Survival of Castration-Resistant Prostate Cancer in Clinical Practice and the Role of Treatment
DOI:
https://doi.org/10.35509/01239015.199Keywords:
Castration-resistant prostate cancer, Treatment, Abiraterone Acetate, Systemic chemotherapy, Survival, Prognostic factorsAbstract
Purpose: To assess, in a clinical practice context, the survival advantages of patients with castration-resistant prostate cancer (CRPC) actively treated with several treatments that include abiraterone acetate (AA) and prednisone, with or without docetaxel.
Material and Methods: An analysis was performed on patient survival with CRPC, and was compared to a group treated with AA and prednisone (n = 33), with a historical control treated exclusively with anti-androgen withdrawal and palliative measures (n = 31). In the population actively treated, variables predictive of prognosis were analysed, as well as an evaluation of the overall response to AA and radiographic progression-free survival.
Results: Cancer-specific survival at 2 years was 79% for patients actively treated and 17.2% for control group (P<.0001). Five (38.5%) of 13 patients treated with AA post-docetaxel received second-line chemotherapy after AA (4 cabazitaxel, 1 vinorelbine), and one (7.7%) enzalutamide. Three (15%) of 20 patients treated with AA without chemotherapy received enzalutamide and 1(5%) docetaxel. The younger patients (<65yrs; P=.02) without metastases at diagnosis (P=.04) had better prognoses. Patients with higher PSA levels (>45 ng/ml; P=.09) and a Gleason pattern 5 in the biopsy had less favourable outcomes. There was a 75.8% over response to AA (80% preand 69.2%post-chemotherapy; P=.1), and 52.4% were radiographic progression-free at 1 year of treatment (47.9% pre- and 49.8% post-chemotherapy; P=.3).
Conclusion: Treatment of CRPC patients extends survival expectations in a clinical practice setting and prognostic predictors can be identified in these patients.
Author Biographies
Javier Angulo, Laureate Universities
Servicios de Urología, Hospital Universitario de Getafe, Universidad Europea de Madrid, Laureate Universities, Madrid, España
Ignacio Romero, Laureate Universities
Servicios de Urología, Hospital Universitario de Getafe, Universidad Europea de Madrid, Laureate Universities, Madrid, España
María Teresa Díaz-Puente, Laureate Universities
Oncología Médica, Hospital Universitario de Getafe, Universidad Europea de Madrid, Laureate Universities, Madrid, España
Santos Enrech, Laureate Universities
Oncología Médica, Hospital Universitario de Getafe, Universidad Europea de Madrid, Laureate Universities, Madrid, España
Raúl Díez, Laureate Universities
Farmacia Hospitalaria, Hospital Universitario de Getafe, Universidad Europea de Madrid, Laureate Universities, Madrid, España
Teresa Molina, Laureate Universities
Farmacia Hospitalaria, Hospital Universitario de Getafe, Universidad Europea de Madrid, Laureate Universities, Madrid, España
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