Early Prostate-Specific Antigen (PSA) Change at Four Weeks of the First-Line Treatment Using Abiraterone and Enzalutamide Could Predict Early/Primary Resistance in Metastatic Castration-Resistant Prostate Cancer
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Cohorts and Variables
2.2. Diagnosis of CRPC, Follow-Up, and Treatments
2.3. Statistical Analyses
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | Total (n = 254) | 1st AA (n = 119) | 1st Enz (n = 135) | p-Value | |||
---|---|---|---|---|---|---|---|
n | % | n | % | n | % | ||
Age at CRPC (years) | |||||||
mean ± SD | 73.0 ± 0.4 | 72.9 ± 0.7 | 73.1 ± 0.6 | 0.880 | |||
≤70 | 94 | 37.0 | 40 | 33.6 | 54 | 40.0 | 0.292 |
>70 | 160 | 63.0 | 79 | 66.4 | 81 | 60.0 | |
PSA (ng/ml) at diagnosis | |||||||
median (IQR) | 179 | (40–710) | 166 | (45–692) | 190 | (33–715) | 0.381 |
Clinical stage at diagnosis | |||||||
T2−T3 | 131 | 51.6 | 55 | 46.2 | 76 | 56.3 | 0.108 |
T4 | 123 | 48.4 | 64 | 53.8 | 59 | 43.7 | |
Gleason sum score at diagnosis | |||||||
<9 | 86 | 33.9 | 39 | 32.8 | 47 | 44.8 | 0.660 |
≥9 | 168 | 66.1 | 80 | 67.2 | 88 | 55.2 | |
duration of ADT before CRPC (months) | |||||||
≥12 | 180 | 70.9 | 78 | 65.5 | 102 | 75.6 | 0.079 |
<12 | 74 | 29.1 | 41 | 34.5 | 33 | 24.4 | |
ECOG-PS at CRPC | |||||||
0 | 164 | 64.6 | 81 | 68.1 | 83 | 61.5 | 0.273 |
≥1 | 90 | 35.4 | 38 | 31.9 | 52 | 38.5 | |
bone mets at CRPC | |||||||
− | 50 | 19.7 | 22 | 18.5 | 28 | 20.7 | 0.652 |
+ | 204 | 80.3 | 97 | 81.5 | 107 | 79.3 | |
lymph node mets at CRPC | |||||||
− | 135 | 53.1 | 64 | 53.8 | 71 | 52.6 | 0.849 |
+ | 119 | 46.9 | 55 | 46.2 | 64 | 47.4 | |
visceral mets at CRPC | |||||||
− | 215 | 84.6 | 101 | 84.9 | 114 | 84.4 | 0.924 |
+ | 39 | 15.4 | 18 | 15.1 | 21 | 15.6 | |
Laboratory data at CRPC | |||||||
median (IQR) | |||||||
PSA (ng/mL) | 10.7 | (3.2–31.1) | 9.5 | (3.1–24.6) | 11.1 | (3.2–39.0) | 0.188 |
ALP (IU/L) | 252 | (198–356) | 256 | (202–381) | 247 | (161–348) | 0.194 |
LDH (IU/L) | 201 | (183–239) | 199 | (182–238) | 201 | (183–243) | 0.350 |
Hb (g/dL) | 12.6 | (11.3–13.5) | 12.7 | (11.4–13.5) | 12.6 | (9.8–13.4) | 0.457 |
Median OS from the diagnosis of CRPC | |||||||
(months) | NR | NR | 45 | 0.325 | |||
Median TTPP from the diagnosis of CRPC | |||||||
(months) | 11 | 12 | 11 | 0.514 |
Variables | Multivariate | ||
---|---|---|---|
HR | (95% CI) | p-Value | |
Age at CRPC (years) | |||
≤70/>70 | 0.82 | (0.47–1.43) | 0.484 |
Clinical stage at diagnosis | |||
T2−T3/T4 | 0.81 | (0.45–1.45) | 0.485 |
Gleason sum score at diagnosis | |||
<9/≥9 | 1.04 | (0.67–1.88) | 0.876 |
duration of ADT before CRPC (months) | |||
≥12/<12 | 3.08 | (1.67–5.74) | <0.001 * |
ECOG-PS at CRPC | |||
