TY - JOUR
T1 - Should We Try Antiandrogen Withdrawal in Castration-Resistant Prostate Cancer Patients? Insights From a Retrospective Study
AU - Hongo, Hiroshi
AU - Kosaka, Takeo
AU - Mizuno, Ryuichi
AU - Ezaki, Taisuke
AU - Matsumoto, Kazuhiro
AU - Morita, Shinya
AU - Shinoda, Kazunobu
AU - Shinojima, Toshiaki
AU - Kikuchi, Eiji
AU - Miyajima, Akira
AU - Oya, Mototsugu
N1 - Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2016/12/1
Y1 - 2016/12/1
N2 - In men with castration-resistant prostate cancer, it might be beneficial to withdraw antiandrogens from patients who have favorable prognostic factors for a response to such withdrawal, notably receipt of hormone therapy for a long period. Antiandrogens should not be withdrawn in patients without favorable factors and in patients with a high prostate-specific antigen level at the time of cancer diagnosis. Background It remains uncertain whether those with response to antiandrogen withdrawal (AAW) have a better prognosis. We investigated the predictors of a better response to AAW and overall survival after acquiring resistance to first-line androgen deprivation therapy inpatients with castration-resistant prostate cancer (CRPC). Patients and Methods We retrospectively reviewed the medical records of 87 CRPC patients treated at Keio University Hospital. Sixty-seven of 87 CRPC patients underwent AAW. We analyzed clinicopathologic parameters to identify predictors of survival in CRPC patients and investigated predictors of good response to AAW. Results Younger age, longer duration of androgen deprivation therapy before CRPC development, and better response to AAW were independent favorable prognostic factors for overall survival. Although better response to AAW was a favorable prognostic factor in this study, trying AAW was not significantly related to overall survival. Duration of hormone therapy was significantly longer in those whose disease responded to AAW (69.9 ± 11.0 months) than those with no response (45.3 ± 5.2 months). Conclusion The prognostic benefit of AAW was not clearly determined in this study. However, AAW might be beneficial in patients who have favorable prognostic factors for a response to AAW—that is, those who have received hormone therapy for a long period. However, AAW should not be done in patients who do not have favorable factors and who had a high prostate-specific antigen level at the time of their prostate cancer diagnosis.
AB - In men with castration-resistant prostate cancer, it might be beneficial to withdraw antiandrogens from patients who have favorable prognostic factors for a response to such withdrawal, notably receipt of hormone therapy for a long period. Antiandrogens should not be withdrawn in patients without favorable factors and in patients with a high prostate-specific antigen level at the time of cancer diagnosis. Background It remains uncertain whether those with response to antiandrogen withdrawal (AAW) have a better prognosis. We investigated the predictors of a better response to AAW and overall survival after acquiring resistance to first-line androgen deprivation therapy inpatients with castration-resistant prostate cancer (CRPC). Patients and Methods We retrospectively reviewed the medical records of 87 CRPC patients treated at Keio University Hospital. Sixty-seven of 87 CRPC patients underwent AAW. We analyzed clinicopathologic parameters to identify predictors of survival in CRPC patients and investigated predictors of good response to AAW. Results Younger age, longer duration of androgen deprivation therapy before CRPC development, and better response to AAW were independent favorable prognostic factors for overall survival. Although better response to AAW was a favorable prognostic factor in this study, trying AAW was not significantly related to overall survival. Duration of hormone therapy was significantly longer in those whose disease responded to AAW (69.9 ± 11.0 months) than those with no response (45.3 ± 5.2 months). Conclusion The prognostic benefit of AAW was not clearly determined in this study. However, AAW might be beneficial in patients who have favorable prognostic factors for a response to AAW—that is, those who have received hormone therapy for a long period. However, AAW should not be done in patients who do not have favorable factors and who had a high prostate-specific antigen level at the time of their prostate cancer diagnosis.
KW - Androgen deprivation therapy
KW - Antiandrogen withdrawal syndrome
KW - Hormone therapy
KW - Nonsteroidal antiandrogens
KW - Prostate-specific antigen
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U2 - 10.1016/j.clgc.2016.02.014
DO - 10.1016/j.clgc.2016.02.014
M3 - Article
C2 - 27036975
AN - SCOPUS:84962278144
SN - 1558-7673
VL - 14
SP - e569-e573
JO - Clinical Genitourinary Cancer
JF - Clinical Genitourinary Cancer
IS - 6
ER -
