Efficacy of androgen deprivation therapy (ADT) in patients with advanced prostate cancer
- 18 January 2008
- Vol. 112 (6), 1247-1253
- https://doi.org/10.1002/cncr.23304
Abstract
BACKGROUND The purpose of this study was to compare predictive factors for the efficacy of androgen deprivation therapy (ADT) in men with hormone‐sensitive prostate cancer (HSPC) either with (M+) or without (M−) metastases. METHODS A cohort of prostate cancer patients was identified from a medical oncology practice treated with ADT for presumed nonlocalized prostate cancer, evaluated the efficacy of ADT using prostate‐specific antigen (PSA) time to progression (TTP) and compared factors associated with TTP in M− and M+ patients. RESULTS In this 553 patient cohort 51% were M− and 49% M+. The median TTP on ADT for the M− group was 33.2 months, versus 15.9 months in the M+ group (P < .0001). In multivariate analyses, lower biopsy Gleason score (GS), the absence of metastases, and lower serum PSA at ADT initiation all were associated with the efficacy of ADT. The association between GS and TTP was confined to M+ patients, whereas the association between PSA at ADT initiation and TTP was confined to M− patients. Use of ADT as part of local treatment was associated with a shortened TTP in both groups (hazard ratio [HR], 1.45, 95% confidence interval [CI], 1.10–1.91). CONCLUSIONS In this large, retrospective study of HSPC patients in a medical oncology practice treated with ADT for nonlocalized prostate cancer, we found factors predicting efficacy of this treatment differed based on whether metastases were present at ADT initiation. The use of ADT as a part of local therapy was associated with a significantly decreased TTP, regardless of metastatic disease status. Cancer 2008. © 2008 American Cancer Society.This publication has 17 references indexed in Scilit:
- The Natural History of Noncastrate Metastatic Prostate Cancer after Radical ProstatectomyEuropean Urology, 2007
- Docetaxel, Estramustine, and 15-Month Androgen Deprivation for Men With Prostate-Specific Antigen Progression After Definitive Local Therapy for Prostate CancerJournal of Clinical Oncology, 2006
- 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)Journal of Clinical Oncology, 2006
- Immediate or Deferred Androgen Deprivation for Patients With Prostate Cancer Not Suitable for Local Treatment With Curative Intent: European Organisation for Research and Treatment of Cancer (EORTC) Trial 30891Journal of Clinical Oncology, 2006
- Predictors of Prostate Cancer–Specific Mortality After Radical Prostatectomy or Radiation TherapyJournal of Clinical Oncology, 2005
- Immediate Versus Deferred Hormonal Treatment for Patients With Prostate Cancer Who Are Not Suitable for Curative Local Treatment: Results of the Randomized Trial SAKK 08/88Journal of Clinical Oncology, 2004
- Early Versus Delayed Hormonal Therapy for Prostate Specific Antigen Only Recurrence of Prostate Cancer After Radical ProstatectomyJournal of Urology, 2004
- Time Trends in Clinical Risk Stratification for Prostate Cancer: Implications for Outcomes (Data From CaPSURE)Journal of Urology, 2003
- Cancer-Specific Mortality After Surgery or Radiation for Patients With Clinically Localized Prostate Cancer Managed During the Prostate-Specific Antigen EraJournal of Clinical Oncology, 2003
- Immediate Hormonal Therapy Compared with Observation after Radical Prostatectomy and Pelvic Lymphadenectomy in Men with Node-Positive Prostate CancerThe New England Journal of Medicine, 1999