Prognostic and predictive factors for anti-androgen withdrawal in castration-resistant prostate cancer

Tomohiko Murakami, Hirofumi Obata, Naoko Akitake, Masaki Shiot, ario takeuchi, Eiji Kashiwagi, Junichi Inokuchi, Katsunori Tatsugami, Masatoshi Eto

Research output: Contribution to journalArticle

Abstract

Background/Aim: We aimed to identify prognostic and predictive factors for anti-androgen withdrawal syndrome (AWS) to help guide decisions on anti-androgen withdrawal in castration-resistant prostate cancer (CRPC). Patients and Methods: This study included 95 patients with prostate cancer which progressed to CRPC despite primary androgen-deprivation therapy (ADT). AWS was defined as >50% prostate-specific antigen decline after anti-androgen withdrawal. Associations between AWS, and clinicopathological factors and prognosis were investigated. Results: Among the 95 patients, 84 (88.4%) underwent anti-androgen withdrawal, among whom AWS was recognized in nine (10.8%). Gleason score and response duration to primary ADT were predictors of AWS. Long duration of response to primary ADT was also associated with better progression-free survival [hazard ratio (HR)=0.021, 95% confidence interval (CI)=0.0025-0.14, p<0.0001] and overall survival (HR=0.0042, 95% CI=0.0001-0.089, p<0.0001). Age (HR=7.19, 95% CI=1.08-54.27, p=0.041) and radiological/ clinical progression (HR=3.14, 95% CI=1.35-6.43, p=0.010) were associated with worse overall survival. Intriguingly, radiological/clinical progression was associated with the differential effect of anti-androgen withdrawal on overall survival (interaction p=0.031). Conclusion: Patients who suffer radiological/clinical progression are unsuitable candidates for anti-androgen withdrawal.

Original languageEnglish
Pages (from-to)4115-4121
Number of pages7
JournalAnticancer research
Volume38
Issue number7
DOIs
Publication statusPublished - Jul 1 2018

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Castration
Androgens
Prostatic Neoplasms
Confidence Intervals
Survival
Neoplasm Grading
Prostate-Specific Antigen
Disease-Free Survival
Therapeutics

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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Prognostic and predictive factors for anti-androgen withdrawal in castration-resistant prostate cancer. / Murakami, Tomohiko; Obata, Hirofumi; Akitake, Naoko; Shiot, Masaki; takeuchi, ario; Kashiwagi, Eiji; Inokuchi, Junichi; Tatsugami, Katsunori; Eto, Masatoshi.

In: Anticancer research, Vol. 38, No. 7, 01.07.2018, p. 4115-4121.

Research output: Contribution to journalArticle

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abstract = "Background/Aim: We aimed to identify prognostic and predictive factors for anti-androgen withdrawal syndrome (AWS) to help guide decisions on anti-androgen withdrawal in castration-resistant prostate cancer (CRPC). Patients and Methods: This study included 95 patients with prostate cancer which progressed to CRPC despite primary androgen-deprivation therapy (ADT). AWS was defined as >50{\%} prostate-specific antigen decline after anti-androgen withdrawal. Associations between AWS, and clinicopathological factors and prognosis were investigated. Results: Among the 95 patients, 84 (88.4{\%}) underwent anti-androgen withdrawal, among whom AWS was recognized in nine (10.8{\%}). Gleason score and response duration to primary ADT were predictors of AWS. Long duration of response to primary ADT was also associated with better progression-free survival [hazard ratio (HR)=0.021, 95{\%} confidence interval (CI)=0.0025-0.14, p<0.0001] and overall survival (HR=0.0042, 95{\%} CI=0.0001-0.089, p<0.0001). Age (HR=7.19, 95{\%} CI=1.08-54.27, p=0.041) and radiological/ clinical progression (HR=3.14, 95{\%} CI=1.35-6.43, p=0.010) were associated with worse overall survival. Intriguingly, radiological/clinical progression was associated with the differential effect of anti-androgen withdrawal on overall survival (interaction p=0.031). Conclusion: Patients who suffer radiological/clinical progression are unsuitable candidates for anti-androgen withdrawal.",
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AU - Obata, Hirofumi

AU - Akitake, Naoko

AU - Shiot, Masaki

AU - takeuchi, ario

AU - Kashiwagi, Eiji

AU - Inokuchi, Junichi

AU - Tatsugami, Katsunori

AU - Eto, Masatoshi

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