regression analyses showed no significant difference in overall survival between the first-line ART (n = 68) and first-line docetaxel (n = 78) therapies (hazard ratio: HR 0.84, P = 0.530), between the ART-ART (n = 35) and docetaxel-mixed (n = 111) sequences (HR 0.82, P = 0.650), and between the first-line abiraterone (n = 32) and first-line enzalutamide (n = 36) sequences (HR 1.58, P = 0.384). Conclusions: The most prescribed treatment sequence was docetaxel followed by ART. No significant difference was observed in overall survival among the treatment sequences in real-world practice.

Intermittent docetaxel chemotherapy as first-line treatment for metastatic castration-resistant prostate cancer patients

2015 ◽  
Vol 11 (6) ◽  
pp. 965-973 ◽  
Author(s):  
Orazio Caffo ◽  
Giovanni Lo Re ◽  
Teodoro Sava ◽  
Sebastiano Buti ◽  
Cosimo Sacco ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Line Treatment ◽  
Castration Resistant Prostate Cancer ◽  
First Line ◽  
Castration Resistant ◽  
Docetaxel Chemotherapy ◽  
First Line Treatment
Sign in / Sign up

Export Citation Format

Share Document