0/≥1 | 3.63 | (2.09–6.44) | <0.001 * |
bone mets at CRPC | |||
−/+ | 4.08 | (1.46–14.70) | 0.005 * |
lymph node mets at CRPC | |||
−/+ | 1.56 | (0.91–2.67) | 0.102 |
visceral mets at CRPC | |||
−/+ | 1.25 | (0.62–2.36) | 0.500 |
first-line treatment of CRPC | |||
AA/Enz | 1.55 | (0.88–2.77) | 0.119 |
>30% PSA decline (PSA30D) at four weeks | |||
−/+ | 0.48 | (0.28–0.84) | 0.009 * |
Variables | At 12 Weeks | ||
---|---|---|---|
PSA30D | (+) (n = 177, 69.3%) | (−) (n = 77, 30.7%) | |
at 4 weeks | (+) (n = 157, 61.8%) | 147 (57.9%) | 10 (3.9%) |
(−) (n = 97, 38.2%) | 30 (11.8%) | 67 (26.4%) |
Variables | Multivariate | ||
---|---|---|---|
HR | (95% CI) | p-Value | |
Age at CRPC (years) | |||
≤70/>70 | 1.18 | (0.49–2.70) | 0.694 |
Clinical stage at diagnosis | |||
T2−T3/T4 | 1.02 | (0.41–2.45) | 0.951 |
Gleason sum score at diagnosis | |||
<9/≥9 | 0.70 | (0.27–1.89) | 0.480 |
duration of ADT before CRPC (months) | |||
≥12/<12 | 3.45 | (1.36–9.25) | 0.008 * |
ECOG-PS at CRPC | |||
0/≥1 | 3.98 | (1.64–10.32) | 0.002 * |
bone mets at CRPC | |||
−/+ | 3.66 | (0.80–28.81) | 0.099 |
lymph node mets at CRPC | |||
−/+ | 1.11 | (0.46–2.66) | 0.806 |
visceral mets at CRPC | |||
−/+ | 1.14 | (0.34–3.13) | 0.810 |
first-line treatment of CRPC | |||
AA/Enz | 1.61 | (0.72–3.66) | 0.241 |
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Uchimoto, T.; Komura, K.; Fukuokaya, W.; Kimura, T.; Takahashi, K.; Nishimura, K.; Nakamori, K.; Fujiwara, Y.; Matsunaga, T.; Tsutsumi, T.; et al. Early Prostate-Specific Antigen (PSA) Change at Four Weeks of the First-Line Treatment Using Abiraterone and Enzalutamide Could Predict Early/Primary Resistance in Metastatic Castration-Resistant Prostate Cancer. Cancers 2021, 13, 526. https://doi.org/10.3390/cancers13030526
Uchimoto T, Komura K, Fukuokaya W, Kimura T, Takahashi K, Nishimura K, Nakamori K, Fujiwara Y, Matsunaga T, Tsutsumi T, et al. Early Prostate-Specific Antigen (PSA) Change at Four Weeks of the First-Line Treatment Using Abiraterone and Enzalutamide Could Predict Early/Primary Resistance in Metastatic Castration-Resistant Prostate Cancer. Cancers. 2021; 13(3):526. https://doi.org/10.3390/cancers13030526
Chicago/Turabian StyleUchimoto, Taizo, Kazumasa Komura, Wataru Fukuokaya, Takahiro Kimura, Kazuhiro Takahashi, Kazuki Nishimura, Keita Nakamori, Yuya Fujiwara, Tomohisa Matsunaga, Takeshi Tsutsumi, and et al. 2021. "Early Prostate-Specific Antigen (PSA) Change at Four Weeks of the First-Line Treatment Using Abiraterone and Enzalutamide Could Predict Early/Primary Resistance in Metastatic Castration-Resistant Prostate Cancer" Cancers 13, no. 3: 526. https://doi.org/10.3390/cancers13030526