| Summary: | 碩士 === 中山醫學大學 === 醫學研究所 === 104 === BACKGROUND
Abiraterone acetate (AA) had been approved in the treatment of castration resistant prostate cancer (CRPC) after docetaxel. We performed a retrospective study in patients with mCRPC patients who received AA treatment after docetaxel and identify clinical predictor for the treatment outcome.
METHODS
From January 2012 to December 2015, 41 patients who received docetaxel after CRPC and followed by AA treatment were included in this chart reviewed study. The general status, including previous radical prostatectomy, radiation therapy, serum PSA level at each time-point, chemotherapy cycles, and AA treatment results were recorded. We divided patients into AA-PSA responder group and AA PSA non-responder group. Analyses of variable differences between two groups were performed and calculated into regression analysis. Analyses about progression-free survival and overall survival were also performed.
RESULTS
Twenty-four patients (58.5%) reached 50% PSA decrease and were selected into PSA responder group. The median PSA progression free survival and overall survival in total 41 patients were 6.2 and 18.9 months respectively. The AA PSA responder group had significant better median progression free survival and overall survival experienced (19.6 vs 1.87, p<0.0001; 20.8 vs 7.7, p=0.002 respectively). Median time to maximam PSA response was 3.7 months. The adverse events developed in 17 patients (41.5%) and most were grade 1/2. In univariate analysis for progression free survival, PSA at AA, PSA progression ratio, Nadir PSA after AA treatment and PSA decline percentage reached statistical significance. In overall survival, CRPC to chemotherapy duration and PSA decline percentage were significant predictors (p=0.0317 and p=0.021 respectively).
CONCLUSION
PSA at AA, and PSA progression ratio are clinical predictors for progression free survival before AA treatment. CRPC to chemotherapy duration can predict the overall survival outcome before AA treatment. PSA decline percentage can be used as a predictor after AA treatment in both progression free survival and overall survival.
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