PSA time to nadir as a prognostic factor of first-line docetaxel treatment in castration-resistant prostate cancer: evidence from patients in Northwestern China.
- Author:
Kai-Jie WU
1
;
Xin-Qi PEI
1
;
Ge TIAN
1
;
Da-Peng WU
1
;
Jin-Hai FAN
1
;
Yu-Mei JIANG
1
;
Da-Lin HE
1
Author Information
- Publication Type:Journal Article
- Keywords: castration-resistant prostate cancer; chemotherapy; docetaxel; prostate-specific antigen; survival; time to nadir
- MeSH: Aged; Aged, 80 and over; Androgen Antagonists/therapeutic use*; Antineoplastic Agents/therapeutic use*; China; Docetaxel/therapeutic use*; Humans; Kallikreins/blood*; Kaplan-Meier Estimate; Leukocyte Count; Lymphocyte Count; Male; Middle Aged; Neoplasm Metastasis; Neutrophils; Prognosis; Proportional Hazards Models; Prostate-Specific Antigen/blood*; Prostatic Neoplasms, Castration-Resistant/pathology*; Retrospective Studies; Survival Rate; Time Factors
- From: Asian Journal of Andrology 2018;20(2):173-177
- CountryChina
- Language:English
- Abstract: Docetaxel-based chemotherapy remains the first-line treatment for patients with metastatic castration-resistant prostate cancer (mCRPC) in China; however, the prognostic factors associated with effects in these patients are still controversial. In this study, we retrospectively reviewed the data from 71 eligible Chinese patients who received docetaxel chemotherapy from 2009 to 2016 in our hospital and experienced a reduction of prostate-specific antigen (PSA) level ≥50% during the treatment and investigated the potential role of time to nadir (TTN) of PSA. TTN was defined as the time from start of chemotherapy to the nadir of PSA level during the treatment. Multivariable Cox regression models and Kaplan-Meier analysis were used to predict overall survival (OS). In these patients, the median of TTN was 17 weeks. Patients with TTN ≥17 weeks had a longer response time to chemotherapy compared to TTN <17 weeks (42.83 vs 21.50 weeks, P < 0.001). The time to PSA progression in patients with TTN ≥17 weeks was 11.44 weeks compared to 5.63 weeks when TTN was <17 weeks. We found several factors to be associated with OS, including TTN (hazard ratio [HR]: 3.937, 95% confidence interval [CI]: 1.502-10.309, P = 0.005), PSA level at the diagnosis of cancer (HR: 4.337, 95% CI: 1.616-11.645, P = 0.004), duration of initial androgen deprivation therapy (HR: 2.982, 95% CI: 1.104-8.045, P = 0.031), neutrophil-to-lymphocyte ratio (HR: 3.963, 95% CI: 1.380-11.384, P = 0.011), and total PSA response (Class 1 [<0 response] compared to Class 2 [0-50% response], HR: 3.978, 95% CI: 1.278-12.387, P = 0.017). In conclusion, TTN of PSA remains an important prognostic marker in predicting therapeutic outcome in Chinese population who receive chemotherapy for mCRPC and have >50% PSA remission.
