Time to PSA nadir as a response factor in CPRC patients treated with abiraterone
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v82i2.763Keywords:
Prostate, prostate-specific antigen, castrationAbstract
Objective: To determine if the time to achieve a PSA nadir is related to a delay in the progression of the disease.
Material and methods: A retrospective study of 36 patients treated with abiraterone acetate in our facilities between January 2014 and May 2018 in CPRC M1 phase. PSA levels are evaluated at the beginning of the treatment, after 4, 8 and 12 weeks, as well as in the successive periods according to our protocol. PSA response is defined as a decrease of ≥30% from the start of treatment and PSA progression as an increase of ≥25% from the beginning. It is considered as 'progression that supposes withdrawal of treatment' the one that associates at least two of the following criteria: PSA progression, clinical progression and radiological progression. We performed a linear regression analysis for PSA variables at diagnosis, PSA nadir, time at nadir, PSA doubling time and decrease of at least 30% of the nadir.
Results: In our series, time to nadir in linear regression is positively associated with progression, obtaining better progression-free survival when a longer-term nadir PSA is achieved (p <0.018); so that for every month of delay in reaching the nadir, a 0.8 months belated progression is expected.
Conclusion: In our series, achieving a belated PSA nadir is related to an improvement in progression-free survival.
References
INE. Distribución de la mortalidad por causas (lista reducida), sexo y edad . Defunciones según la causa de muerte (2016). 2016. [accessed 30 Apr 2022] Available from: https://www.ine.es/jaxi/Datos.htm?path=/t15/p417/a2016/l0/&file=01003.px
Hussain M, Tangen CM, Higano C, Schelhammer PF, Faulkner J, Crawford ED, et al. Absolute prostate-specific antigen value after androgen deprivation is a strong independent predictor of survival in new metastatic prostate cancer: data from Southwest Oncology Group Trial 9346 (INT-0162). J Clin Oncol. 2006 Aug 20;24(24):3984–90. doi: https://doi.org/10.1200/jco.2006.06.4246
Wu K-J, Pei X-Q, Tian G, Wu D-P, Fan J-H, Jiang Y-M, et al. PSA time to nadir as a prognostic factor of first-line docetaxel treatment in castration-resistant prostate cancer: evidence from patients in Northwestern China. Asian J Androl. 2018 Apr;20(2):173–7. doi: https://doi.org/10.4103/aja.aja_34_17
Taussky D, Bedwani S, Meissner N, Bahary J-P, Lambert C, Barkati M, et al. A comparison of early prostate-specific antigen decline between prostate brachytherapy and different fractionation of external beam radiation-Impact on biochemical failure. Brachytherapy. 2018 Apr;17(2):277–82. doi: https://doi.org/10.1016/j.brachy.2017.11.014
Choueiri TK, Xie W, D’Amico AV, Ross RW, Hu JC, Pomerantz M, et al. Time to prostate-specific antigen nadir independently predicts overall survival in patients who have metastatic hormone-sensitive prostate cancer treated with androgen-deprivation therapy. Cancer. 2009 Mar 1;115(5):981–7. doi: https://doi.org/10.1002/cncr.24064
Thoma C. Validating early PSA response to enable improved treatment decisions. Nat Rev Urol. 2016 May;13(5):239–239. doi: https://doi.org/10.1038/nrurol.2016.59
Rescigno P, Lorente D, Bianchini D, Ferraldeschi R, Kolinsky MP, Sideris S, et al. Prostate-specific Antigen Decline After 4 Weeks of Treatment with Abiraterone Acetate and Overall Survival in Patients with Metastatic Castration-resistant Prostate Cancer. Eur Urol. 2016 Nov;70(5):724–31. doi: https://doi.org/10.1016/j.eururo.2016.02.055
Hong SY, Cho DS, Kim SI, Ahn HS, Kim SJ. Prostate-specific antigen nadir and time to prostate-specific antigen nadir following maximal androgen blockade independently predict prognosis in patients with metastatic prostate cancer. Korean J Urol. 2012 Sep;53(9):607–13. doi: https://doi.org/10.4111/kju.2012.53.9.607
Sasaki T, Onishi T, Hoshina A. Nadir PSA level and time to PSA nadir following primary androgen deprivation therapy are the early survival predictors for prostate cancer patients with bone metastasis. Prostate Cancer Prostatic Dis. 2011 Sep;14(3):248–52. doi: https://doi.org/10.1038/pcan.2011.14
Tomioka A, Tanaka N, Yoshikawa M, Miyake M, Anai S, Chihara Y, et al. Nadir PSA level and time to nadir PSA are prognostic factors in patients with metastatic prostate cancer. BMC Urol. 2014 Apr 29;14:33. doi: https://doi.org/10.1186/1471-2490-14-33
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Revista Mexicana de Urología
This work is licensed under a Creative Commons Attribution 4.0 International License.
